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[Dysphagia] Jello question

Hi Lucy - I work in a similar facility.? Yes, jello is an excellent option, as 
well as popsickles, slushes (if they use a switch they can use there switch to 
help make the slush to possibly add intrest), flavored water, etc.? One of the 
most successful strategies is to ensure staff offer a small drink every hour (or 
20 munutes etc).? If handed the cup between meal times with one ounce in it then 
they may be more likely to drink.? Also, some individulas do like to have fluids 
thickened so they can spoon it and sometimes that is the best you can do - but I 
would still try to offer small amounts of thin liquid in between these times and 
more frequently.? Especially since these are the individuals that will tend to 
have high impactions, chronic constipation and other related issues.? If they 
have ID and dementia, promote motor cueing to encourage the motoric function 
(general the last to go?- motor memory pattern).? In other words if they can 
hold the cup independently, put a small amount in the cup and place it in their 
hand.? If they don't drink, give a light physical cue by slightly touching the 
hand in an upward motion - the individuals with dementia will generally continue 
the movement and drink.? I would ask staff to document each time and keep good 
documentation on your food/fluid tracking sheet.? This should be checked each 
shift to see if they are getting enough fluids.? If they were way short on the 
first shift, the second shift should encourage more frequently.? It will take 
everyone working together but it can be done.? 

Debbie Jones-Ellison, MS, CCC-SLP
Physical Nutrional Management Team

From: "Balch, Lucy (DBHDS)" <Lucy.Balch at dbhds.virginia.gov>
To: dysphagia at dysphagia.com
Sent: Tue, June 28, 2011 12:57:16 PM
Subject: [Dysphagia] Jello question

I work at a state facility for ID adults. Some of them refuse to drink
much of anything and have correspondingly poor lab values (high BUNs,
etc). One of our doctors recently started ordering Jello, to be given
when liquids are refused. Has anyone ever heard of this strategy? If so,
does anyone know of any research to back it up? Does anyone have any
ideas about keeping someone hydrated who refuses to drink?
(Hypodermoclysis is not an option at this facility). 
For one particular individual, liquids have been thickened since she
prefers the thick liquid over the thin.? Are there any other strategies
that could make an ID person accept thin liquid better? Flavoring the
water is another option we use here, but it doesn't always help.
Any input would be greatly appreciated.
Lucy Balch, CCC/SLP
Southside Virginia Training Center
Petersburg, Virginia

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