Severe Dysphagia Management

What is Dysphagia?

Dysphagia includes:

• Difficulty swallowing
• Difficulty biting or chewing on food,
• Coughing or choking on food or fluid, and
• Food or drink falling from a person’s mouth.

Note: While dysphagia sounds similar to dysphasia, these two terms refer to separate conditions. While dysphagia is difficulty with swallowing, dysphasia (also known as aphasia) is difficulty with speaking. Even though these are two different conditions, they both commonly affect people who have had a neurological event such as a stroke and are both treated by speech pathologists.

Symptoms and diagnosis

Dysphagia is difficulty swallowing. This can include having problems with:

• Inability to swallow
• Pain when swallowing
• Food feeling stuck in the throat, inducing coughing
• Food going down the wrong way
• Drooling
• Hoarseness of the voice
• Coughing or gagging when swallowing
• Frequent throat clearing during or after eating and drinking
• Shortness of breath when eating and drinking
• Taking a long time to finish meals (more than 30 minutes)
• Frequent chest infections with no known cause.

Dysphagia is not necessarily part of the normal ageing process. However, it is not uncommon for older adults to experience presbyphagia - age-related changes to the swallowing mechanism. While presbyphagia can be a predisposing factor to dysphagia, an older adult’s swallow is not inherently an issue. Instead, dysphagia is most commonly associated with underlying conditions that have a greater prevalence in older populations and interrupt the swallowing process, such as:

• Stroke (about 50% of stroke survivors)
• Dementia (about 84% of people living with dementia)
• Head injury
• Alzheimer’s disease
• Neurodegenerative conditions such as Parkinson’s disease motor neuron disease (MND) and multiple sclerosis
• Cerebral palsy
• Head and neck cancers requiring radiotherapy or surgical treatment
• Reflux
• Age-related changes
• Frailty.

If you are experiencing any issues as mentioned above, seek advice from your doctor. Treatments and supports are available. Depending on your symptoms, your doctor might refer you to a specialist, or for further tests. 

Management and supports available for bowel care

A participant with dysphagia and severe dysphagia must have a Mealtime Management plan written by a health professional. Severe dysphagia meal management plan assessment and review requires both consent and involvement from the participant. A speech pathologist can prescribe and recommend specific actions to eat and drink safely, develop a mealtime management plan for their needs, and specify a plan review timeframe. A dietitian may contribute to the mealtime management plan by ensuring enough nutrition and hydration in the recommended modified meals.

Mealtime plans are promptly reviewed if there are any changes or observed difficulties or at least annually.

With your consent, your doctor may wish to give a copy of your management plan to those who may help you manage the dysphagia issues, such as family or support workers.

Your doctor and carers may need to discuss your management plan so that everyone understands what is needed. 

Severe Dysphagia Management and the NDIS

If you have a permanent and significant disability, you might be able to access the National Disability Insurance Scheme (NDIS).

The NDIS funds many disability-related health supports that can help you put your Servere Dysphagia Management plan in place. These include assitive technology, occupational therapy, speech therapy and the training and ongoing assistance of a support worker. 

Find out who to contact about the NDIS where you live for more information about accessing the Scheme.

If you’re already an NDIS participant and want to know how to access severe dysphagia supports, talk to us. We are an NDIS registered provider and our knowledgeable staff are experienced in navigating the NDIS and can ensure you make the most of your plan.

You should be involved in the assessment and development of your Mealtime Management plan, including how any risks and emergencies will be managed. Anyone providing support related to severe dysphagia should be suitably skilled and trained.

How Caremantra can support you

At Caremantra, we will manage your severe dysphagia care needs with dignity and empathy, working with you and your treating health professionals to provide quality, professional care. We provide in-home care and services  to help you maintain your wellbeing and independence.

Our trained and qualified staff will work alongside you to:

• understand your specific dysphagia and any related conditions,
• monitor your dysphagia conditions and any changes that need to be reported to your speech pathologist as agreed in your mealtime management plan,
• administer medication and treatments prescribed by your speech pathologist,
• ensure your oral hygiene and follow all other hygiene control protocols,
• put in place your nutrition and hydration requirements,
• provide support and services safely and competently, and 
• respect your privacy and dignity at all times.

We partner with specialist healthcare organisations to connect you with the allied health services that are crucial to your long-term wellbeing, such as speech pathology, dietetics, physiotherapy, occupational therapy and podiatry supports.

Fill out our Enquiry Form and we will contact you to talk about the right support options.