TY - JOUR
T1 - Texture-Modified Diet for Improving the Management of Oropharyngeal Dysphagia in Nursing Home Residents
T2 - An Expert Review
AU - Ballesteros-Pomar, María D.
AU - Cherubini, A.
AU - Keller, H.
AU - Lam, P.
AU - Rolland, Y.
AU - Simmons, S. F.
N1 - Funding Information:
The study was funded by Nestlé Health Science. The authors acknowledge Ananya Das, of imc, for medical writing support.
Funding Information:
Dr. Simmons reports personal fees from Nestlé Health Science, during the conduct of the study. Dr. Ballesteros-Pomar reports personal fees from Nestlé Health Science, during the conduct of the study. Dr. Cherubini reports personal fees from Nestlé Health Science, during the conduct of the study. Dr. Keller reports other from Nestlé Health Science during the conduct of the study; grants and other from Abbott Nutrition, outside the submitted work. Dr. Rolland reports grants from Biophytis, Novartis, outside the submitted work. Mr. Lam reports other from Nestlé Health Science, during the conduct of the study; other from International Dysphagia Diet Standardization Initiative, personal fees from Nestlé Health Science, outside the submitted work; and Co-chair of the International Dysphagia Diet Standardization Initiative.
Publisher Copyright:
© 2020, The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Objectives: This paper provides evidence-based and, when appropriate, expert reviewed recommendations for long-stay residents who are prescribed texture-modified diets (TMDs), with the consideration that these residents are at high risk of worsening oropharyngeal dysphagia (OD), malnutrition, dehydration, aspiration pneumonia, and OD-associated mortality, poorer quality of life and high costs. Design: Nestlé Health Science funded an initial virtual meeting attended by all authors, in which the unmet needs and subsequent recommendations for OD management were discussed. The opinions, results, and recommendations detailed in this paper are those of the authors, and are independent of funding sources. Setting: OD is common in nursing home (NH) residents, and is defined as the inability to initiate and perform safe swallowing. The long-stay NH resident population has specific characteristics marked by a shorter life expectancy relative to community-dwelling older adults, high prevalence of multimorbidity with a high rate of complications, dementia, frailty, disability, and often polypharmacy. As a result, OD is associated with malnutrition, dehydration, aspiration pneumonia, functional decline, and death. Complications of OD can potentially be prevented with the use of TMDs. Results: This report presents expert opinion and evidence-informed recommendations for best practice on the nutritional management of OD. It aims to highlight the practice gaps between the evidence-based management of OD and real-world patterns, including inadequate dietary provision and insufficient staff training. In addition, the unmet need for OD screening and improvements in therapeutic diets are explored and discussed. Conclusion: There is currently limited empirical evidence to guide practice in OD management. Given the complex and heterogeneous population of long-stay NH residents, some ‘best practice’ approaches and interventions require extensive efficacy testing before further changes in policy can be implemented.
AB - Objectives: This paper provides evidence-based and, when appropriate, expert reviewed recommendations for long-stay residents who are prescribed texture-modified diets (TMDs), with the consideration that these residents are at high risk of worsening oropharyngeal dysphagia (OD), malnutrition, dehydration, aspiration pneumonia, and OD-associated mortality, poorer quality of life and high costs. Design: Nestlé Health Science funded an initial virtual meeting attended by all authors, in which the unmet needs and subsequent recommendations for OD management were discussed. The opinions, results, and recommendations detailed in this paper are those of the authors, and are independent of funding sources. Setting: OD is common in nursing home (NH) residents, and is defined as the inability to initiate and perform safe swallowing. The long-stay NH resident population has specific characteristics marked by a shorter life expectancy relative to community-dwelling older adults, high prevalence of multimorbidity with a high rate of complications, dementia, frailty, disability, and often polypharmacy. As a result, OD is associated with malnutrition, dehydration, aspiration pneumonia, functional decline, and death. Complications of OD can potentially be prevented with the use of TMDs. Results: This report presents expert opinion and evidence-informed recommendations for best practice on the nutritional management of OD. It aims to highlight the practice gaps between the evidence-based management of OD and real-world patterns, including inadequate dietary provision and insufficient staff training. In addition, the unmet need for OD screening and improvements in therapeutic diets are explored and discussed. Conclusion: There is currently limited empirical evidence to guide practice in OD management. Given the complex and heterogeneous population of long-stay NH residents, some ‘best practice’ approaches and interventions require extensive efficacy testing before further changes in policy can be implemented.
KW - Dysphagia
KW - malnutrition
KW - nursing home
KW - texture-modified diet
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U2 - 10.1007/s12603-020-1377-5
DO - 10.1007/s12603-020-1377-5
M3 - Article
C2 - 32510109
AN - SCOPUS:85085152748
VL - 24
SP - 576
EP - 581
JO - Journal of Nutrition, Health and Aging
JF - Journal of Nutrition, Health and Aging
SN - 1279-7707
IS - 6
ER -