swallowing/communication and SALT assessment

[Maya]

My Mum is having trouble swallowing water without coughing and choking and the Speech and Lang Therapist (SALT) has said that she is at risk of aspirating. She even chokes on water fed to her with a spoon.

I was told by one nurse that they encourage the person to drink for as long as possible to keep the reflux instinct working - does anyone know if this is right. I think she is ready to use thickener myself.

Also she rarely speaks only saying yes, no and a few words here and there so asked for SALT input on that and I have been told by a nurse 'well there isnt much you can do beyond what you are already doing'. But I think that this should come from a SALT not nurse.

Does anyone else have experience of this and communication difficulty what is the criteria for communication assessment ?

Maya

 

[1948NHSBaby]

Salt

Hi Maya

Sorry that your post has not had any replies.

I had the same situation with my relative, we didn't know of the S.A.L.T. service then, the home did not involve these professionals at all in our case, just accepted the situation as part of the pathway within the dementia journey.

I believe that involving the SALT/Nutrition/Dietician is part of the national framework for older people 2001, required to be identified as part of the CQC checks & their core standards, and a standard part of THE NH/Res home care plan within the Nutrition/Diet/Food & Drink , where all risk factors and all 'needs' must be identified and a specific 'management plan for each identified 'need'' mentioned in the overall care plan, with updates, actions taken, risks, notes, times for review, etc.

Has this happened yet with your mother?

I understand you have obtained fully funded continuing health care or is it just the funded nursing care portion?

When completing the assessment process together in a multi disciplinary team environment, the new framework dst domains, this element should be a prominent part of the Nutrition Domain.

Was your observation that a SALT professional assessment should be undertaken actioned?

 

[JPG1]

Hello Maya

Here’s a link for you about Dysphagia, and it takes you through the symptoms – causes – diagnosis – treatment – complications. Bear in mind that there may be no cure, there may be no solution, but there should definitely be help available from the SALT.

http://www.nhs.uk/Conditions/Dysphagia/Pages/definition.aspx

If the SALT has said that your Mum is at risk of aspirating, then I think you should ask to speak with the SALT – I agree with you that it should come from the SALT her/himself. It may be a case of adjusting your Mum's position while trying to get her to take fluids.

One word of caution (from personal experience of nursing staff in a nursing home): if ever a ‘nurse’ suggests using a syringe to introduce fluids, then question that one immediately. It has been known to contribute to – and cause - aspiration pneumonia. With fatal consequences. And it is not a recommended method of introducing fluids.

The criteria for assessment? It’s a requirement if someone has difficulty swallowing.

Don’t give up – where there’s a will, there’s a way.

.

 

[Bookworm]

You are getting conflicting info from SALT & nurse - I'm sure the nurse is well meaning and maybe very experienced - but the SALT is the one to listen to here - check with GP - who will order changes such as thickener - certainly going for nil by mouth & Peg tube is an option no-one should take lightly - but maybe she will have a phase with both - keeping the mouth moist is a very kind thing and a little by mouth is the easiest way - but it sounds as if she has got beyond being able to take enough fluids by mouth & a chest infection is the last thing you need.