Updated Care Plan for Dysphagia

Updated Care Plan for Dysphagia

Category / Primary Body System:

Digestive System / Swallowing Function

Problem:

The patient is at risk of complications due to dysphagia.

Goal:

The patient will not have episodes of aspiration or choking for 30 days.

Plan/Approach:

1. Speech Therapy Evaluation and Treatment:

   • Step: Arrange for speech therapy evaluation and treatment as needed.
   • Rationale: Speech therapists can provide specialized assessment and interventions to improve swallowing function and safety.
   • Actions: Schedule an initial evaluation with a speech therapist and follow up with recommended therapy sessions. Document the patient’s progress and any adjustments to the treatment plan.

2. Encourage Participation in Speech Therapy:

   • Step: Encourage the patient to actively participate in speech therapy.
   • Rationale: Active participation in therapy can improve outcomes and enhance the patient’s swallowing abilities.
   • Actions: Motivate the patient to engage in therapy sessions, provide positive reinforcement, and address any concerns or barriers to participation.

3. Patient and Family Education:

   • Step: Educate the patient and family regarding dysphagia and safety measures.
   • Rationale: Education ensures that the patient and family understand the condition, recognize signs of aspiration, and implement safety precautions.
   • Actions: Provide educational materials and one-on-one teaching sessions covering the nature of dysphagia, safe eating practices, and the importance of following dietary modifications. Encourage questions and provide clear, supportive answers.

4. Supervised/Assisted Meals:

   • Step: Supervise and/or assist the patient during meals.
   • Rationale: Supervision helps prevent aspiration and choking by ensuring the patient follows safe swallowing techniques.
   • Actions: Be present during meals to observe the patient’s eating habits, provide assistance as needed, and ensure adherence to recommended techniques and dietary modifications.

5. Proper Positioning During Meals:

   • Step: Ensure the patient is out of bed or the head of the bed is elevated for all meals.
   • Rationale: Proper positioning reduces the risk of aspiration and facilitates safer swallowing.
   • Actions: Assist the patient in sitting upright at a table or elevate the head of the bed to at least 45 degrees during meals. Maintain this position for at least 30 minutes post-meal.

6. Mechanically Altered Diet:

   • Step: Provide a mechanically altered diet as appropriate.
   • Rationale: Modifying the texture of foods can make swallowing safer and easier for patients with dysphagia.
   • Actions: Work with a dietitian to determine the appropriate diet texture (e.g., pureed, minced, or soft foods). Ensure all meals and snacks meet these dietary specifications and monitor the patient’s tolerance and response.