Oropharyngeal dysphagia among patients newly discharged to nursing home care after an episode of hospital care

Abstract

Background

Oropharyngeal dysphagia (OPD) is a common but under-recognized problem among older residents in nursing homes. If not detected and properly managed, it is a risk factor for failure to thrive and aspiration pneumonia. Discharge to nursing home from hospital may provide an opportunity for detection and subsequent management.

Objective

To assess the extent of transfer of communication of swallow disorders in patients newly discharged to nursing homes from a university teaching hospital and catalogue recommendations suggested at discharge.

Setting

University teaching hospital

Method

Speech and language therapy (SLT) consultation notes of referrals from 100 consecutive patients discharged to nursing homes for the first time are reviewed for presence of a swallow disorder. The discharge documentation was then assessed to determine transfer recommendations for management of swallow disorders.

Results

Fifty-three patients had been referred to SLT for suspected OPD during hospitalization. At time of discharge, 35 (35%) continued to present with OPD and swallow recommendations were made as part of the management plan. An SLT report was transmitted to the nursing home in 80% of these cases.

Conclusions

OPD is present at discharge in over one-third of patients newly discharged to nursing home following a hospital admission, and this may be an under-estimate. This is significant in terms of planning of future care of management in nursing homes. It is important that the syndrome is duly noted in transfer documentation and that appropriate multi-disciplinary support arranged for residents in nursing homes with OPD.

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Authors

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Correspondence to Desmond O’Neill.

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The authors declare that they have no conflict of interest.

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Key points

• Aim: To investigate whether diagnosis of oropharyngeal dysphagia in nursing home residents newly admitted from hospital is appropriately communicated through assessment in the hospital.

• Findings: One-third of patients admitted to nursing home for the first time from hospital were affected by oropharyngeal dysphagia at the time of transfer. A speech and language therapy report was not transmitted to the nursing home in 20% of these cases.

• Message: Assessment prior to a new discharge to nursing home from hospital provides an important opportunity for diagnosis and treatment recommendations for nursing home residents with oropharyngeal dysphagia.

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Horgan, E., Lawson, S. & O’Neill, D. Oropharyngeal dysphagia among patients newly discharged to nursing home care after an episode of hospital care. Ir J Med Sci 189, 295–297 (2020). https://doi.org/10.1007/s11845-019-02061-0

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Keywords

  • Deglutition disorders
  • Nursing homes
  • Patient transfer