What happens when you swallow?
Swallowing is an act usually unconscious, although it requires precision and rapidity in its development.
Swallowing occurs in 3 phases:

  • oral stage,
  • pharyngeal phase,
  • esophageal phase.

Oral Phase:
Properly: Formation of food bolus by chewing. The tongue and palate push the bolus towards the back of the mouth.

difficulty-in-swallowing

Pharyngeal phase:
Properly: swallowing reflex, lowering the epiglottis, pharynx closure, the passage of bolus into esophagus.
Incorrectly: Reflex swallowing delayed or absent, risk of aspiration, airway closure is not assured.
Esophageal phase:
Properly: Phase entirely reflex, it is a final phase of swallowing.
Incorrectly: The food particles that have not been evacuated during swallowing can be inhaled during inspiration.
Swallowing disorder = wrong
Responsible for complications:

  • broncho-pulmonary complications,
  • Undernutrition progressive
  • asphyxiation in cases of obstruction.



Epidemiology:
ΒΌ Meadows residents of a unit of long-term care suffer from these disorders to varying degrees,
Their frequency is related pathologies:
cerebro-vascular
dementia.
Abnormal swallowing several times:
Time to oral feeding (food reflex) of the available therapeutic
difficulty chewing (edentulous, denture inappropriate, fungus, irritation, …)
retention intraoral food (decreased salivation). Saliva lubricates the food bolus.
Pharyngeal Time: ALERT! (Involuntary reflex =)
swallowing cough = => frequent bronchitis, asthma postprandial.
Aggravating
The polypharmacy increases the oral dryness,
As a result the elderly often choose home less food or liquid:
nutrient imbalance,
gradual weakening.
Preventing False roads:
Ensure good oral,
Adapting hydration and nutrition by disorder,
Installing the correct person
Managing the meal
Negotiate with the medical treatment.


Project Team:
Ensure good oral:

  • fight against dry mouth,
  • hygiene and dental prostheses,
  • detect and report any glossitis or gingivitis
  • monitor tooth.

Adapter hydration and feeding disorders in the elderly:

  • seek a dietician,
  • train health care providers to report to the physician any coughing during the ingestion of solid or liquid
  • adapting the feeding method: Move to cut the solid end to semi-liquid and knowledge to make the opposite
  • promote smooth textures,
    homogeneous, pasty,
  • avoid substances that crumble,
  • replace fluids by drinking water or gelled.

Properly install the elderly:

  • put the patient in sitting or reclining,
  • keep your head up, torso leaning slightly forward,
  • sit in front of the person in power,
  • if total aid, take the time needed.

Manage the meal:

  • can serve as a meal in the dining room, which allows stimulation of behavior and better monitoring,
  • serve a dish after another
  • add the sauce to dry food
  • revive gestures
  • stimulate chewing and swallowing,
  • do u drink and eat in small quantities,
  • stimulate swallowing by placing the food in the middle of the tongue,
  • observe and analyze the behavior for readjustment.

Negotiate with the medical form and administration of medicines:
refer to specific courses.
Support often in emergency:

  • Dental Implants withdrawn
  • oral cavity disengaged with fingers hooked,
  • Suction airway if swallowed important.

Results of actions:

  • obstructive material are expelled,
  • The skin is recolorent,
  • The agitation is reduced.

In case of failure: practice the Heimlich maneuver as many times as necessary.
If failure of the maneuver:

  • cerebral oxygenation,
  • anguage maintained by a Guedel airway, the patient is placed supine lateral.
  • other functions are monitored:
    • heart rate,
    • blood pressure,
    • consciousness.

Support for indirect effects:

  • The occurrence of broncho-pneumonia acute or recurrent,
  • The gradual onset of malnutrition …