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Program Profile:
Dysphagia (Swallowing Disorders) Rehabilitation
The condition known as dysphagia can be caused by various things, including Stroke, Parkinson’s Disease, Multiple Sclerosis, ALS, Head or Spinal Trauma, Alzheimer’s Disease, Oral Cancer and Reflux Disorders. A normal swallow involves 25 different muscles and 5 different nerves, and occurs in 3 different phases: oral, pharyngeal and esophageal. Dysphagia can occur at any one or several different stages, thus affecting one’s ability to manage or swallow food, tolerate different food consistencies or the ability to manage and swallow liquids. Recognizing the growing importance of helping people with this condition, VNSW provides comprehensive program to dysphagia patients, a multi-disciplinary approach.
 David Jagoda instructing a patient on use of liquid thickener |
Heading up this effort is David Jagoda, MA, CCC-SLP, VNSW’s Director of Rehabilitation Services, who acts as a coordinator to enhance the knowledge and performance of the people involved in the patient’s environment. “This involves givng guidance to the VNSW team providing related services,” explains David, “plus the education of family, home heath aides, and other caregivers. We make every effort to ensure that they are instructed in proper positioning and diet modification for the patient, so that the care and wellness of the patient is carried out cohesively by the different people in a patient’s environment.”
The program also reaches out into the community, so, that, according to David, “if there’s a need for an Ear/Nose/Throat referral, we make sure that the patient is being seen, that the proper tests are given, and that the patient is placed on a proper diet. These diets involve different food and liquid consistencies. If a person is having difficulty managing solid foods, or regular liquid such as water or juice, they may be given a modified barium swallow test or a FEES (Fiberoptic Endoscopic Evaluation Of Swallowing), to determine their safety by objective means. Based on the outcome, a thickener for liquids or a different type of food might be given to the patient so that they are not at risk, and not having difficulty managing their eating and drinking.”
Often there are speech problems associated with swallowing difficulty – a slurry, imprecise quality to the patient’s speech – and VNSW recently expanded the program to include speech pathology rehabilitation services. This involves helping patients to coordinate their speech and swallowing, to do breathing exercises, and generally increase their endurance.
“Bottom line,” says David, “the global mission of the program is to pursue the rehabilitative goal to ensure the most independent possible functional level. The ultimate goal is safety for patients, and their ability enjoy a productive meal with their families.”
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