Swallowing without difficulty is necessary to easily and safely consume food, drink and medication.

Swallowing difficulties, medically known as dysphagia, are most apparent to an older person, their family and hospital staff when the person is eating, drinking or taking medication. Swallowing difficulties can have an acute onset during illness and may be short term in nature or they can be a symptom of severe illness and become more severe due to neurological diseases such as Parkinson’s disease or dementia.

Mild swallowing difficulties are common in older people, particularly in those over the age of 80. There are many strategies we can implement to optimise food and fluid intake to avoid the difficulties becoming more severe and avoid a series of cascading risks.

This topic provides an overview of swallowing difficulties. It recommends actions that we and our organisations can take, in addition to health service policy and procedures, to provide quality care to older patients with swallowing difficulties.

All Australian hospitals are being accredited under The Australian Commission on Safety and Quality in Healthcare’s (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards. Each of the ten standards relate to optimising clinical care and better outcomes for all patients. While identifying and responding to issues of swallowing are not directly referred to within the NSQHSS, implementing the evidence in this topic will assist us and our organisations to meet the requirements of the standards. It also highlights the need to approach the clinical issues that older people face in hospital in a holistic and person-centred way in order to identify and respond to multiple modifiable risk factors. This topic relates to improving our identification and response to people presenting with or developing a cognitive impairment (cognition clinical care standard), recognising and responding to clinical deterioration (standard 9) and promoting medication safety (standard 4).

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