Impact of Abnormal Swallowing Patterns in the Elderly

Faculty

Needs Statement

A Bedside Swallow Evaluation (BSE) has definite limitations and aspiration cannot be confirmed or ruled out without Modified Barium Swallow Study (MBSS) (Swigert,1998). Approximately 40% of the patients who aspirate regularly during an MBSS were not identified as aspirating when examined at bedside because they did not cough or show outwards signs of aspiration (Logemann,1983). The MBSS can diagnose oral control of the bolus, pharyngeal and esophageal stage of dysphagia and presence of aspiration, as well as determine appropriate diet and liquids consistencies, swallowing precautions/strategies, and appropriate treatment techniques to reduce aspiration risk.  One must know when and why penetration/aspiration occurred to treat dysphagia effectively. A Modified Barium Swallow Study allows the swallow to be viewed in real time and all phases of the swallow be evaluated on various consistencies.  The Modified Barium Swallow Study is considered the Gold Standard in evaluating dysphagia in literature and it provides a visual to what you cannot see at a clinical bedside.

 

Swigert, N, The Source of Dysphagia The Source for Dysphagia: Copyright © 1996, 2000, 2007 LinguiSystems, Inc. 
Logemann, J. A., & Logemann, J. A. (1983). Evaluation and treatment of swallowing disorders. Pro-Ed
Dysphagia Diagnosis and Management Third Edition, Michael E Groher,and Olle Ekberg , Radiologic Evaluation of Swallowing 191-222

Target Audience

This activity was planned to address the educational needs of physicians, physician assistants, nurse practitioners,  nurses, speech therapists and physical therapists.

Objectives

• Conclude the limitations of a bedside swallow evaluation
• Recognize and summarize dysphagia indicators in the elderly
• Identify disorders on an MBSS that would be undetectable during a bedside swallow evaluation

Accreditation

CNE

UNT Health Science Center is approved by the California Board of Registered Nursing, Provider # 16274. This activity is approved for 1.20 Contact Hours.

UNTHSC
The University of North Texas Health Science Center certifies this activity for 1.00 hour of participation.

Physicians

The University of North Texas Health Science Center is accredited by the American Osteopathic Association to award continuing medical education to physicians.

The University of North Texas Health Science Center has requested that the AOA Council on Continuing Medical Education approve this program for 1.00 hour of AOA Category 1B CME credits. Approval is currently pending.

The University of North Texas Health Science Center is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of North Texas Health Science Center designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The University of North Texas Health Science Center presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

ACGME Competencies

• Medical knowledge

IOM Competencies

• Work in interdisciplinary teams
• Employ evidence-based practice

PT

UNT Health Science Center is accredited by Texas Physical Therapy Association, Provider 1810035TX. This activity is approved for 1.00 CCU for PTs and PTAs.

For successful completion, a participant must attend the program, complete the evaluation, and request credit online at conclusion of the activity.

The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE.

IACET
The University of North Texas Health Science Center is accredited by the International Association for Continuing Education and Training (IACET) to apply 1.00 contact hour (0.1 CEUs) to participants.

Faculty Disclosure

Ms. Ragland and Ms. Polansky have disclosed they are part-owners of Diagnotex, LLC. Dr. Lowry has nothing to disclose. The UNT Health Science Center Professional and Continuing Education staff have nothing to disclose.

Acknowledgment

Data collected as part of this activity may be analyzed as part of educational research to study the effectiveness of interventions. This project is included under UNTHSC IRB protocol #2017-056.