EBS - SLP Opportunities - January 2019

The Aging Swallow

The Aging Swallow
Angela Mansolillo, MA, CCC-SLP, BCS-S
March 18, 2016

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oday we are going to talk about the aging swallow.  I thought I would start out with a quote by George Carlin: “Death is caused by swallowing small amounts of saliva over a long period of time." I think that quote sets the tone for today, because the overriding theme of today's discussion is going to be about differentiating between what is normal aging and what is truly a disorder.

Here are the specific learning objectives for today. We are going to describe how to distinguish normal aging from a truly disordered dysphagic swallow. We are going to define three strategies to improve nutrition and hydration in our elderly clients.  We are going to describe how to identify those clients who could potentially benefit from some of our interventions, particularly from exercise to improve endurance for feeding and swallowing.  As we will see, for some of our clients, eating really is an endurance activity.

As speech pathologists working in this field of dysphagia, we have a lot of challenges around staying up to date. We are bombarded with information. There is a lot of information about normal swallowing and disordered swallowing and treatment strategies. Unfortunately, a lot of it conflicts with a lot of other information. We are getting information from a wide variety of sources, including our fellow clinicians, and it can be really difficult sometimes to sort out what information is truly evidence-based, what information is anecdotal, and what is just speech pathology urban legend.

Practice Patterns of SLPs

A case review–type study was conducted in 2013 (Carneby & Harenberg). It was an internet survey in which SLPs were given a case with a lot of specific information and then were asked, “What would you do if this were your client?”

The results indicated that there were as many as 47 different interventions that were recommended.  The problematic part was that only a very small percentage of people reported that they were choosing their recommendations based specifically on the physiological abnormalities. We are often in a situation where we are just throwing the kitchen sink at people and putting all kinds of interventions into place, including dietary interventions, compensatory strategies, maybe some sensory interventions and exercises. We are just throwing the kitchen sink at people without really trying to match specific dysphagia symptoms to the specific interventions.

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angela mansolillo

Angela Mansolillo, MA, CCC-SLP, BCS-S

Angela Mansolillo, MA/CCC-SLP,BCS-S is a Speech-Language Pathologist and Board Certified Specialist in Swallowing Disorders with over 25 years of experience. She is currently a senior Speech-Language Pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts where she provides evaluation and treatment services for adults and children with dysphagia and is involved in program planning and development for inpatient and outpatient programming including quality improvement initiatives, patient education, and clinical policies and protocols.  In addition, she is an adjunct faculty member at Elms College Department of Communication Sciences and Disorders in Chicopee, Massachusetts.  Over the course of her career, she has worked in a variety of clinical settings, provided numerous regional and national presentations, and lectured at several colleges and universities throughout Massachusetts. 

Ms. Mansolillo received her Bachelor of Arts degree in communication from Rhode Island College in 1983 and earned her Master of Arts in Speech-Language Pathology in 1985 from the University of Connecticut. She is a member of the American Speech-Language-Hearing association and is a member of Special Interest Division 13, which focuses on swallowing and swallowing disorders.



Related Courses

The Aging Swallow
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video
Course: #74781.5 Hour
The aging swallow has specific characteristics that are distinct from and should not be confused with dysphagia. This course will describe changes in swallowing and supporting systems in the elderly and discuss potential interventions to improve nutrition and hydration, endurance, and oral health in an aging population. This course is open captioned.

Pharmacology and Swallowing
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video
Course: #84641.5 Hour
Speech Language Pathologists are often asked to make recommendations for safe swallowing of medications for patients with dysphagia, but have limited information about pharmacodynamics. This course will provide clinicians with the information they need to understand and manage swallowing-related medication effects, identify potential impacts of food and thickener on medication effectiveness, and prevent medication errors in their clients with dysphagia.

Aspiration Pneumonia: It's Not Just Aspiration
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video
Course: #85781.5 Hour
Do dysphagia and aspiration inevitably lead to aspiration pneumonia? Our current evidence base suggests that the answer is, in fact, no. This course will enable clinicians to identify the clients on their caseload who are at higher risk for illness and to identify and address those risk factors that can be modified to reduce the likelihood of aspiration-related illness.

Gut Instinct: Making the Connection between the Intestines and the Brain
Presented by Natalie Allen, MEd, RD, LD
Video
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New research shows promising connections between the gut and brain, spanning all ages from newborns to the elderly. This course will focus on understanding the research on the gut/brain connection, identifying foods that can improve gut health, learning how to identify allergens in common foods, and modifying food textures to help with swallowing issues.

Reflux: The Impact on Our Patients and Evidence Based Treatments; Part 1
Presented by Denise Dougherty, MA, SLP
Video
Course: #74711 Hour
This is Part 1 of a two-part series that will provide an overview of reflux and its impact on our patients. Part 1 will focus on particular disorders that contribute to reflux, and the various treatment options that are available. This course is open captioned. (Part 2 - Course #7532)