Question
Please discuss/review how to measure ''success'' with dysphagia patients post-treatment.
Answer
Success is in the eye of the beholder! Dysphagia therapy begins with a medical ''complaint'' from the patient, their subjective statement of the problems they are experiencing with the swallowing process. It is our responsibility to assist the patient's physician in diagnosis and treatment of the disorder.
Bedside exams, radiographic assessments and FEES are evaluation tools designed to identify the etiology of dysphagia, used in conjunction with a physical examination by the patient's physician. Once the etiology is determined, a plan of treatment is designed to address the components of the swallow process found to be affected by the disorder and to alleviate the symptoms reported by the patient.
How do we know when we have achieved success? Probably when the patient is able to state that they no longer experience the symptoms initially reported as their ''problem.'' Success can be measured in terms of amounts and/or types of foods that may be consumed, decreased risk of aspiration, shorter length of time needed to consume a meal, ability to eat in a public place without assistance or embarrassment, and other objective measures. True success lies in FUNCTIONAL improvement and the patient's subjective feeling of accomplishment. Our goal as SLPs is to improve not just muscle strength, coordination, timeliness of swallow initiation and other formal measures, but to improve the patient's ability to function in an everyday environment with minimal adaptation and effort and decreased risk of medical complications related to dysphagia. Kathy Thayer received her Master of Arts in Health Services Management from Webster University and a Certificate in Gerontology and a Master of Arts in Communication Disorders from Saint Louis University. Kathy has worked for several years as a Speech-Language Pathologist and is currently employed by Rehab Works in Sparks, Maryland.
Kathy Thayer, M.A.
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