Numerous disorders predispose the nursing home resident to aspiration and aspiration pneumonia. In addition to aging itself, many nursing home patients suffer from mental retardation, dementia, and neurologic impairments. Tracheotomized individuals, as well as those receiving enteral tube feedings, are at greater risk for aspiration and its respiratory sequelae.
This article focuses on the conditions that predispose nursing home residents to aspiration, the respiratory and psychosocial consequences of aspiration, and the evaluation of dysphagia and aspiration. It concludes with a discussion of the therapy and prevention of chronic and recurrent
Aspiration is defined as the displacement of oropharyngeal contents below the true vocal cords and into the larynx. Aspiration and aspiration pneumonia are frequently encountered in nursing home residents. Swallowing abnormalities are present in an estimated 30% to 40% of patients living in nursing homes.
Topics covered (click on above URL):
Physiology of Swallowing
Conditions Predisposing to Aspiration
Dementia and Mental Retardation
Tracheostomy and Tube Feedings
Medication-Induced Dysphagia (list types of medication which can
Evaluation of Dysphagia
Evaluation of Aspiration
Conclusion (part of it)
Chronic aspiration, in turn, may lead to a number of respiratory and psychosocial sequelae, such as airway obstruction, chemical pneumonitis, infectious pneumonia, sitophobia, social withdrawal, dependency, and malnutrition. When treating patients with chronic aspiration difficulties, the physician must address the individual's nutritional status, cognitive skills,
behavior patterns, immunocompetence, and his or her preferences.
Numerous therapeutic options are available to the clinician caring for patients with recurrent aspiration. In addition to diet selection, swallowing rehabilitation may benefit persons with disabling dysphagia.
Enteral feedings and surgery may be necessary in patients who continue to aspirate despite optimal medical management.