Dysphagia Revisited: A Podcast with Raele Donetha Robison and Nicole Rogus-Pulia

Almost a decade ago, our hospice and palliative care team decided to do a "Thickened Liquid Challenge."  This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids.  The rules of the challenge were simple: fluids must be thickened to "honey consistency" using a beverage thickener for a 12-hour contiguous period.

All of us failed the challenge. We then decided to challenge others and asked them to post their videos online using the hashtag #thickenedliquidchallenge.  Here are some of the results of those videos: https://geripal.org/the-thickened-liquid-challenge/

On today's podcast, we revisit dysphagia and thickened liquids with two researchers and speech-language pathologists, Raele Donetha Robison and Nicole Rogus-Pulia.  We talk with them about the epidemiology, assessment, and management of dysphagia, including the role of modifying the consistency of food and liquids, feeding tubes, and the role of dysphagia rehabilitation like tongue and cough strengthening.  We also talk about the importance of a proactive approach to involving speech-language pathologists in the care of individuals early on with neurodegenerative diseases like dementia and ALS.

If you want to take a deeper dive, take a look at these articles:

• A nice overview of swallowing disorders in the older adults published in JAGS

• A study in JAGS showing that 89% of feeding tubes inserted during hospitalization were in patients with no preexisting dysphagia

• Nicole's article on shifting to a proactive approach of dysphagia management in neurodegenerative disease