January 8, 2019

A big win for NDIS participants & how Speech Pathology is helping

NDIS recently accepted responsibility for the funding of mealtime management and swallowing assessments for participants (except when they are in hospital). This is great news for all NDIS participants and their families, the support workers who assist people in the community with swallowing problems and the many people with swallowing disorders who have recently had their access to Speech Pathology for swallowing management cut by the NDIS. Speech pathologists fought long and hard to make this a reality and should be celebrated for helping save lives. Read the Minister’s press release here (https://ministers.dss.gov.au/media-releases/4246).

Humans swallow at least 900 times a day. We swallow food, liquids, medications and saliva. All told, we swallow approximately 20, 000 litres of saliva over our lifetime. People who have trouble swallowing are at risk of poor nutrition, dehydration, lower quality of life and death.

For some people mealtimes can be daunting. Their risk of food going down the wrong way into their lungs (aspiration) or getting stuck in their mouth or their throat (obstruction) means mealtimes can be a life and death situation.

What does a speech pathologist do to help with swallowing?

Speech pathologists are trained to assess the neurological, physiological and structural function of the oral and pharyngeal (back of the throat) area. They ascertain problems with strength and co-ordination of the movements for swallowing (e.g. mouth, lips, tongue, jaw, palate) and establish whether the reflex protection mechanisms are working (e.g. laryngeal elevation, cough).

A speech pathologist will assess the risks and provide recommendations to reduce the risk of food, liquids, medication and saliva going down into the lungs (aspiration) or getting stuck (obstruction in the mouth or throat) in order to improve an individual’s health and wellbeing through adequate nutrition. Some strategies include body or head positioning, swallowing techniques or diet modification e.g. thickened fluids, puree. This can be achieved with Mealtime Management Plans that guide carers through mealtimes, including food consistency (e.g. thickening of foods), supervision and assistance required, cups and utensils and monitoring choking risks, feeding tubes and mouth hygiene.

Speech Pathologists also provide education and training to people who have trouble swallowing (dysphagia) food and drink safely, as well as their support workers and families. In-services and education sessions can be organised to cover the following topic areas e.g. swallowing mechanisms, swallowing difficulties and risks, correct diet consistencies, emergency processes, when to refer to speech pathology and understanding Mealtime Management Plans.

How can you help identify someone is at risk of swallowing problems (dysphagia) ? 

Awareness about dysphagia and identifying an individual’s risk is an important part of the care of a people with a disability. Some examples of populations where dysphagia is likely to be present: 

What signs may result in you considering whether a speech pathologist is required?

  • Weaknesses in the face i.e. drooping lips
  • Saliva running out of the mouth (i.e. not being swallowed)
  • A ‘gurgly’ voice quality (including changes in voice quality)
  • Coughing and choking at mealtimes
  • Food collecting in the side or roof of the mouth
  • Spitting food out of the mouth
  • A long delay between food being placed in the mouth and swallowing
  • Regurgitation of food/liquid through mouth or nose
  • Deterioration of speech clarity

What questions can you ask to help identify whether a speech pathologist is required?

  • “Do you have any difficulties with eating or drinking? “
  • “Do you ever cough, choke, or feel food is stuck when eating/drinking/ taking tablets?”
  • “Have you had recurrent chest infections/ aspiration pneumonia?”
  • “Do you have a Mealtime Management Plan in place? When was it last updated?”(Mealtime Management Plans should be reviewed yearly)
  • “Do you/ participant have difficulty communicating your wants/needs/opinions?

If ‘Yes’ to ANY these questions – our speech pathologists experienced in assisting in swallowing and/ or communication disorders are available for consultation.

Our team of speech pathologists help our clients improve communication by treating issues related to language, speech, articulation, fluency, stuttering and voice. Helping with social skills, our speech pathologists can also assist individuals to communicate their wants, needs and opinions effectively every day. These issues could stem from developmental delays, stroke, brain injuries, learning disability, intellectual disability, cerebral palsy, dementia or hearing loss. 

Potential outcomes of working with a Speech Pathologist can include:

  • Developing and implementing a mealtime management plan 
  • Improving the ability to swallow, eat and drink safely 
  • Improving and building communication skills 
  • Improving social skills using communication and an understanding of socially appropriate behaviours 
  • Improving the ability to communicate using alternative communication strategies and devices 
  • Enhancing literacy and understanding, e.g. with reading and spelling

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Recovery Station has a dedicated Client Services Manager to discuss any health requirements your client may have. We match your client with a clinician who will best meet his or her individual needs.

If an individual has a suspected swallowing problem, we offer urgent appointments.

Call us to discuss your client’s Allied Health needs.

P: 1300 588 851

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Learn more about speech pathology here:

Speech Pathology Australia Factsheets – https://www.speechpathologyaustralia.org.au/SPAweb/Resources_for_the_Public/Fact_Sheets/Fact_Sheets.aspx

Learn more about swallowing and specific disabilities with these factsheets:

Parkinsons Disease (PD) and swallowing – https://docs.wixstatic.com/ugd/bfe057_1ae4d4bdfe5742908e252962e0110acc.pdf

Motor Neurone Disease (MND) and swallowing – https://www.mndcare.net.au/Living-with-MND/Symptom-management/Swallowing.aspx

Stroke and swallowing – https://strokefoundation.org.au/About-Stroke/Help-after-stroke/Stroke-resources-and-fact-sheets/Swallowing-problems-after-stroke-fact-sheet