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[Dysphagia] Re: Fluid intake
In a message dated 9/29/2005 2:28:10 PM Central Standard Time,
dmhignight@comcast.net writes:
SLP who saw the patient in the midst of an acute, often
life-threatening illness, where the lungs simply would not tolerate, to the best of the
pulmonologist's and perhaps other team members' estimation, any, or at
least, very little, aspiration!
*** The most harmful thing to such a patient remains the aspiration of his.her own saliva that cannot be prevented.
, but when it is obvious that a thicker liquid is
being tolerated....to the best we can tell...and especially when the patient
is not actively balking at it, we tend to see it as the lesser of the evils,
*** It is not the use of thickened liquids per se that is the problem ? it?s ignoring the importance of hydration ? and that means water, however it?s introduced. Thickened liquids increasingly are being shown to contribute to dehydration, particularly in the frail elderly since simply not enough is ingested. Clinicians, acute and LTC should be promoting hypodermoclysis for as long a period as is required to maintain adequate water volumes. Vikki is a pediatrician and in a position to keep a close eye of hydration status with or without thickened fluids. Who is doing the same for the LTC elderly?.
Many patients enter acute care from long term with an active pneumonia
*** Are assumed to have an active pneumonia. The extreme difficlty of diagnosis in the elderly makes this a contentious issue.
but believe me, if I had a serious illness, I hope I would look at all the angles.
*** I would elect ?clysis as the safest and surest.
calling them "fruit smoothies, shakes", etc,
*** But, how much water do they contain? And how do you monitor hydration status?
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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