[Dysphagia] VFSS

[LiWalsh at serha.ca (Walsh, Linda (R1SE))]

Hi Brad,
It is difficult to interpret the results of your VFSS without more info
on:
- etiology of the dysphagia
- other medical problems and prognosis
- ability to tolerate aspiration, including oral care
- meds
- timing, extent and reason for aspiration
- response to compensatory manoeuvres
- cranial nerve assessment
The VFSS is only a small part of the overall assessment.  Two residents
with identical VFSS may need very different recommendations depending on
the total picture.
Linda

Message: 1
Date: Thu, 05 Jan 2006 12:05:09 +0000
From: "Brad Harvey" <rd4u@sympatico.ca>
Subject: [Dysphagia] VFSS
To: dysphagia@b9.com
Message-ID: <BAY15-F70CD0460F8922CD1CA0B4E62E0@phx.gbl>
Content-Type: text/plain; format=flowed

I have a question about the interpretation of VFSS.  One of my residents

recently had one done that showed residuals on the valleculae with
cookie, 
fruit cocktail, thin fluids and thick fluids.  Aspiration occurred 2 out
of 
3 attempts with thin fluids, none with thick fluids and 1 out of 2
attempts 
with fruit cocktail and it was suspect it was the thin fluid component.
The 
cookie left residuals, but no observed entry into the airway.  No cough
was 
observed with the aspirations.

The recommendation was for minced texture with honey thick fluids.  The 
resident is refusing to eat minced texture and thick fluids.  We have 
recently changed to already prepared thick fluids and she has agreed to
try 
these only after I explained the results of her VFSS and the likelihood
of 
aspiration and risk of pneumonia.  She is adament that she receive
regular 
texture which I have reluctantly agreed to.  She is her own POA and she
is 
91yo and feels it is a quality of life thing. I have the staff tracking
any 
difficulties and discussed appropriate interventions.

Is a digestive cookie not considered minced texture?  With residuals
being 
left with even thick fluids is there any increased risk providing
regular as 
I would think that pureed would be fairly comparable to thick fluids?

Your help is much appreciated,
Brad Harvey, RD


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