Analysis of Patients' Dietary Status/Restrictions Following Instrumental Swallow Evaluations in Skilled Nursing Facilities.
Theresa Hopkins-Rossabi, Amy Lenze, Sarah Carter Lindler and 2 others
PMID 39214883WHAT IT FOUND
After mobile swallow evaluations in skilled nursing facilities, many residents were recommended less restrictive diets and liquids.
Thin liquids were recommended for 651 residents after the evaluation, compared with 301 before. The paper did not confirm that residents tolerated these changes.
Key findings
01The number of residents recommended thin liquids increased from 301 (32%) to 651 (68%) after the FEES.
02Of 209 residents receiving only non-oral nutrition before the FEES, 77% were recommended to receive oral nutrition after the FEES.
03After the FEES, fewer restrictions were the most frequent liquid recommendation (50.3%), while no change was the most frequent diet recommendation (48.6%).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a retrospective review of clinical reports, so there was no comparison group and no assigned intervention. The data came from one month in 2019. Medical history and co-morbidities were limited to what the evaluating speech-language pathologist wrote in the report. The study did not report whether residents tolerated the new diet or liquid recommendations after the evaluation. The facilities had not consistently adopted IDDSI levels, so IDDSI levels were not used. The analysis reports recommendations after FEES, not outcomes after those recommendations.
Declared interests
Medical University of South Carolina funded the work. No other conflicts of interest are reported in the supplied text.
The easy way to misread this
Do not read the post-FEES diet and liquid upgrades as proof that swallowing improved. The paper reports only what the evaluating speech-language pathologist recommended after the mobile FEES. It did not follow residents to confirm they tolerated the changes. There was also no comparison group, so it cannot show what would have happened without the evaluation.