Management of Dysphagia in Nursing Homes: A National Survey.
Mina C N Engh, Renée Speyer
PMID 33660070WHAT IT FOUND
Residents were not routinely screened for swallowing problems in 75% of Norwegian nursing homes, yet almost all modified food and liquid textures.
Oral hygiene after meals was rare, and nearly half lacked access to speech therapists.
Key findings
01Swallowing function was not routinely screened or assessed in approximately 75% of homes, despite widespread use of diet modifications.
02Oral hygiene after meals was implemented in less than 18.2% of nursing homes.
03Nearly 50% of homes did not have access to external experts such as speech therapists for dysphagia management.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The 23.2% response rate means the findings may not represent all Norwegian nursing homes, potentially introducing selection bias. Data are self-reported by staff with varying professional backgrounds (mostly nurses and managers), not verified by clinical audits or patient records. The survey design prevents causal conclusions; it describes practices but does not measure patient outcomes like aspiration pneumonia or malnutrition. Respondents may have conflated 'eating and swallowing difficulties' with general nutritional risk, leading to underestimation of dysphagia prevalence.
Declared interests
Funded by the University of Oslo (including Oslo University Hospital). The authors declared no other conflicts of interest.
The easy way to misread this
Do not interpret the high self-rated quality of care as evidence of safe dysphagia management. The survey shows that texture modifications are widespread despite a lack of specific swallowing screening in 75% of homes, suggesting many residents may be on inappropriate diets without clinical assessment.