definition
difficulty or discomfort in swallowing that persists over a prolonged period of time |
dysphagia diet simplified
diet 1 |
thin liquids |
fruit juice, coffee tea |
diet 2 |
nectar thick liquids |
cream soup, tomato juice |
diet 3 |
honey thick liquids |
liquids that are thickened to a honey consistency |
diet 4 |
pudding thick liquids/foods |
mashed bananas, cooked cereals, purees |
diet 5 |
mechanical soft food |
meat loaf, baked beans, casseroles |
diet 6 |
chewy foods |
pizza, cheese, bagels |
diet 7 |
foods that fall apart |
bread, rice, muffins |
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oral motor problems
poor lip closure |
Food and liquid escape through the lips, causing drooling and loss of food during chewing and swallowing. |
poor lateralization of tongue movements |
Poor formation of the bolus prior to swallowing, pocketing of food in the cheeks due to the inability of the tongue to clear food. |
tongue thrust |
Food is pushed out of the mouth instead of up and back toward the throat. |
poor lateral movement of the jaw |
Ineffective formation of the bolus, food particles may be too large to swallow. |
misaligned or weak bite |
Inability to take small pieces of food into the mouth |
ot tx
poor postural control |
Position the patient sitting upright with head and spine aligned in neutral, hips and knees at a 90 degree angle, and feet on the floor. -use head, lateral and pelvic supports if the patient is unable to maintain this position independently. -if the patient cannot get out of bed, position the patient in bed as close to the upright neutral position as possible. |
poor upper extremity control |
-facilitate hand to mouth movement patterns during neuromuscular treatment. -provide adaptive eating utensils and dishes to compensate for weakness, tremor, athetosis, or other upper extremity problems. |
poor lip closure |
Manual stimulation including: -light touch to the midline of the lips -firm maintained pressure around the lips. -stretch pressure around the lips. Sucking and blowing activities: -blow bubbles through a straw -suck on a popsicle -blow up a balloon |
poor tongue mobility, tongue thrust |
-tongue “exercises” including up/down and side to side movement, repetitive tongue tip sounds, holding the tongue behind the upper teeth. -licking flavor off the lips, i.e. rub a lollipop on the lips and have the patient lick the flavor off. -facilitating tongue retraction during feeding by pressing the bowl of the feeding spoon on the middle of the tongue before withdrawing it from the mouth. |
weak or misaligned bite |
-use chew tubes for oral motor exercise -bite and hold objects in the teeth (make sure objects are safe to bite) -use handling techniques to align the jaw and facilitate lower jaw mobility during feeding. |
oral sensory problems |
-use a z-vibe or other small vibrator to provide vibratory input to the mouth, lips, and facial areas -aromatherapy -deep pressure and proprioceptive activities to all joints -present new food items one at a time in a fun, non-threatening manner. -match food textures and temperatures to the patient’s oral motor abilities. |
impaired cognitive abilities |
-use sectioned dishes to separate foods of different textures. -use high contrast place settings, i.e. white plate on blue placemat. Make sure food colors contrast with plate. -provide smaller size utensils to control amount of food that enters the mouth. |
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