Dysphagia Management and FEES in the senior citizen and nursing facilities and in the patient's home
18 April 2018 (online)
Patients in care facilities of various kinds are often treated with a tracheostomy tube due to their underlying disease. They frequently suffer from dysphagia or malfunctions in the area of the tracheostomy. Many are highly immobile and require also constant suction or oxygen supply.
Taking into consideration these many, complex and very individual symptoms, we tried to find a way of optimal examination with the minimum stress for the patients. Through the examination at patient's bed in the patient's accustomed environment with the direct involvement of the nursing staff and the speech therapists it is possible to achieve an optimal amount of information within a reasonable time. To visualize the findings, the smart scope from STORZ was used in combination with corresponding optics as part of the fiberendoscopic evaluation of the swallowing act (F.E.E.S.).
More than 25 patients in Berlin and the surrounding area were examined and treated in this way during the last two years. According to the FEES and its results we managed to optimize the treatment of the tracheostomy and the tracheostomy tube and in some cases to create a plan of decannulation.
Targeted questions to the nursing staff and specific examinations can lead to a shorter duration of the patient examination and minimize the patient stress. Nevertheless, therapy goals could be achieved. Technical improvements are discussed when it is needed with the nursing staff on site. The inclusion of the nursing staff enables a more focused patient training which contributes to the realization of the therapy goals. We would like to report about our experiences as we consider this approach very suitable for the wellbeing of these patients.