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Huntington's Disease Caregiving

Swallowing Safety in HD
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SWALLOWING SAFETY
Feeding and Nutrition Tips for caregivers, Speech Language Pathologists,
and patients with Huntington Disease

CONSIDERATIONS WHEN PLANNING DYSPHAGIA INTERVENTION:

  • diet must be specified to the particular patient's needs and desires
  • diet should have variety in consistency
  • diet should be well balanced to maintain nutrition and hydration...this person may be dependent on you!
  • supplements may be needed such as vitamins or even a short term feeding tube
  • discuss the plan with caregivers, family members, patient, speech language pathologist, nutritionist, and physician

FACTS ABOUT DYSPHAGIA:

  • one way people maintain independence is by feeding themselves
  • never leave a patient alone while eating  dysphagia is a factor
  • length of time eating is not always a sign of how many nutrients are being taken in, a large amount of food can be wasted during the struggle to eat
Textures
Certain textures are easier then others to swallow, here are some helpful tips about food texture:
  • thin liquids are the hardest to swallow and cause the most difficulty for Huntington's patients
  • also, frozen liquids...remember they melt into thin liquids
  • dairy products may cause excess secretions but this varies
  • temperate foods are easier to swallow then those that are very hot or very cold
  • fruits and vegetables with skins, pits, or membranes should be avoided these are very easy to choke on
  • nuts, seeds, coconut, and dried fruit should be avoided they are hard to swallow
  • stringy vegetables (celery and asparagus) should be avoided
SAFE SWALLOWING TIPS FOR THE CAREGIVER, SPEECH PATHOLOGIST, AND PATIENT:
Because each patient has different needs and abilities,  a Speech Language Patho-logist must always be consulted when developing a plan for dysphagia inter-vention.
 
After doing a detailed diagnostic (Modified Barium Swallow), an SLP may help you implement some of the following:
  • a specific diet limiting hard to swallow foods (such as thin liquids)
SETTING CHANGES:
  • makes eating pleasant
  • quiet and calm
  • avoid eating when upset or tired
  • do not overtax the system
  • do not eat while talking
 
POSTURE CHANGES:
Decreases excess movement and decreases chance of choking
  • upright with head and neck support
  • "chin tuck": directs food directly toward the esophagus preventing aspiration, if the patient has a weakness on one side turn the head toward that side as well
  • sit upright after eating for about 20 minutes to keep the patient from aspirating any reflux that may occur
  • have patient do a dry swallow after swallowing
DIET CHANGES: makes eating safer
  • keep food amounts small try using a smaller fork or spoon
  • Wait until you are completely finished swallowing and clearing a bite of food before you get ready to take another bite