Posted by ProPortion Foods Blog on Sep 24, 2019 in Uncategorised
Dysphagia, or failures with swallowing, can range from mild to severe, acute to chronic, and short- to long term. It can result in unintentional weight loss, malnutrition and dehydration, social and psychological challenges, complications with other conditions, and, more seriously, life-threatening problems like choking, suffocation and lung infections or pneumonia.
The most common form is oropharyngeal dysphagia – difficulty with the reflexive act of swallowing itself which involves moving food or liquid from the mouth through the pharynx and into the oesophagus. The other main type is oesophageal dysphagia, which produces the feeling of food being stuck in the throat or chest and possibly chest pain.
The most frequent causes of dysphagia are neurological disorders including stroke, dementia and Parkinson’s disease. Other triggers include head injury, motor neuron disease, depression, chronic obstructive pulmonary disease, frailty, cancer and postoperative problems involving the head and neck. Weakened muscles and sarcopenia can also impact swallowing. Pills themselves – which 40% of adults find hard to swallow – can cause dysphagia through medication side effects.
It is very important to identify swallowing problems and their cause as early as possible. People who have experienced stroke are at high risk and should be immediately screened for swallowing problems before ingesting anything. People with other high-risk medical conditions as outlined above should be asked if they have experienced any issues with swallowing.
Apart from obvious difficulties, other signs to look for include coughing before swallowing, during or after eating, heartburn or reflux, drooling, frequent chest infections, storing food in the cheeks, taking a long time to eat, or reluctance to eat or swallow anything. Changes in facial features, speech or voice, like slurring or gurgling, could indicate silent aspiration. Family members should look for these signs and seek professional help if concerned.
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High intensity interval training, which has established heart health benefits, could also help prevent cognitive decline and dementia in older adults.
A University of Queensland study has found that it may increase blood flow in the brain even more effectively than continuous exercise.
It could therefore help protect against the decreased circulation and blood vessel function that occur inevitably with aging, which increases risk of cognitive decline, heart disease and stroke.
Interval training involves short bouts of intense physical activity alternating with periods of rest – and it appears that both aspects contribute to the benefits.
“One of the key takeaways from the study,” says researcher Tom Bailey, “was that both the exercise and the rest period were important for increasing brain blood flow in older adults.”
The experiment compared young males with an average age of 25 years and older men aged around 69. They cycled continuously for 10 minutes followed by 10 minutes of rest or for one-minute bouts alternated with one minute’s rest.
Continuous exercise improved cerebral blood flow more than interval training in the younger men but not the older adults, in which both activities had a similar impact on brain blood circulation.
The overall blood flow was higher in both groups during the interval training when measuring the entire activity and rest periods, even though perceived exertion was lower than during the continuous cycling.
This is good news for older adults who struggle to maintain non-stop exercise. It’s also encouraging to note that, contrary to previous suggestions, the interval training did not cause spikes in blood pressure.
“The benefits of exercise on brain function are thought to be caused by the increase in blood flow and shear stress, the frictional force of blood along the lining of the arteries, which occurs during exercise,” Bailey explains, suggesting that the interval training may have increased the shear stress and allowed the blood vessels to adapt to interval training.
He adds that this research will help to optimise exercise programs to improve brain function but points out that the study was short term and more research needs to look at longer term outcomes.
Disturbingly low levels of activity around the world have sparked the World Health Organisation to recommend that governments take policy action to get people moving more.
They urge all adults – including people over 65 – to do at least two and a half hours of moderate-intensity physical activity each week, for at least 10 minutes at a time, a minimum of 75 minutes of vigorous-intensity aerobic exercise, or a combination of both.
Mobility has numerous health benefits and helps older adults retain better health along with greater independence and quality of life. Aerobic exercise should be interspersed with strength training for optimal benefits to help avoid bone and muscle loss.
Posted by ProPortion Foods Blog on Sep 11, 2019 in Dysphagia
Dysphagia refers to any failure in the act of swallowing. It can range from mild to severe, acute to chronic, and short- to long term.
A team of health professionals helps to manage dysphagia and navigate individuals through the act of safe swallowing and recovery, with speech pathologists at the helm and dietitians on board to carefully monitor a patient’s ability, progress and nutrition status.
Dysphagia needs to be carefully managed in any patient, but older populations are of particular concern. Nutrition management is more important than ever to ensure the well-being of older adults, who are at increased risk of malnutrition. This can result from insufficient calories and macronutrients such as protein or micronutrients – vitamins and minerals.
To avoid malnutrition, food and liquid consumption needs to be optimised according to the patient’s needs. This may include adding nutritional supplements and providing fortified or nutrient-dense options – like adding milk powder or butter to food – while ensuring foods and liquids are at the correct level of texture-modification for the individual. By using one or more of these options, the risk of malnutrition can be significantly lowered and improve quality of life.
Because thin fluids are avoided for fear of choking, it is important to maintain good hydration, and watch out for signs of dehydration including dark-coloured urine, skin turgor and dry membranes.
Several strategies can help patients swallow, including postural adjustments, swallow manoeuvres, trained feeding assistance, adaptive feeding equipment like special cups, dishes and utensils, and a distraction-free environment.
Treatment for dysphagia includes medical, surgical and behavioural options. Interventions to rehabilitate the swallow function include sensory stimulation, biofeedback, electrical nerve stimulation and a range of different strengthening exercises.
Exercises are designed to target specific muscles involved in swallowing. These oral-motor treatments range from passive to more active. Examples include sliding up a pitch scale and holding a high note to elevate the larynx or holding the tongue forward between the teeth while swallowing (with no food or liquid in the mouth). There are other variations on targeting muscles while swallowing, like the “effortful swallow”, “supraglottic swallow” and “super supraglottic swallow manoeuvre”.
More physically, the “shaker exercise” involves lying down, raising the head slightly off the ground and looking at the toes for a few seconds, before putting the head back down. This is repeated few times, and the whole sequence three to six times a day. In the “hyoid lift manoeuvre”, the patient sucks up and moves up to 10 pieces of paper with a straw into a cup. These and other exercises are provided as part of an individual treatment plan.
In this report The Future of Dysphagia we outline the problem, evolving solutions and technological advancements in the area.
Posted by ProPortion Foods Blog on Sep 5, 2019 in Aged Care
Few of life’s pleasures match the gratification and connection that comes with crafting a meal for loved ones, sending mouth-watering aromas wafting through the house and sitting down to eat, drink, chat and share stories.
This is one of the activities that older adults lose when they move to aged care. But one retirement village has brought it back.
Scalibrini Village is a group of aged care facilities that specialise in dementia and palliative care in NSW. They have employed Italian-speaking staff and Italian food to not only engage residents in cooking but reconnect them to their culture – which is much more than just food.
To embed the experience, they produced the Scalabrini Village Cookbook “Cibo é vita” (cooking is life), featuring Italian recipes that are well-known and loved by the residents.
“Most of Scalabrini’s Italian residents come from a background where food isn’t purely a source of human nourishment; it’s a way of life,” says Daz Smith, advisor at the village.
Traditional Mediterranean diets have received much attention for their health benefits. They also bring people together through cooking and eating together and promoting social interactions which are another important aspect of healthy aging.
Familiarity is something else that people miss in aged care, according to a report by the MBF, including familiar food, eating environment and people from assorted cultures.
There is an urgent need to enhance nutrition and flavour in aged care food. Enjoying home-cooked food in a warm, convivial environment also motivates people to eat more, addressing the prevalent issue of malnutrition in older adults.
And cooking has its own unique benefits. A large review found that mental stimulation can help improve cognition and mood in people with dementia – that includes baking.
At Scalabrini, Smith witnessed this himself, saying that he saw residents’ moods pick up when they were in the kitchen. Engaging in familiar tasks can stimulate memories at a time when they are slipping away.
“In the early stages of dementia,” he explains, “people find great satisfaction in assisting with preparing foods like they may have done for years in their family home.”
“In the later stages of dementia, the taste, colour, aroma, feel and presentation of the food becomes an important part of a sensory experience.” Indeed, stimulating all the senses not only stirs memories but can also improve appetite.
While aged care is long overdue for a desperately overhaul to improve conditions across the board, the village demonstrates that cooking and eating home cooked food is a pleasurable and achievable target that ticks several boxes at once.