The Essentials: Dysphagia and End-of-Life Patients
Presented by Angela Mansolillo
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Dysphagia is a symptom, not a disease unto itself. Difficulty swallowing can be a symptom of a wide variety of medical diagnoses. The underlying diagnosis is a critical factor to consider when developing a treatment approach. Dysphagia clinicians must guard against a “one-size-fits-all” approach and instead develop an understanding of the causative factors and pathophysiology of swallowing disorders in each disease process.
This course will discuss dysphagia in the setting of end-of-life care. The characteristics of dysphagia in patients at end of life will be reviewed, and specific considerations for assessment of the unique needs of actively dying patients will be discussed. The role of tube feeding at end of life will be examined. The evidence base for treatment strategies specific to end-of-life care will be provided, including oral care and comfort, strategies for nutritional support, and alternatives to non-oral feeding. Participants will be provided with an opportunity for problem-solving through case review.
This course is appropriate for dysphagia clinicians working in medical settings, including acute care, outpatient rehabilitation, inpatient rehabilitation, and long-term care.
Meet your instructor
Angela Mansolillo
Angela Mansolillo is a speech-language pathologist and board-certified specialist in swallowing disorders with more than 25 years of experience. She is currently a senior speech-language pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts, where she provides evaluation and treatment services for adults and…
Chapters & learning objectives
1. End-of-Life Patients: What the Dysphagia Clinician Needs to Know
This chapter will provide an overview of end-of-life care for the dysphagia clinician. Palliative and hospice care models, cancer cachexia, and dehydration in dying patients will be discussed to provide the clinician with an understanding of swallowing at end of life.
2. Dysphagia and End of Life
This chapter will describe dysphagia as it manifests in patients at end of life. Signs and symptoms of dysphagia will be reviewed, and factors specific to assessment of these patients will be discussed, including caregiver burden and the role of non-oral feeding in actively dying patients.
3. Management Strategies
This chapter will provide a discussion of the evidence base for management strategies for patients at end of life. Management techniques that have been specifically targeted for these patients will be highlighted, including strategies for oral care and comfort, techniques to support nutrition, and alternatives to tube feeding for dying patients.
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