Thickened fluids in residential aged care facilities – Are we getting the recipe right?

Abstract

Background/aim: Swallowing difficulties (dysphagia) affect at least 50% of people living in residential aged care facilities and can result in malnutrition, dehydration, or aspiration-related pneumonia. Speech pathologists often recommend thickening fluids for people with dysphagia to increase swallowing comfort and safety. In the aged care sector, nursing and personal care staff are often responsible for manually thickening a resident’s fluids. Incorrectly prepared fluids can lead to adverse outcomes for the resident. To avoid these risks, Australia adopted the International Dysphagia Diet Standardisation Initiative (IDDSI) in 2019. IDDSI is a global standardised framework developed to provide terminology, labelling and testing methods for texture modified food and fluids. This project aimed to 1) quantify adherence to IDDSI guidelines and identify factors influencing manually prepared fluids, and 2) explore staff perceptions relating to thickening fluids. Population/setting: This study was conducted across ten residential aged care facilities with 146 residents, all operated by one rural health service. Approximately 180 enrolled nurses, registered nurses and personal care workers who work across the facilities were invited to participate in the study. Methods: This descriptive cross-sectional study collected data through staff surveys and observations of thickened drinks preparation. The survey included closed and open-ended questions relating to staff perceptions of barriers and facilitators, current processes, and confidence relating to accurate manual thickening of drinks. The speech pathologist observed nursing and personal care staff prepare a drink of a requested thickness and temperature. The drinks were assessed using IDDSI testing measures. Results: 52 surveys and 40 observations were completed. Data analysis is under way and preliminary results will be presented at the symposium. Conclusion: Not completed. Translational impact/implications for future practice: Previous studies investigating dysphagia management in rural residential aged care facilities have identified significant issues in the accurate provision of prescribed texture modified food and drinks. It is unclear if the recent introduction of the IDDSI framework adds to existing challenges for accurate manual thickening of drinks. This study’s results will help understand staff perceptions of barriers and facilitators to ensure appropriately thickened drinks are provided for the residents’ ongoing swallowing safety and quality