Overview
The goal of this proof-of-concept study is to assess the potential of a newly developed intervention with combined skill- and strength-based principles for maximizing swallowing-related outcomes and prevent further weakening of the swallowing muscles in older people with dysphagia (difficulty swallowing).
The main questions to be answered are:
- Does the intervention produce clinically significant improvement in ingestive skills during meals in older individuals with dysphagia?
- Does the intervention produce clinically significant improvements in tongue strength and orofacial function in older persons with dysphagia?
- Does the intervention produce clinically significant improvements in nutritional status and quality of life in older individuals with dysphagia?
- Is there an association between perceived autonomy support and intervention engagement when older individuals with dysphagia receive the intervention during hospitalization and continued in community-based rehabilitation after discharge?
Participants will be asked to perform goal-directed and task-specific swallowing exercises in eating and drinking activities where the intensity variables include advancing steps of an altered bolus volume and consistency according to a 17-level task hierarchy, which are introduced according to predetermined progression rules, as well as increases in swallowing repetitions. The dosage is 2-3 individual, face-to-face therapy sessions per week for up to a maximum of eight weeks. A therapy session lasts up to 45 min. In between therapy sessions, participants integrate the achieved level from therapy into their daily meals as self-training.
Eligibility
Inclusion Criteria:
- A score of 5-18 on the Gugging Swallowing Screen.
- Speaks and understands Danish.
- Are able to cooperate in the intervention and give written informed consent; i.e. is
oriented in time, place and own data, and able to perform four simple oral motor
movements on request.
- Has given written informed consent.
Exclusion Criteria:
- Esophageal dysphagia.
- Progressive neurologenic dysphagia.
- Psychiatric illness.
- Delirious.
- Infections that requires isolation.
- Need for palliative care.