Critical Ethical Considerations for Dysphagia Treatment

How to Ensure Your Patients’ Dysphagia Treatment is Ethical

Dysphagia treatment can be complex, requiring healthcare professionals to balance a patient’s unique preferences, quality of life, and medical consequences. It’s critical for clinicians and caregivers to know how to competently and compassionately approach dysphagia, so patients can safely receive adequate nutrition, hydration, and care. However, given the complexity of swallowing disorders, ethical challenges are not uncommon. What happens when a patient refuses tube feeding or other clinical recommendations during treatment?

In this article, we’ll discuss a few strategies that can help you ensure your patients’ dysphagia treatment is ethical, as well as some tips for creating an effective dysphagia management plan for your facility. Keep reading!

Tip 1: Focus on the Big Picture

During dysphagia treatment, it’s a clinician’s job to rehabilitate a patient’s swallow function. That’s why we primarily focus on recommending the safest, least restrictive diet texture to optimize oral intake. However, this is far from the only thing to consider—we must focus on the big picture as well, accounting for a patient’s safety, their goals for therapy, their likes and dislikes, their family’s wishes, as well as our own professional expertise.

It can be helpful to take a step back and focus on the patient rather than the disorder itself. By being compassionate, considering a patient’s wishes when preparing a therapy plan, providing education when assisting patients and their families, documenting all instances of education, and empowering families and caregivers to participate in the patient’s plan of care, we mitigate the risk of going on “autopilot”—or worse, entering a morally grey area where a patient feels unsupported or unsafe.

Tip 2: Involve Your Entire Team

For many working in in-patient rehab facilities, dysphagia treatment requires a true interdisciplinary team effort. It’s essential that therapy and nursing staff are on the same page about who is responsible for supervising patients when dining outside of their room.

One helpful strategy may be to start a dining room program for supervised dining. Implementing a program like this can help staff members know which patients require the most assistance or supervision (such as those with dysphagia diet restrictions or strategies), as well as improve patient safety, intake, and socialization. Make sure that you increase communication when initiating a dining room program at your facility; you’ll need every department to understand why the program is being implemented to assist with staff compliance and to best serve your patients.

Check out the ‘Say This, Not That!’ Cheat sheets here to make communicating about altered diets easier for everyone!

Tip 3: Factor Oral Care into Your Dysphagia Management Plan

Finally, having an effective dysphagia management plan at your facility can help ensure that patients are comfortable, educated, and cared for. For example, your plan may include implementing a robust oral care program, including assembling a dedicated interdisciplinary team, refining your current process, assessing your oral care inventory, using a formalized assessment tool (such as the Oral Health Assessment Tool), and educating your staff.

Remember: Oral care programs should NOT be structured as a “one size fits all” solution for patients. They must be tailored to your specific work setting and patient population to maximize their success.

Explore Ethical Dysphagia Treatment with ARC Seminars

If you’re ready to advance your career as a clinician or caregiver, ARC Seminars is here to give you a boost! Register for our accredited course “Life with Dysphagia: Knocking Down Social & Ethical Barriers” for a deep dive into the social impact and ethical aspects of dysphagia management.

Course attendees will also learn more about approaches to care during dysphagia treatment, caregiver burden, condition-specific treatments, case studies, ethical dilemmas, and more. This course is PERFECT for Speech and Language Pathologists, Occupational Therapists, Occupational Therapy Assistants, Dietitians, Physical Therapists, and more. Enroll now on our website, or contact us today for more information!

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