2022 Volume 26 Issue 1 Pages 24-30
Objective: This study aimed to clarify the status of support provided by multidisciplinary medical personnel for frail elderly with dysphagia and their caregivers.
Methods: Semi-structured interviews were conducted with 8 multidisciplinary medical professionals working in a dysphagia clinic at 4 hospitals that cooperated with this research from 21 hospitals located in prefecture A in Japan. Data were analyzed using the modified grounded theory approach.
Results: The results generated 30 concepts and 7 categories. Multidisciplinary medical personnel working in dysphagia clinics provided the initial support by “listening to frail elderly and their caregivers talk about their hopes regarding eating” and “swallowing evaluation based on the overall background of the frail elderly and their caregivers.” These personnel supported the frail elderly at risk of aspiration by “educating frail elderly and their caregivers to consider the balance between overall life and the state of care.”
They supported frail elderly who had difficulty in ingesting and a high risk of aspiration as follows: “They explained to their families the current situation wherein it is difficult for them to swallow,” “They strived to help frail elderly to enjoy the taste of food,” and “They discussed a stable life with the frail elderly and caregivers.”
Caregivers decide on end-of-life care without wishing for artificial hydration and nutrition; conversely, some frail elderly ate what they wanted despite having dysphagia. Multidisciplinary medical personnel supported these people “to determine the direction of support through a multidisciplinary approach.”
The personnel provided the ultimate goal of these support processes: “Frail elderly, their caregivers, and multidisciplinary medical personnel coordinate to achieve feasible goals.”
Conclusions: Multidisciplinary medical personnel working in dysphagia clinics aim to gain an understanding of the eating preferences of the elderly patients with dysphagia and their caregivers. Caregivers decide on end-of-life care and help treat the elderly patients so that they can eat their desired food despite the presence of dysphagia. For this reason, elderly patients with dysphagia, their caregivers, and multidisciplinary medical personnel coordinate to achieve feasible goals.
