Survey on dysphagia home-caring patients

― By using questionnaire to home-visiting nurses ―

Abstract

Providing adequate assistance during eating is one of the most important aspects of caring patients with dysphagia at home． ln order to provide the care service more effectively， we surveyed the actual conditions of the patients with dysphagia at home by conducting questionnairing on home visiting nurses． Nurses at several home nursing teams in Mie prefecture including lse-Hisai-Tsu city areas submitted their replies to the questionnaire on their patients under care． Of 169 patients surveyed， 28 suffered from dysphagia and five were placed on tube feeding． Prevalence of dysphagia was higher in the patients in their seventies（18.8％）and eighties（18.7％）than those in sixties (53％)．Fourteen dysphagic patients had history of pneumonia (50％)． Prevalence of pneumonia was significantly higher in the patients who often choked during feeding（64.7％，11/17）than those who had no history of choking (27.％，3/11)．Regarding the relationship between the feeding position and the incidence of choking， those who needed aid to sit up at 90 degrees choked more frequently（81.8％，9/11）than those who sat up at 60 degrees (47.1％，8/17)．Furthermore，the patients who were placed in lower position than the usual sitting position during feeding had fewer choking episodes （41.7％，5/12） than those who were placed in a constant position (75％，12/16)．Of 28 patients who often choked， ten were fed in relatively short period． This fact suggested the importance of taking sufficient feeding time for the patients who had the history of choking． We should consider not only patients’ levels of disability but also their ages when we take care of those with dysphagia at home． Aspiration pneumonia is one of the life-threatening events in home care patients． Appropriate care should be provided for the patients with dysphagia by maintaining lower sitting position during feeding and keeping pace with them．