Abstract
Aim : The purpose of this study is to clarify the skills of an expert nurse to support oral intake for people with dysphagia by using tools.
Method : Two methods are used to collect data : one is the participant observation by video recording and the other the semi-structured interviews while watching the recorded video. The research participant is a nurse.
Results : Tool-body assimilation is found in the expertise of a nurse. She treats the tools, a spoon and a brush for oral care, as extensions of her index finger, there by sensing various information inside the mouth to assess the status of people with dysphagia. Moreover, her attitude toward oral care is original in that she puts importance on implementing it even during eating to encourage functional normalization of a swallowing reflex trigger zone. When supporting oral intake, she puts a spoon on the tongue after checking for the position to assess the function of the tongue ; and uses an oral brush before, during and after eating to remove dry or glutinous tongue coating (she calls it a "facial mask"), which allows functional recovery of the tongue sensor to encourage swallowing. In case of near-choking, she regards it as a normal swallowing function as it is a sign of coughing and eliminating tongue coating on one’s own.
