F E AT U R E
Safe and Enjoyable Meals for People with Disabilities and Dysphagia Courtney Reddacliff, Research Project Manager, UTS Professor Bronwyn Hemsley, PhD, Head of Speech Pathology, UTS Fiona Given, Research Assistant and Person with Lifelong Swallowing Disability, UTS
OTA is pleased to be a key consortium partner for a new project funded by the NDIS Quality and Safeguards Commission under the Support for NDIS Providers Scheme “Supporting NDIS Participants with Swallowing Difficulties”. The interdisciplinary project team is led by Bronwyn Hemsley (Professor of Speech Pathology, University of Technology Sydney (UTS)) and Susan Balandin (Adjunct Professor in the Faculty of Health, UTS, Emeritus Professor, Deakin University). Dr Kath Benfer (University of Queensland), Professor Simon Darcy (The Business School, UTS), Dr Deb Debono (Faculty of Health, UTS), Mr Shaun McCarthy (University of Newcastle), and Professor Alison Lane (La Trobe University) are also investigators and experts to the project.
A
s well as OTA, consortium partners reflect the interdisciplinary nature of dysphagia and mealtime management in the field of lifelong disability. They include Speech Pathology Australia, Dietitians Australia, The Benevolent Society, Aruma, the NSW Council for Intellectual Disability, Assistive Technology Australia, Valid, Minda, people with lived experience of swallowing disorders and mealtime support, a consultant chef, occupational therapist, practising dietitian, and an inclusive learning design team. 34 otaus.com.au
Dysphagia, or difficulty swallowing, affects an estimated eight per cent of the world’s population, including about two million Australians. People with dysphagia include people with intellectual disabilities, cerebral palsy, autism, stroke, traumatic brain injury, and others (Steele et al., 2015). Dysphagia has a range of health and social impacts, affecting respiratory and nutritional health, and carries the risk of death. Dysphagia can also cause discomfort and fear during mealtimes, which can impact mental health and quality of life (Chadwick, 2017 and Holland et al., 2011). People with dysphagia often need texture-modified foods and fluids, including puree meals. This can sometimes result in a limited variety of foods, and unappealing food presentation. Dysphagia management in people with disabilities is necessarily multidisciplinary (Chadwick, 2017). The person with dysphagia should be central to a team that includes family members and direct support workers, speech pathologists, occupational therapists, dietitians, and physiotherapists. A common barrier to effective dysphagia management is lack of training in mealtime management for direct support workers (Chadwick, 2017). Innovative training in effective mealtime assistance and food texture modification is expected to prevent
aspiration and choking by ensuring effective and safe practices (Hemsley et al., 2019). Training in providing safe and enjoyable meals aims to increase knowledge about the important support role of the assistant, ways to identify symptoms and risks of dysphagia, and dysphagia management strategies including modification of food and fluid consistencies. It is also important to address the concerns and beliefs of those who hesitate, or struggle, to follow dysphagia management recommendations (Chadwick, 2017). Mealtimes are an important opportunity for socialisation and enjoyment. It is crucial that members of the intervention team understand, and respond respectfully to, the social, cultural, and environmental aspects of mealtime. They must recognise the importance of informed choice and ethical decision making in dysphagia management (Hemsley et al., 2019). In July 2020, the NDIS Quality and Safeguards Commission funded UTS and key partners to lead a one-year project to develop a national training course for direct support workers and others to reduce the choking deaths of people with disabilities and swallowing disorders. In April 2021, the inclusive, interdisciplinary, and collaborative team at UTS will launch a co-created
