Managing Swallowing Disorders During COVID Takes Extra Effort


ven in ordinary times, managing swallowing disorders can require complex coordination and care in senior living communities—and

these are not ordinary times. With the limitations and precautions the

COVID-19 pandemic has imposed, senior living operators have had to make adjust- ments to ensure residents who suffer from swallowing disorders continue to receive the close attention that they require to eat safely and receive sufficient nutrition to stay healthy. “COVID has presented a whole new set

of circumstances that require us to double down on our efforts to focus on our high priority residents,” says Margaret Roche, founder of Roche Dietitians. Roche says focusing on top priorities is key

to navigating the COVID era, and “residents with chewing and swallowing problems are certainly near the top of the list.” Katie Holterman, senior director of clini-

cal programming, Legacy Healthcare Servic- es, says there is a great deal of coordination involved in managing patients and residents with swallowing problems, and “making sure that coordination is still taking place is at the forefront of everybody’s mind.”

Risks can increase “A speech-language pathologist’s role in combatting swallowing difficulties and dis- orders is vast,” says Jonross Neptune, MS, CCC-SLP, director of speech-language pathology (SLP) clinical services at FOX Rehabilitation. “At the core, SLPs assist in identifying

abnormal structures and functioning as well as treating those living with swallowing difficulties, that if left unchecked can place the senior living population at a high risk of hospitalization and worse.”


Individuals with chewing and swallowing disorders are at risk for choking and aspira- tion pneumonia, which occurs when par- ticles of food or liquid do not travel down the esophagus into the stomach but rather into the lungs, Roche says. Another risk is malnutrition, because those with chewing and swallowing problems tend to be reluc- tant to eat and drink as much as they need because they find the process difficult. “Dietitians and dining leaders work to-

gether to make sure that foods and liquids are modified to the appropriate consistency and then monitor the resident’s eating and weight,” Roche says. “Weight change is an important indicator

of how well the resident is doing nutritionally. So you can see why in senior living, those with chewing and swallowing problems have always been one of our top priorities.”

ing Disorder members and speech-language pathologists board-certified in the treatment of swallowing and swallowing disorders. A major challenge for residents with the

COVID-19 virus, they point out, is the po- tential impact of the loss of taste and smell. This loss of sensory function can influence some residents’ acceptance and intake of food, exacerbating problems those with swallowing disorders may already have. “COVID-19 has positioned a spotlight

on the benefits gained by having a strong rehabilitation partner,” says Neptune. “Residents being socially isolated, meals

taken in rooms, and the lack of access to extremely important instrumental swal- lowing assessments are only a few of the roadblocks created by this pandemic that can create unsafe situations for the residents. With this, SLP’s have been forced to rely

“Coordinate with your dietitian to keep monitoring your residents with chewing and swallowing problems even after the dining rooms are open. It will take some time and focus to gain back losses in nutritional status,” says Margaret Roche, founder of Roche Dietitians.

Sensory losses Marta Kazandjian, director of speech pathology and resident centered care for Silvercrest Center for Nursing and Reha- bilitation in New York, and Faerella Boczko, director of speech-language and swallowing disorders at The New Jewish Home in New York, are National Foundation of Swallow-

even more on their own clinical skills to create and implement a plan of care that addresses the needs of the residents.” In a more stable environment, Adrienne Ellison, regional director of operations, Legacy Healthcare Services, says the indus- try has excelled at supporting residents with swallowing disorders, both in a therapeutic

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