innovation in nutritional treatment for dysphagia thérèse dufresne, rd

Innovation in NutritionalTreatment for Dysphagia

Thérèse Dufresne, RD

Innovation in Nutritional Treatment for Dysphagia

Prophagia : a network of strategic alliances

– Synergy : together, we go faster & further

– Convergence of mission : quality of nutritional care for the Hospital client and LTC Resident

– Complementarity of compentencies

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Our clientOur client

Technology Partner

Scientific PartnerResearch PartnersSainte.Anne’s HospitalMcGill University


Outline Overview of Dysphagia

– General Overview– Prevalence – Consequence

Epikura : a Novel Treatment for Dysphagia– Background– History– Results

Introduction to Food Rheology– Texture Parameters– Application to Nutritional Treatment of Dysphagia


Oral Phase - Preparatory - Transport

Pharyngial Phase

Oesophagial Phase

from: ME Groher, Dysphagia: Diagnosis and Management

Dysphagia dys = difficulty phagein = eat

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Over 50 nerves and arteries


Over 45 muscles


Etiology of Dysphagia

Dementia Multiple SclerosisCVA - Strokes Muscular DystrophyParkinson’s Disease Alzheimer’s DiseaseHuntington’s Disease

– Neurogenic

– PsychiatricDepression

– Iatrogenic ConditionsMedication Induced Injury Chemotherapy Radiotherapy

– Inadequate dentition


Cancer1%

Strokes12%

Parkinson's Disease

4%

Medication1%

Dentition35%

Dementia37%

Psychiatric Diseases

3%

Others5%Esophageal

Diseases1%

Sainte.Anne’s Dysphagic Population per DiagnosticApril 2005 – March 2006


Prevalence of Dysphagia

– Acute Care Setting: 30 to 35%

– Chronic Care: 35 to 75%

from: ME Groher, Dysphagia: Diagnosis and Management

– In Canada: 400,000 dysphagic persons

98,200 institutionalized dysphagic persons


Traditional Modified Texture Diet

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– Unappealing

– Diluted (↓nutrients, ↓taste)

– Unrecognizable

– No quantification nor standardization of texture

– No demonstrated efficiency to treat dysphagia


Consequences of dysphagia

– Dysphagia

– Slow eating – Choking– Fear to eat or drink

– Reduced food intake

– Undernutrition, frailness, decreased quality of life, decreased autonomy, increased infections, pneumopathies and cost of care

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A Revolution in the Nutritional Treatment of Dysphagia

– 40 main entrees– Normal looking– Minced & Pureed– Meats, poultry & fish– Pasta

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The Joy of Eating back on the menu!


Epikura’s Fresh Tasting Veggies

– 10 Vegetables– Cooked & Raw– Puréed

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– 9 Cakes– 6 Fruits– Puréed

Epikura’s Sweetness

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Tasting Break

1. Awareness of 3 phases of swallowing2. Dysphagic swallow3. Food Descriptors

- Compaction vs aeration

- Particle size

- Cohesiveness

- Adhesivene

- Syneresis4. Taste profile: intensity of flavours


Randomized Clinical Study 1999 (n=17)

A Demonstrated Efficacy (Germain et al, JADA, Oct. 2006)

The BMI of the Treated Subjects increases from 22 to 24 in 12 weeks while the BMI of Control Subjects remains low

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For the Joy of eating and a taste af life!

Before: 60 kg After : 82 kg

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– Something for every taste, every day– Offers the dysphagic clientèle a balanced

and varied diet– Competitive prices– Fresh food, pure ingredient– Handy frozen individual portions

A Unique Technology which offers:

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Implementation Support

– Expert Team

– Consulting and training

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Objectives and Indicators

– consumption of meals served (or food intake: protein, energy, …)

– variety of foods consumed

– weights (BMI) and nutritional status of residents – meal appreciation by patients

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Strategy, steps and calendar– Impact analysis

– Identification of operational needs – equipements– procedures, recipes, menus, …

– Communications– Operation team – Admin and multi team – Nursing team

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Now available for the Canadian Health Centres

innovation in nutritional treatment for dysphagia thérèse dufresne, rd

Documents

dysphagia sainte

dysphagia prophagia

dysphagia tasting break

management dysphagia

dysphagia thrse dufresne

novel treatment

rd slide

muscles slide