Digital dysphagia guide supports staff in care homes

A digital dysphagia guide developed by colleagues at Hallam has been providing support to staff in care homes. The project was funded by Abbeyfield Foundation and Innovate UK, with collaboration between Sheffield Teaching Hospitals, Sheffield Hallam University, and NIHR Devices for Dignity MedTech Co-operative at Sheffield Teaching Hospitals. We have been speaking with Dr Julie Skilbeck (Senior Lecturer in Nursing) and Dr Sally Fowler-Davis (Associate Professor in Organisation in Heath and Care) to find out more about the digital dysphagia guide.

Can you tell us a little bit more about dysphagia?

Dysphagia is the medical term for swallowing difficulties. Whilst some people have problems swallowing certain foods or liquids, some people are unable to swallow at all. People who have dysphagia can experience many symptoms, but the main ones include choking, a sensation that food is stuck in the throat, and regurgitating food. Dysphagia can alter a person’s whole relationship with food and mealtimes. The management of dysphagia depends on the underlying cause, but there are a range of treatments, including speech and language therapy, changing the consistency of food and liquids to make swallowing easier, and other forms of artificial feeding.

Why was it important to develop a learning guide to help support staff in care homes?

It is acknowledged that staff working in care homes need education and training to support residents to eat and drink safely to optimise health and quality of life.  Our research identified that social care staff in care homes wanted additional information about dysphagia and needed to access learning in a ‘bitesize’ way. The aim of our study was to develop an evidence-based tool that supported the management of dysphagia in a care home setting as well as embedding organisational change via the use of a consensus-based approach.

Many older people who live in care homes experience dysphagia because of medical conditions such as stroke and dementia. In the United Kingdom, the number of older residents experiencing swallowing difficulties is growing year on year as national demographics change and age-related changes occur in the swallowing mechanism due to loss of muscle mass and strength. Making sure that older residents receive optimum nutrition and hydration is complex, and for those with dysphagia they are at risk of developing pneumonia – this is 10 times more likely than those living in their own homes. Considering the current and future challenges in ensuring that care home staff can access education and training was also critical to the design of the novel training intervention.

What skills and experience were you able to bring to the project?

I was able to bring knowledge and experience of working with older people in later life; research project design and management skills – Julie

My experience in the areas of knowledge exchange with care homes and consensus methods to support the design of the digital learning tool, and creating impact – Sally

The study team was drawn from Sheffield Teaching Hospitals and researchers in the College of Health, Wellbeing and Life Sciences based on the strong working relationship forged between the Speech and Language Therapy Service through the secondment of a ‘researcher in residence’ from SHU (Sally Fowler-Davis).

What challenges did you face?

Social care staff in care homes are held in low esteem across the health system and this often resonates with the public perception of care homes as a negative choice.  It was therefore very important to engage care home staff, including catering and care assistants, in decisions about the new ‘product’.  Whilst this was challenging due to rotas and availability, recruiting staff to participate in the qualitative element of the study was vital. We worked flexibly with the teams at the care homes to maximise engagement and used digital methods to collect information about usage of the tool.

Do you foresee the digital education tool being developed further or being used more widely?

The tool is now available for any care home to use and is consistent with the International Dysphagia Diet Standardisation Initiative. As well as being hosted on HEE as an online learning package, a further study is being developed with a larger number of care homes and with their workforce in order to scale up the implementation of the digital dysphagia guide. There is also the intention to refine the technology to optimise accessibility of the guide by increasing the range of platforms.

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