Dysphagia: Clinical Management in Adults and Children A 75-year old patient with
ID: 73615 • Letter: D
Question
Dysphagia: Clinical Management in Adults and Children
A 75-year old patient with respiratory disease was evaluated for difficulties swallowing liquids. Physical evaluation revealed that he had generalized weakness in the lips and tongue. He could take his liquids from a cup without any coughing episodes, but he had some coughing while using a regular straw. The patient reported that he was more comfortable using a straw and preferred it to the cup. The SLP cut the straw in half and the patient then took his liquids with the straw without any difficulty.
Why might this patient have more difficulty using a regular straw than a cup?
Why might shortening the length of the straw improve his swallowing performance?
Explanation / Answer
1.
Straw drinking is more difficult than using a cup. This is because straw drinking (sucking) needs more pressure to swallow the liquid bolus compared to using a cup. It requires good strength in lips, tongue, jaw, velum, lungs, and masticatory muscles. Since older people experience reduced strength in all these parts, it is difficult for them to drink using straw. Loss of elasticity in lung tissue coupled with reduced respiratory capacity effects their swallowing process resulting in coughing episodes.
2.
Shortening the length of the straw minimizes the pressure the person needs to apply while straw drinking (sucking). Therefore, he can be comfortable using shortened straw rather than full length straw.
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