MODULE 1: METHODOLOGY AND TOOLS DEVELOPMENT FOR ADULT EDUCATORS

Optimal nutritional status means providing all the nutrients in the right proportions to meet the individual's requirements to achieve the best performance and the longest possible lifetime in good health.

Improving nutritional status is a powerful factor in preventing and treating diseases and maintaining a good quality of life.

In view of the regular consumption of modified and/or less nutrient-dense meals, combined with difficulties in tolerating large volumes of fluids, dysphagic patients are at particularly high risk of inadequate macro- and micronutrient intakes.

Consequently, adults can suffer a negative energy balance, resulting in sustained weight loss, and their risk of sarcopenia, inadequate fluid intake and micronutrient deficiencies is increased. Referring to children, this situation can cause permanent, widespread damage to their growth, development and well-being. 

The psychological implications of dysphagia should also be observed. Patients find increased dependence on caregiver at mealtimes and new feeding patterns, as degrading and upsetting, which may further lead to loss of appetite, depression and anxiety or fear at mealtimes – contributing to weight loss and exacerbation of malnutrition.

In fact, it is well-documented that dehydration and malnutrition, mainly undernutrition, are linked to undiagnosed or untreated dysphagia.

Malnutrition leads to systemic muscle mass loss and atrophy of the muscles used to swallow, and this ultimately leads to worsening of dysphagia.

Effective nutritional management is crucial to to maintain good nutritional status or to reverse malnutrition. The first step to stablish appropriate nutrition care plans is the nutrition assessment.

Goals of Nutritional Management:

• Maintain and ensure adequate nutrition and hydration status;

• Implement the correct and safe texture modified diet upon speech and language therapist recommendations;

• Maximize nutritional intake while maintaining safe eating, i.e. to prevent aspiration and choking.

• Establish the need for dietary supplementation and/or fortification.