Thickened fluids play a key role in the management of swallowing difficulties, clinically known as dysphagia, but are they the best solution? While there are clear benefits of thickened liquids for someone with dysphagia, there are also several disadvantages that should be considered.
What are thickened fluids?
Thickened fluids are fluids that are of a thicker consistency than thin fluids (which have the same consistency as water). There are products available, such as powders and liquids, which can thicken thin fluids when added to them. These products use starches and gums as the thickening agents and typically have little to no taste. Additionally, there are fluids that are naturally thick, such as fruit nectar juices and milkshakes.
Who needs thickened fluids?
Thickened fluids are often recommended for those who have dysphagia. Drinking thickened fluids can assist in preventing fluid from entering the airway and lungs. Thickened fluids move more slowly than thin fluids, therefore allowing the body more time to move the muscles in the throat and close and protect the airway as the fluid moves down into the oesophagus.
What’s so good about thickened fluids?
There are numerous benefits of consuming thickened liquids for someone with dysphagia. Some of these include:
■ reduced risk of aspiration and aspiration pneumonia (which is an infection caused by bacteria from saliva, food or fluid travelling into the lungs)
■ increased hydration
■ improved timing, control and sensation involved when swallowing fluids
■ improved swallow safety and airway protection
■ reduced hospitalisation risk
■ reduced anxiety and embarrassment during fluid intake
■ improved quality of life.
What could go wrong with thickened fluids?
While there are many advantages of thickened fluids, we also need to consider the cons. Some examples of this include:
■ A change in texture can be unappealing to consume
■ dehydration due to reduced fluid intake from the texture being unappealing
■ time needed for preparation
■ increased risk of silent aspiration
■ non-compliance with the recommended thickened fluid
■ increased fatigue when drinking
■ increased feeling of fullness when drinking
■ affecting the way the body processes medication.
It is also important to note that some commercial supplements should not be thickened. For example, ‘Resource Fruit and Arginaid Extra’ (tetra pack) cannot be thickened safely and should not be provided to anyone requiring thickened fluids.
To thicken or not to thicken?
Thickened fluids can be a valuable tool, and arguably essential for some people with dysphagia to improve the safety of their swallow. However, it is not the only solution for dysphagia.
There are many things that need to be considered before thickened fluids can be recommended, and it is essential to have a discussion with residents and their families about the pros and cons of consuming them.
Picture this: someone has been given thickened fluids, but the taste and texture is off-putting to them, and they refuse to drink fluids. Isn’t the risk of dehydration much greater than the risk of aspiration?
Involving a speech pathologist, dietician, or GP is important when someone chooses not to have thickened fluids, despite the recommendation they have been given. There are many safe swallowing strategies that someone with dysphagia can follow to reduce their risk of aspiration, aside from thickening fluids.
To manage dysphagia safely, it is important to work with a health professional like one of our team at OSCAR Care Group, to make sure every individual gets personalised care and a solution they feel comfortable with and that keeps them safe.
OSCAR Care Group