New guidelines to make swallowing safer for people in Australian nursing homes

The ability to eat and drink are things most Australians take for granted. That’s why Speech Pathology Australia is an active participant in an international initiative that is working to make swallowing safer for people in Australian hospitals and nursing homes.

On the eve of the Royal Commission into Aged Care Quality and Safety, Australia is set to adopt new international standardized terminology and definitions for texture modified food and drink. The quality of meals and the appropriateness of food served have already been identified as an important matter for investigation by the Royal Commission.

From 1 May 2019 new guidelines about standardized names and descriptions of food and drink used in medical and community settings to reduce choking risk will be introduced in Australia.

An analysis of Australian Bureau of Statistics population and Australian Institute of Health and Welfare nursing home data on deaths reported to coroners, found that after falls, choking was the second largest cause of death in aged care.

Around 15‐30 per cent of people aged 65 and over living in the community have a swallowing difficulty, this figure rises to over 50 per cent for older Australians living in nursing homes. People who suffer from age-related conditions such as stroke, dementia, and Parkinson’s disease are also likely to have a swallowing difficulty and are at risk of choking on food or developing pneumonia.

People over the age of 65 years have 7x the risk of choking on food as children aged 1-4 years.

The new IDDSI framework includes easily accessible testing methods that allow consumers, health professionals, nursing homes and hospitals to check that the food or drink they are serving is correct for older Australians with swallowing difficulties.

For producers of thick drinks and food specially prepared to reduce choking risk (texture modified food), the IDDSI standards mean a single set of labeling for packaging, including standardized color and number codes, which can be used and recognized around the globe.

Speech pathologists are the professionals who provide swallowing assessments and develop mealtime management plans, including advising on changes to the texture of food and drinks to enable safe and effective eating and drinking.

“The sad reality is,” said Dr Julie Cichero, “that the most common factors in choking deaths is a lack of clear personalized information about safe eating and drinking for older Australians, and inadequate supervision."

“The texture of food and drink is important the older we get. In nursing homes especially it is critically important that the texture of food and drink is appropriate for each individual person. One size fits all is not appropriate.”

Speech Pathology Australia, as the peak body for the speech pathology profession in Australia, is actively supporting The International Dysphagia Diet Standardization Initiative (IDDSI). IDDSI promotes safety for people with swallowing difficulties (dysphagia), through a common standardized international terminology for food and drinks that reduce choking risk.

The IDDSI draws its membership from around the world and a diverse range of professions, including: speech pathology, nutrition and dietetics, medicine, occupational therapy, nursing, patient safety, engineering, and food science and technology. In 2019, IDDSI will formally be adopted in Australia, Canada, the UK and the USA, with another 18 countries in progress. IDDSI has support from health professional associations around the world, and the international food and beverage industry.