In the fourth instalment of our dysphagia feature David G Smithard MD FRCP, consultant in elderly and stroke medicine, chair of the UK Swallowing Research Group, Hon Reader University of Kent, explains the effect on lifestyle sufferers experience and the role of the pharmacist.

Lifestyle

Living with dysphagia can prove to be problematic not only for the person with dysphagia but also family members.

Dysphagia can lead to social isolation and embarrassment.

Enterostomy feeding may take over one’s life as feeding is often done over many hours, usually at night.

Nasogastric feeding may affect body image. Enteral tubes are not without their complications

Even where swallowing problems are not overt, such as in presbyphagia, dietary changes may have taken place subconsciously and people may not wish to attend events that involve eating.

Swallowing problems are common and may occur in non-neurological conditions. Swallowing problems are particular problem in older people, and dysphagia should be recognised as a geriatric syndrome.

It is important to identify this to ensure appropriate intervention and management is put into place.

Pharmacists have an important role in advising on routes and modes of drug administration.

The role of the pharmacist

Medication can pose a particular challenge in people who have, and carers of those with, an abnormal swallow.

The pharmacist can be the key to assisting the patient, carer and clinical staff to make the right decision.

There are two main roles the pharmacist can fulfill, education and advice. Education in medicines management, and assistance in determining the formulation of a drug and its dispensing.

Join us for our final instalment tomorrow for advice on key questions to ask and how to manage patients with dysphagia in the pharmacy.