Research Abstract: Free Paper - Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Bringing endoscopic evaluation of swallowing to adults in residential aged care homes in Australia. (#66)

Olga Birchall 1 2 , Michelle Bennett 3 , Nadine Lawson 4 , Amanda Richards 5 , Susan M. Cotton 6 7 , Adam Vogel 1 8 9
  1. Centre for Neurosciences of Speech, The University of Melbourne, Melbourne, Victoria, Australia
  2. Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
  3. School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia
  4. Speech Pathology Department, Cabrini Health , Melbourne, Victoria, Australia
  5. FRACS, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
  6. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia
  7. Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  8. Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tubingen, Germany
  9. Redenlab, Victoria, Australia

Aims:

To describe the feasibility, utility, and acceptability of mobile Flexile-Endoscopic-Swallowing-Assessment (mFEES) in Australian residential-aged-care-homes (RACHs).

 

Methods:

Older adults with dysphagia living in RACHs received onsite mFEES services. Assessments were conducted by a visiting speech-pathologist (SLP), with assistance from a facility-based nurse. An otolaryngologist provided online support on request. Residents rated their pre-procedural anxiety and procedural comfort using the Visual Facial Anxiety Scale, and the Faces Pain Scale–Revised, respectively. Nurses, SLPs, and legally appointed medical-decision-makers (MDMs) completed an anonymous online post-mFEES survey. The feasibility, utility, and acceptability of the mFEES service model were examined.

 

Results:

Twelve residents living in RACHs in Victoria consented and successfully participated in mFEES between February and October 2021. Recruitment was challenged by the COVID-19 pandemic. Residents were seen within 7.6 days (average) from referral. There were no adverse events requiring mFEES to be ceased. Pre-procedural anxiety was ‘none’ or ‘mild’ in 50.0% of residents. Only two residents described ‘moderate-to-high’ anxiety. Average procedural discomfort was 2.83 (range 0-6) on a 10-point ordinal rating scale. Healthcare professionals and MDMs (100%, n=26, N=26) were satisfied (rating 8-10/10) with the mFEES service model; believed that mFEES was highly useful (rating 9-10/10) compared to off-site assessment; and should be a standard option available to residents (92%, n=23, N=25).

 

Conclusions:

Mobile FEES is a safe, well-tolerated service that offers potential to improve access to person-centred, timely swallowing care for older adults with dysphagia living in RACHS, in Australia. This feasibility trial offers a platform for future research with larger participant samples.