Background Patients with advanced COPD have an increased risk of dysphagia1 and malnutrition2. These symptoms are frequently inter-related and can have a detrimental impact on patients’ nutritional wellbeing, frequency of exacerbations and quality of life. Speech and Language Therapists (SLT) and Dietitians possess expertise in the diagnosis and management of dysphagia and malnutrition however their role supporting palliative patients with advanced COPD is not well established.
Aim To explore the role of SLT and Dietitian in the screening, diagnosis and management of dysphagia and malnutrition in patients with advanced COPD.
To raise awareness of swallowing and nutrition difficulties in advanced COPD amongst patients, carers and palliative care professionals.
Approach Used All hospice patients with a diagnosis of advanced COPD were screened for dysphagia and malnutrition by the SLT and Dietitian over a one month period. Anecdotal qualitative information was gathered on the impact of COPD on aspects of everyday life relating to feeding including shopping, food preparation, fatigue, appetite, ability to eat a meal.
Outcomes The majority of hospice patients with advanced COPD presented with a degree of oropharyngeal dysphagia and malnutrition (weight loss and fatigue). Patients were unaware that eating and drinking was affected by COPD, believing that swallowing difficulties and loss of appetite were things they would ‘have to put up with’. Patients were unaware that help was available and had no understanding of the role of SLT and Dietitian in supporting their symptom management.
Application to hospice practice SLT and Dietitian appear to have important roles in raising awareness and supporting best management of dysphagia and malnutrition in patients with advanced COPD, to optimise their feeding and nutritional wellbeing.
Hospices caring for patients with advanced COPD should proactively screen for dysphagia and malnutrition to ensure these symptoms are recognised and appropriately managed.