Dysphagia assessment and management falls within the dietetic scope of practice in all jurisdictions in Canada. There is a direct relationship between swallowing function and nutritional status. Registered dietitians are professionally obligated to meet client care needs by practising to full scope and recognizing context and practice setting, while appreciating the value of interprofessional collaboration and effective team work.
When clients have difficulties with swallowing, the dietitian’s role is to provide services to meet the nutrition care needs of individuals, while minimizing risks of choking and aspiration. Dietitian activities within dysphagia assessment and management include:
- identify signs and symptoms of dysphagia through mealtime/feeding observations,
- assess the client’s nutritional status and nutrient requirements,
- conduct or coordinate clinical (bedside/tableside) swallowing assessment and/or instrumental swallowing assessment, in accord with provincial regulation,
- determine appropriate interventions for dysphagia management, including diet/meal pattern, nutritional supplements, assistive devices as needed, food texture and liquid consistency modifications, positioning and route of feeding (including enteral and parenteral feeding regimes),
- counsel the client, provide family education,
- monitor and evaluate client response, and modify the care plan as needed, and
- work collaboratively within the interprofessional team.
In January 2019, a Canadian IDDSI (International Dysphagia Diet Standardisation Initiative
) Expert Reference Group was formed, which includes many dietitians and DC members. This group of dedicated volunteers, alongside other dysphagia professionals in speech language pathology, occupational therapy and food service management will support stakeholders in moving forward with IDDSI Implementation in Canada. The work will include the development, translation and sharing of resources and training tools.
In March 2015, Dietitians of Canada published a role paper addressing dysphagia assessment and management for practising dietitians, based on the principles and ideals of evidence-informed, interprofessional, safe, competent and ethical client-centred care. The paper is derived from a review of the literature, expert opinion, and a review of provincial legislation, including papers available through provincial regulatory bodies (Quebec, 2006; Ontario, 2007; Alberta, 2013). This paper is an update to a previous Dietitians of Canada paper published in 2005.
Want can you do to learn more about dysphagia?
- Join the Dysphagia Assessment and Treatment network, which helps define, expand and secure the dietitian’s role in the assessment, management and treatment of dysphagia within the health care team and to promote sharing of expertise and resources to build capacity within Canadian dietitians.
- DC offers a three part online course on dysphagia management. The program includes:
Go to online courses