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 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 (Can J Diet Prac Res. 2005;66(2):91-94.)
The full statement can be accessed online using this short url www.dietitians.ca/dysphagia. (in French www.dietetistes.ca/dysphagie ) and listed below as a public resource.
- DC Statement on IDDSI
(June 2017) – Dietitians of Canada applauds efforts to improve patient safety and interprofessional collaboration and communication through the International Dysphagia Diet Standardisation Initiative (IDDSI).
- Defining the Role of the Dietitian in Dysphagia Assessment and Management
(March 2015) – This role paper discusses dysphagia assessment and management based on the principles and ideals of evidence-informed, interprofessional client-centred care.