Versorgungslage von Schluckstörungen in Pflegeheimen – Herausforderungen und Notwendigkeiten

Dysphagia is a frequently underdiagnosed consequence of dementia (up to 95%) (Dziewas & Pflug et al. 2020), which often goes unnoticed by those around the patient and is probably not always recognised by those affected, and is the cause of a higher risk of complications and life-threatening conditions (Baijens 2016, Namasivayam & Steele 2015): Dysphagia-related malnutrition and dehydration as well as aspiration pneumonia and the need for enteral feeding, among other things, lead to increased and repeated hospital admissions with stressful interventions, longer hospital stays and the likelihood of being discharged to rehabilitation facilities and nursing homes instead of home after hospitalisation (Altmann 2010). Even medication taken with the intention of improving the condition becomes a risk: chemical pneumonitis is the result of aspirated medication, leading to odynophagia due to mucosal damage in the swallowing route, viral or fungal-associated oesophagitis due to immunosuppressants. Compensatory functions can be impaired, particularly in old age and as a result of multiple medications (Schwemmle et al. 2015). Untreated pneumonia can also exacerbate existing coronary heart disease and trigger other acute cardiac syndromes or death from sepsis.