Navigating the Challenges of Dysphagia Management in Dementia Care

Due to the high prevalence of dysphagia among individuals with dementia, it was important to investigate whether speech-language pathologists (SLPs) exhibit any bias when making treatment decisions for this population.Clinical bias in individuals with dysphagia may result in pulmonary compromise, malnutrition, dehydration, and decreased quality of life.Research suggests SLPs predominantly use compensatory strategies for individuals with dementia and dysphagia.Therefore, the current survey-based study aimed to explore whether SLP practice patterns differ between individuals with dementia and those without dementia.The research questions were: 1. Do SLPs initiate dysphagia treatment at the same frequency for individuals diagnosed with dementia as for those without a dementia diagnosis?2. Do SLPs select compensatory or rehabilitative treatment strategies differently for individuals with dementia versus those without dementia?SLPs reviewed two dysphagia cases: one involving a patient with a dementia diagnosis and the other involving a patient without dementia.Both cases included written information pertaining to the patient and a video capture of the patients' swallows.SLPs responded to specific questions regarding each case and video.Frequency counts, McNemar's Test, and descriptive analysis of responses revealed that participants were significantly less likely to initiate dysphagia therapy (p < .001) or employ rehabilitative swallowing strategies (p = .008)for individuals with dysphagia and a dementia diagnosis compared to those with dysphagia but without a dementia diagnosis.The results of the current survey indicated that SLPs exhibited a bias when a dementia diagnosis was present.The bias was evident regardless of the SLPs' years of experience or level of education.Failing to initiate treatment or provide rehabilitative strategies may negatively impact the health and quality-of-life of individuals with dementia.