As with any muscle strengthening therapy, the key to rehabilitating the swallow is repetition. Spending half an hour on swallowing exercises can become mundane for both the patient and the therapist. If no one is having fun, therapy will be less effective.
So how can we spice up dysphagia treatment? I have taken suggestions from SLPs all across the internet in my FaceBook group and compiled them here for you! Some of the suggestions do require a cost or equipment but many are absolutely free.
What can you do prior to therapy?
Know what you are treating. Through instrumental evaluation, bed side evaluation and other methods, know what the deficits are and specifically which areas you need to focus on.
Evaluation tools and rating forms:
Check out these FREE swallowing assessment downloads from Eat Speak Think.
Listen to this Down the Hatch podcast, specifically the episode about strengthening therapy vs. coordination
Listen to this Swallow Your Pride episode 13 with Rebecca Levy, SLP on evidenced based intervention for exercises. There is a fantastic download that accompanies it too!
What can you do during therapy?
Do you have Synchrony in your facility? If you are fortunate enough to already have a contract with ACP®, ask your director about adding this visual biofeedback modality. If not, open the lines of conversation with your director or administrator. Do your research ahead of time and know how you can use the program specifically with the patients in your facility.
For cognitively intact patients, show the patient videos of FEES and normal vs. abnormal MBSS to explain anatomy and physiology of the swallow. Education is a huge component to understanding which leads to improved participation.
Use the same terms you hear the Physical Therapist using to further emphasize the relation to large muscle strengthening and small muscle strenthening. Have the patient roll a dice or pull a card from a deck to determine the amount of repetitions for each exercise.
Use the therapy session to develop a home exercise or in room exercise program. Once a patient is able to describe the exercise and the “why” behind it or what they are working on, start a log and let them do it several times throughout their day for repetition. This can be resident directed or family member directed for someone who frequently visits.
Use a metronome or the beat of a familiar song to time exercises or effortful swallows.
Reward effort with a sensory component, a trial of their favorite drink or snack.
There are apps!
For patients who are motivated by technology, try looking into these apps:
- Dysphagia2Go by SmartyEars
- iSwallow by Infonet
- Dysphagia by Northern Speech Services
- Dysphagia Therapy by Tactus
The most important thing is to focus on the swallow. Watching someone eat is not skilled therapy. Keep chit chat to a minimum. Maximize your time together.
Please feel free to share tips in the comments below that you have found purposeful and effective: