Aspiration pneumonia is a common complication among persons that are on long term care but may also occur in any other person. The condition is encountered when an individual inhales food contents either from the oropharynx or from the stomach. These contents end up in the lower respiratory tract. The incidence of the condition is at least three times as common in persons on long term care as it is in the general population. There a number of things one can do in aspiration pneumonia prevention.
The main factors that have been found to increase the risk of suffering the condition among patients in long term care include difficulty in swallowing (dysphagia), the use of certain medications among these patients and poor oral hygiene. Addressing these factors significantly helps to minimize the risk and reduce the morbidity associated with aspiration that include pneumonia, pneumonitis, abscess formation and obstruction. Pneumonia is likely to be encountered if the aspirated contents contain bacterial organisms.
It is estimated that close to 15% of adults have problems of swallowing, a known risk factor for aspiration. The problem appears to worsen with advancing age and increases 50% in patients aged 80 to 89 years. The physical and physiological changes that occur within the head and neck region as we age are responsible for this. Other conditions that may also contribute to the difficulty in swallowing include stroke, cerebral palsy, dementia and traumatic brain injury among others.
There are several interventions that can be undertaken as measures to help patients with dysphagia. Swallowing therapy is one of the most effective. In this form of therapy, the patient is taught to engage in certain maneuvers that will help reduce the risk of aspirating. Dietary modification is another intervention that can be considered. Lighter viscosity diet can be more easily aspirated than honey-like viscosity. The third option that can be tried is tube feeding.
A majority of long term care patients have been shown to have poor oral hygiene. In one study involving 260 patients, it was established that 70% of them had not been by a dentist in 5 years. Many of these patients may not be able to clean their own teeth which worsens the problem further. Providing assistance on teeth cleaning on a regular basis is one of the interventions that may be undertaken to reduce the incidence of aspiration.
Many of the patients who are on long term care tend to be on multiple medications some of which may hinder the swallowing function. It is important that all the drugs are evaluated before being administered. Some of the drugs that may increase the risk of aspiration include hypnotics, sedatives, antiemetics and muscle relaxants among others.
Drugs may also have a useful function as regards the reduction of aspiration risk. These benefits may be conferred through reduced secretions or enhanced swallowing. Levodopa, a drug used in treating Parkinsonism, is among those that improve the swallowing function by maintaining the tone of muscles used in swallowing. Enalapril and other angiotensin enzyme converting enzyme inhibitors work by reducing secretions.
Aspiration pneumonia is a major cause of morbidity among patients in long term care. Although it can be treated by use of antibiotics, the general recommendation is that greater emphasis should be placed on prevention. This should be done by a multidisciplinary team that includes a physician, nurses, swallowing therapists and physiotherapists.
The main factors that have been found to increase the risk of suffering the condition among patients in long term care include difficulty in swallowing (dysphagia), the use of certain medications among these patients and poor oral hygiene. Addressing these factors significantly helps to minimize the risk and reduce the morbidity associated with aspiration that include pneumonia, pneumonitis, abscess formation and obstruction. Pneumonia is likely to be encountered if the aspirated contents contain bacterial organisms.
It is estimated that close to 15% of adults have problems of swallowing, a known risk factor for aspiration. The problem appears to worsen with advancing age and increases 50% in patients aged 80 to 89 years. The physical and physiological changes that occur within the head and neck region as we age are responsible for this. Other conditions that may also contribute to the difficulty in swallowing include stroke, cerebral palsy, dementia and traumatic brain injury among others.
There are several interventions that can be undertaken as measures to help patients with dysphagia. Swallowing therapy is one of the most effective. In this form of therapy, the patient is taught to engage in certain maneuvers that will help reduce the risk of aspirating. Dietary modification is another intervention that can be considered. Lighter viscosity diet can be more easily aspirated than honey-like viscosity. The third option that can be tried is tube feeding.
A majority of long term care patients have been shown to have poor oral hygiene. In one study involving 260 patients, it was established that 70% of them had not been by a dentist in 5 years. Many of these patients may not be able to clean their own teeth which worsens the problem further. Providing assistance on teeth cleaning on a regular basis is one of the interventions that may be undertaken to reduce the incidence of aspiration.
Many of the patients who are on long term care tend to be on multiple medications some of which may hinder the swallowing function. It is important that all the drugs are evaluated before being administered. Some of the drugs that may increase the risk of aspiration include hypnotics, sedatives, antiemetics and muscle relaxants among others.
Drugs may also have a useful function as regards the reduction of aspiration risk. These benefits may be conferred through reduced secretions or enhanced swallowing. Levodopa, a drug used in treating Parkinsonism, is among those that improve the swallowing function by maintaining the tone of muscles used in swallowing. Enalapril and other angiotensin enzyme converting enzyme inhibitors work by reducing secretions.
Aspiration pneumonia is a major cause of morbidity among patients in long term care. Although it can be treated by use of antibiotics, the general recommendation is that greater emphasis should be placed on prevention. This should be done by a multidisciplinary team that includes a physician, nurses, swallowing therapists and physiotherapists.
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