[Management of dysphagia in the institutionalized elderly patient: current situation].
Elderly patients suffering from dysphagia, institutionalised either in hospital or nursing homes, have been studied. Etiology, characteristics and complications of dysphagia were studied as well as the most frequently used strategies to improve the management of swallowing disorders.


METHODS
A retrospective study of the complications of dysphagia found during the last 4 years in our hospital were conducted in addition to a cross-sectional study of the techniques used to manage dysphagia. A postal questionnaire was sent to all the registered nursing homes in the Valencian Community.


RESULTS
Inhospital patients: 58% of physicians estimated that no less than 20% of patients under their care presented dysphagia. 13% of the total number of hospital diets were specific for swallowing disorders. All the patients suffering from dysphagia used a liquid thickener. Nursing Homes residents: 107 questionnaires were returned. This represents 7057 residents of which 3.6% were suffering from dysphagia. 54% of nursing homes have a specific diet for the management of dysphagia, 51% used nasogastric feeding and 30% consider PEG. The most frequent complications were 75% lung aspirations, 39% dehydration, 32% malnourishment and 31% pneumonia.


CONCLUSIONS
Dysphagia is an important problem in elderly people. In our hospital there is a correct use of a dysphagia diet but it could be more widespread and further measures should be taken. Complications are frequent but are not correctly documented in the medical records. Nursing home residents have frequent and important complications when suffering dysphagia. Interventions towards a better management of dysphagia should be recommended and implemented.
Botella Trelis
J J
JJ
Geriatra, Médico Adjunto, Servicio de Medicina Interna. botella_jos@gva.es
Ferrero López
M I
MI
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003680:Deglutition Disorders / Q000150:complications / Q000178:diet therapy* / Q000453:epidemiology / Q000209:etiology; D003681:Dehydration / Q000453:epidemiology; D004032:Diet; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D005521:Food Service, Hospital; D006760:Hospitalization; D006801:Humans; D007326:Institutionalization; D007441:Intubation, Gastrointestinal / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes; D009748:Nutrition Disorders / Q000453:epidemiology / Q000517:prevention & control; D011015:Pneumonia, Aspiration / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires