title: Understanding mealtime changes for adults with cerebral palsy and the implications for support services.
abstract: BACKGROUND
  Changes in the swallowing capabilities of adults with cerebral palsy as they age may impact on their health, safety, and well-being.
  
  
  METHODS
  Thirty-two adults with cerebral palsy aged between 30 and 69 years participated in in-depth interviews about their experiences of changes in their swallowing and related management of their mealtimes within the last two years. A constant comparative qualitative analysis of the interviews elucidated the changes they experienced.
  
  
  RESULTS
  Changes included increased coughing and choking, digestive or gastro-oesophageal symptoms, diet modification, loss of independence with psychosocial consequences. Participants reported unsatisfactory collaboration with service providers over mealtime management decisions and interventions.
  
  
  CONCLUSIONS
  Adults with cerebral palsy may experience gradual changes in their swallowing and mealtime capabilities from as early as 30 years of age. Regular collaborative assessment and involvement of all stakeholders in decisions are important to facilitate compliance with recommendations, ongoing safety, and optimal well-being.
authors.affiliation: University College Molde, Norway. susan.balandin@hiMolde.no
authors.forename: Susan
authors.initials: S
authors.lastname: Balandin
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Hemsley
authors.forename: Leah
authors.initials: L
authors.lastname: Hanley
authors.forename: Justine Joan
authors.initials: JJ
authors.lastname: Sheppard
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000375:Aging; D000402:Airway Obstruction / Q000453:epidemiology / Q000209:etiology; D001071:Appointments and Schedules; D017028:Caregivers; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D003142:Communication; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D003657:Decision Making; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004644:Emotions; D005195:Family Relations; D005260:Female; D005522:Food Services / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged