A new report from the Patients Association called ‘Survey of medicines related care of residents with dysphagia in care homes’ has found as many as 50% of residents are affected by swallowing difficulties (dysphagia), which can make tablets difficult or even impossible to swallow. Despite the number of people affected by swallowing problems in care homes, only 10% of the homes surveyed had a specific protocol to guide staff in administering medication to people with dysphagia and only 20% had arranged training in this important area.
The report is based on a recent survey of 30 care homes which found that on a daily basis, staff are crushing tablets and mixing them with food to make medication easier to swallow. Altering medication (not designed to be crushed) increases the likelihood of side effects, may reduce the effectiveness of the drug and subsequently compromises residents’ safety. Yet staff had limited awareness of the impact of tampering with medication in this way.
Katherine Murphy, Chief Executive of the Patients Association said: “The NHS was set up to provide health care from the cradle to the grave. Yet from our National Helpline we hear very worrying trends regarding the care of older people, care of the dying and those who are struggling to access appropriate care and treatment.
“The survey found that swallowing difficulties were a significant issue for residents, who often struggle to take medication in the form of tablets. They may chew the tablets or attempt to swallow them whole, leading to choking or coughing fits. A resident’s ability to swallow should be assessed on admission and observed on a regular basis, as the ability to swallow may deteriorate. Of particular concern are older residents and those with dementia who ‘suffer in silence’, unable to communicate and unable to swallow their much needed medicines.
“There was evidence of good practice being adopted in some of the care homes surveyed but this also highlighted the need to raise the profile of people with swallowing difficulties through better training for staff so they are able to provide more effective care to the substantial numbers of people in care homes who are affected in this way.”