The rehabilitation nurse's intervention in elderly people with dysphagia: systematic literature review

Abstract

Context: Dysphagia in aging is associated with malnutrition and cognitive changes resulting from the natural decline of the body's homeostasis at the end of life. It is a permanent challenge for the rehabilitation nurse (RN) to ensure a safe nutrition of the elderly person by re-educating swallowing. Objective: To identify the current scientific evidence on the effectiveness of swallowing rehabilitation interventions in older people with dysphagia. Methodology: Systematic Literature Review (SLR) conducted according to the methodology proposed by the Joanna Briggs Institute, based on studies published between 2017 and 2022, in the databases: CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive Edition and Cochrane Central Register of Controlled Trials and PubMed. Critical appraisal, data extraction and synthesis were performed by two independent reviewers. Results: Initially 647 articles were identified, however only 7 were included in this Review as they met the defined criteria. We found very disparate oropharyngeal rehabilitation plans, particularly regarding the type of exercises/techniques and the use of devices. As for the devices, we tested the Gentle Stim® for transcutaneous electrical neurostimulation (TENS); the IQoro® to stimulate sensory input and strengthen facial, oral, and pharyngeal muscles; the Tongue Pressure Strengthening (TPS) for tongue muscle exercise with resistance training. Conclusion: The elderly person can improve swallowing ability if subjected to a personalized oropharyngeal rehabilitation plan, minimizing the risk of complications. Further research by RN is recommended.