Dysphagia and aspiration during a Parkinson's hospitalization: a care partner's perspective and recommendations for improving standards of care

Abstract

People with Parkinson's disease have a significantly increased incidence and risk of aspiration pneumonia when compared to those without. Aspiration pneumonia associated with dysphagia (swallowing issues), which is the leading cause of death among people with Parkinson's disease, accounting for 25% of Parkinson's deaths. There is relatively limited evidence of the most effective strategies to balance the competing needs of each Parkinson's patient as providers aim to prevent, diagnose, and manage dysphagia. Exacerbated, and in part caused, by the intricacies of dysphagia and Parkinson's disease, there is still limited understanding among hospital providers and the Parkinson's community regarding the most appropriate measures to prevent and manage dysphagia in Parkinson's disease. The Parkinson's Foundation Hospital Care Recommendations identified the prevention and management of dysphagia as a care standard necessary to eliminate harm and attain higher reliability in care. This article discusses key components of dysphagia management in the hospital, provides a case example to demonstrate the challenges that people with PD and their care partners experience in the hospital related to dysphagia, and offers recommendations on how to better manage dysphagia and involve care partners in PD hospital care.