Assessing adherence and exploring barriers to provision of texture-modified diets in a residential aged care facility in rural Australia
Cara Hill1 1Barwon Health, Geelong, Victoria, Australia
Abstract
Purpose: Between 55–65% of residents living in residential aged care facilities (RACFs) experience dysphagia (swallowing difficulties) and are prescribed texture-modified diets by a speech-language pathologist (SLP). The aim of this study was to assess adherence to prescribed texture-modified diets and explore the barriers to implementation in a rural aged-care setting.
Method: This mixed methods study involved two phases. The first phase involved texture audits (n=42) of meals provided to residents with dysphagia who were prescribed texture-modified food or fluids by SLP staff. The second phase involved semi-structured focus groups with nursing and food services staff (n=11) to identify barriers to the implementation of texture-modified diets and fluids.
Result: Meal texture audits identified that 64.3% (n=27) of meal trays contained foods that were inconsistent with SLP prescribed textures. Focus group data highlighted major barriers to the provision of texture-modified diets in aged care, particularly, complicated communication and documentation processes involving nursing, food services and SLP staff. In addition, staffing issues, time pressures, resourcing, resident preferences and perceptions of texture-modified diet options at the RACF were also contributing factors. Based on these barriers, recommendations were made to improve the provision of texture-modified food and fluids in the participating RACF leading to a number of key translational outcomes.
Conclusion: This study identified low adherence to SLP prescribed texture-modified diets and fluids in the participating rural RACF. This was influenced by multiple factors particularly complicated communication and documentation processes. Strategies to facilitate more effective dysphagia management were identified and implemented.
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