Dysphagia Clinical Resources & Guidelines for Healthcare Professionals

This year's Nutrition and Hydration week will take place from the 16th to the 22nd of March. The week is designed to highlight the importance of adequate hydration and nutrition and how to support patients in achieving this.The Global Tea Party is a highlight of Nutrition and Hydration Week. Support people with dysphagia to safely enjoy shared moments, with dysphagia-appropriate tea-party recipes.

Watch this on-demand webinar: “Eating and Drinking with Acknowledged Risk in Practice: A clinical journey through an EDAR case study”. Expert speakers, Charles Douthwaite, Speech and Language Therapist (SLT) and Co-Owner of Excel SLT, and Hannah Plant, Specialist Neurology Dietitian, talk us through an insightful session, followed by an excellent Q and A. They covered:1. Patient Background: Medical history, social context, PEG placement rationale, and impaired swallow function.2. SLT Input: Swallow assessments, therapy attempts, and outcome measures.3. EDAR Framework: Introduction to EDAR, application to this case, and considerations for patients lacking capacity.4. Legal Context: Overview of the JJ vs Spectrum (2023) case and its implications for practice.5. MDT Process: Best interests meetings, risk analysis, and team collaboration in the care plan.6. Ongoing Management: Monitoring, risk review, and feed adjustments based on clinical changes.

Watch this insightful webinar focused on the terminology and guidelines surrounding at-risk feeding. We delve into the Royal College of Physicians (RCP) guidelines to clarify what constitutes at-risk feeding and the circumstances under which it applies. The session will highlight the crucial roles of the multidisciplinary team (MDT), including speech and language therapists and medical staff, in the shared decision-making process. Viewers can also explore a case history that underscores the significance of effective decision-making in this context. Additionally, we will discuss best-practice approaches for clear and defensible documentation that accurately reflects MDT decisions and prioritises patient-centred care. This webinar is valuable for professionals involved in the care of individuals with feeding risks, aiming to enhance understanding and improve outcomes.

Watch our webinar: “Dysphagia & Dietetics Management in Stroke Care”, where expert speakers Smruthi Venkat and Rachel Lenderyou discuss evidence-based practices for assessing and managing dysphagia, and the role of dietetics in addressing dysphagia-related challenges. The session aims to uncover strategies for safe and effective swallowing, and collaborative approaches to enhance patient outcomes.

The brochure gives an overview on the EAT-10 tool and its validation covering it’s use in the diagnosis, screening, and intervention of dysphagia. Eating Assessment Tool 10 (EAT-10) is a list of 10 questions that can be completed in approximately 2 minutes and helps to measure to what extent a patient may experience swallowing difficulties and risk of dysphagia.

Objective: EAT-10 helps to measure swallowing difficulties. It may be important for you to talk with your physician about treatment options for symptoms.

Recorded webinar of Dr Ana Canton Blanco discussing the scientific evidence supporting the EAT-10 validation tool for dysphagia.

This year's Nutrition and Hydration week will take place from the 16th to the 22nd of March. The week is designed to highlight the importance of adequate hydration and nutrition and how to support patients In achieving this.Malnutrition and dehydration are common complications of dysphagia. This Poster Pack is designed to support you in improving the nutrition and hydration status of dysphagia patients.

Presentation covers how a multidisciplinary team involving a speech and language therapist, dietitian, and a nurse work together to manage patients with Motor Neurone Disease who have swallowing difficulties.

Information for Healthcare Professional Use OnlyThis webinar with Speech and Language Therapists, Lucy Taylor and Eleanor Girdowood, explores cognitive dysphagia—swallowing difficulties influenced by cognitive impairments—and offers practical strategies for speech and language therapists to manage associated feeding behaviours.Highlights include:Cognitive dysphagia affects swallowing due to impairments in attention, memory, and executive function.Common issues include mouth holding, spitting, food refusal, impulsivity, and wandering.Strong links exist between cognitive decline (e.g., dementia, Parkinson’s) and dysphagia risk.Practical strategies include priming (e.g., using smells), creating calm mealtime environments, and promoting independence.Documentation should clearly describe the cognitive impact and effective strategies to be used.Staff education, cultural sensitivity, and personalised care plans are essential for effective management.Watch the full webinar to learn more about cognitive dysphagia.

Information for Healthcare Professional Use OnlyThis webinar with speech & language therapist, Sandra Robinson and physiotherapist, Renjith Reghu, discusses dysphagia, aspiration, and the evidence and presentation of aspiration pneumonia in patients.Highlights of the webinar include:Dysphagia is the difficulty in swallowing, affecting various populations. Aspiration occurs when food or liquid enters the airway, potentially leading to pneumonia.The video explores the relationship between aspiration and lung infections.It addresses misconceptions about aspiration pneumonia among healthcare professionals.Strategies for preventing and managing aspiration-related complications are provided.Watch the full webinar to learn more about dysphagia and aspiration pneumonia.

In this video we will view the summary results of a systemic review paper by Vinas and colleagues entitled “The hydration status of adult patients with oropharyngeal dysphagia and the effect of thickened fluid therapy on fluid intake and hydration: Results of two parallel systematic and scoping reviews”.

Information for Healthcare Professional Use OnlyThis webinar session with expert Speech and Language Therapists, Sandra Robinson and Olivia Nicholson discusses the critical importance of mouth care in individuals with dysphagia, emphasising the link between oral health and systemic conditions.They highlight the importance of proper mouth care for individuals with dysphagia to prevent complications like choking and respiratory issues.They discuss the research and connections between periodontal health and systemic diseases, though causation remains unproven.The role of saliva in digestion and oral hygiene and its interaction with dysphagia is also discussed. They discuss the impact of a dry mouth, xerostomia, on swallowing and subsequent dysphagia management.They introduce the mouth care map and initiatives to improve oral health practices in care settings. They place an emphasis on multidisciplinary teamwork and advocacy for comprehensive mouth care in clinical practice.Watch the full webinar to learn more about mouth care in dysphagia.

Information for Healthcare Professional Use OnlyThis video provides essential guidance on safely mixing thickened drinks for patients with dysphagia using Resource ThickenUp Clear.Highlights include:Understanding Dysphagia: The video discusses the nature of dysphagia and the use of thickened fluids to reduce the risk of aspiration.Types of Thickeners: The video differentiates between starch-based and gum-based thickeners, emphasising the benefits of using gum-based thickeners for safety.Preparation Guidelines: The video offers step-by-step instructions for correctly mixing drinks based on prescribed thickening levels, using Resource ThickenUp Clear.Mixing Techniques: The video highlights best practices for mixing various types of drinks, including hot and fizzy beverages.Storage and Safety: The video stresses the importance of proper storage and labelling of thickener products to ensure patient safety.Watch the full video to learn how to thicken drinks safely using Resource ThickenUp Clear.You may also be interested in this video on texture modified diets for dysphagia.Take the quiz

Information for Healthcare Professional Use OnlyThis safety briefing video discusses managing dysphagia through texture-modified diets, highlighting the importance of correct food consistency levels to ensure patient safety.The video discusses the importance of assessment. Referral to speech and language therapy is crucial for assessing dysphagia in patients.The video introduces the International Dysphagia Diet Standardization Initiative (IDDSI) which defines seven levels ranging from regular to pureed diets, used in dysphagia management.The video shares testing techniques including various fork tests, which are explained to assess the appropriateness of food textures for dysphagic patients in line with IDDSI guidance. Similar testing methods for fluids are also outlined, with specific testing guidance on thickening fluids.The video highlights safety precautions with an emphasis on avoiding modifications that could create choking risks, with techniques to ensure safe food and fluid consistency.Watch the full video to learn more about texture modified diets for dysphagia.Take the quiz

Information for Healthcare Professional Use OnlyThis safety briefing video provides an overview of dysphagia, its risks, symptoms, and management strategies to ensure safety in individuals with swallowing difficulties.Highlights include: Understanding Dysphagia: Dysphagia is a medical term for swallowing difficulties that can lead to severe health risks. Risks of Aspiration: Aspiration can result in serious complications, including pneumonia and choking, making awareness and management essential. Common Causes: Dysphagia can be linked to conditions like stroke, Alzheimer’s, Parkinson’s, and general ageing.Importance of Oral Care: Good oral hygiene can prevent dangerous bacteria from entering the airways, reducing aspiration risks. Identifying Symptoms: Key signs of dysphagia include coughing while eating, facial colour changes, and avoidance of food or liquids. Watch the full safety briefing video to learn more about dysphagia.Take the quiz

Choosing appropriate side dishes for dysphagia patients can be challenging and mashed potato can get repetitive. Gary Brailsford shares tips on how to create rice alternatives with cauliflower and broccoli, adding both colour and vegetables on to the plate in a creative way. Suitable for IDDSI levels 4, 5 and 6.

The Effective management of each resident’s hydration and nutrition can prevent complications and improve quality of life for patients. Explore NHS Enhanced Care in Care Homes framework’s best practice guidance for healthcare professionals.

The needs of dysphagia patients is diverse and can vary from patient to patient. To keep patients safe, it is important that the right questions are being asked. Read the latest Care Quality Commission guidelines for guidance and support on key considerations in the management of dysphagia. 

This is a great recipe for dysphagia patients looking to enjoy a biscuit with their afternoon tea. Suitable for IDDSI levels 4,5 and 6 this recipe provides a step-by-step guide on soaking solution for biscuit.

Providing more choices for your dysphagia patients can help encourage patients to drink and may improve hydration. This IDDSI 3 level smoothie recipe is a great option for patients looking for a fruity drink or a refreshing summer beverage.

Information for Healthcare Professional Use OnlyNéstle Health Science dysphagia chef Gary Brailsford demonstrates how to prepare a raspberry and white chocolate celebration cake, suitable for those on IDDSI level 4/5/6 diets.The video walks through the step-by-step instructions for creating this tasty celebration cake for your patients with dysphagia.The video includes a:Demonstration of cooking raspberries with icing sugar to create a syrup-like coulis.Layering technique for a trifle presentation using sponge and jelly.Preparation of whipped double cream with vanilla and melted white chocolate to enhance the taste.Final presentation tips, including piping and garnishing with grated chocolate.If you enjoyed watching this video, watch the following recipe videos for another dessert or a main course suitable for those with dysphagia.

You asked and we listened! The Cooking with Confidence video series is almost here. So, what can you expect in season one of our ‘Cooking with Confidence’ series? Brought to you by renowned Dysphagia Chef Gary Brailsford, from menu planning to perfecting your presentation, in this series we provide a step-by-step guide on how to create recipes that bring back the joys of food.

Are you looking to cook with confidence for your dysphagia patients? We have teamed up with Dysphagia Chef Gary Brailsford to create the ultimate guide of golden rules that will have you cooking with confidence for patients on IDDSI levels 4, 5 and 6.  

A classic recipe for fish lovers, this texture modified Fish Pie recipe is perfect for a hearty lunch or dinner. Suitable for IDDSI level 5 dysphagia patients, Chef Gary provides a step-by-step guide to help you create the perfect pie!

A wholesome vegetarian option or simply a great meal for those who love beans, this optionally spicy stew is a great choice for IDDSI level 4 dysphagia patients who are looking for a more adventurous lunch or dinner.

A flavoursome meaty option for meatball and sausage fans, this Pork and Chorizo Meatballs recipe is great lunch or dinner choice. Suitable for IDDSI level 5 dysphagia patients.

A lovely fruity dessert perfect any time of year, this recipe by Chef Gary, provides a step-by-step guide on how to prepare rhubarb and ginger fool for dysphagia patients on IDDSI levels 4, 5 and 6.

A national favourite and timeless British dish, this textured modified diet sausage, mash and beans recipe is a great option for IDDSI level 4 dysphagia patients looking for a classis British meal.

A hearty winter option, the sweet potato, cauliflower and lentil goulash recipe is a great vegetarian choice for IDDSI level 6 dysphagia patients.

Perfect for fans of classic Chinese food, this recipe is suitable for IDDSI level 5 dysphagia patients who are vegetarian, vegan or just looking for something a little more adventurous for tea!

A fragrant Indian vegetable curry, this recipe is perfect for IDDSI level 6 dysphagia patients looking for a meal with a little bit of spice in it.

A creamy vegetable recipe, packed full of root vegetables and perfect for those colder nights, the vegetable stroganoff recipe is suitable for vegetarians and dysphagia patients on IDDSI level 6.

A great option to up protein levels on a pasta dish, this Bolognese sauce recipe is suitable for IDDSI level 5 dysphagia patients.

A lovely recipe choice for a heart-warming soup, this broccoli and stilton soup recipe is suitable for IDDSI level 4 dysphagia patients.

Chef Gary’s take on the traditional cauliflower cheese, this cauliflower and broccoli cheese recipe adds some additional colour and is suitable for IDDSI level 6 dysphagia patients.

A great go to for special occasions, the celebration cake recipe offers a step-by step guide on how create this sweet treat and is suitable for IDDSI level 4, 5 and 6 dysphagia patients.

An indulgent fruit and chocolate dessert for those with a sweet tooth, this chocolate and pear custard recipe is suitable for dysphagia patients on IDDSI levels 4, 5 and 6.

A classic meat and potato pie, this cottage pie recipe is suitable for IDDSI level 4 dysphagia patients.

For the festive season, Chef Gary offers a simple step by step guide to create a delicious 3 course meal for texture modified diet patients, that is perfect for this time of year. Take away the hassle and stress of eating for dysphagia patients with these IDDSI 4, 5 and 6 compatible recipes.

Nestlé Health Science is proud to host our next webinar ‘Risk taking in Dysphagia management: should we be bolder?’  This webinar aims to stimulate professional debate and progress practice in dysphagia management. An understanding of risk and risk-aversion is explored in the context of healthcare, how this relates to supporting patients with dysphagia by speech and language therapists and if a balance is being achieved in risk management, rehabilitation and quality of life.

The successful introduction of Resource® ThickenUp™ Clear took place across the Leeds Teaching Hospitals NHS Trust (LTHT) in January 2016. This includes: Leeds General Infirmary St James’s University Hospital Chapel Allerton Hospital The speech and language therapy LTHT outpatient service Why switch thickener? The switch from the previous starch-based thickener was ...

N. Vilardell1, L. Rofes2, V. Arreola1, R. Speyer3,4, P. Clave´1,2,3,5 Received: 16 December 2014 / Accepted: 11 November 2015 / Published online: 25 November 2015 © Springer Science+Business Media New York 2015 N. Vilardell natalia.vilardell@hotmail.com 1 Unitat d’Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataro´, Universitat Auto`no...

Purpose Diet modification is an established first-line compensatory technique for dysphagia management, and thickeners are used to modify liquids. Commercial thickening agents are used to decrease the flow rate of liquids, and allow patients more time to initiate the swallow. Patients do not always like thickened fluids and so compliance can be difficult to achieve. We unde...

For people with dysphagia, it is commonly recommended for fluids to be thickened in order to assist with bolus control and help reduce the risk of choking and aspiration.1-4 However, it has been found that many patients report a dislike of thickened fluids, especially thicker consistencies, thus reducing their quality of life and increasing their risk of dehydration from..

This animation shows what happens during the normal swallowing process, in a person who does not have dysphagia. It provides a detailed animation of the normal swallowing process, including a step-by-step explanation of each stage of swallowing and the role of key anatomical structures. Please feel free to use these in practice with patients and/or for internal training.

Bolus manipulation is a primary treatment strategy in the management of oral-pharyngeal dysphagia. The use of thickening agents to alter bolus rheology is particu-larly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The purpose of our study, a prospective, double-blind clinical trial (Level 1b), was to investigate the effects o...

S. Popa Nita •  M. Murith •  H. Chisholm • J. Engmann •  Received: 5 March 2012 / Accepted: 10 December 2012 / Published online: 14 February 2013 The Author(s) 2013. This article is published with open access at Springerlink.com S. Popa Nita M. Murith H. Chisholm J. Engmann (&) Nestle´ Research Center, Nestec Ltd, Vers-chez-les-Blanc, PO Box 44, 1000 Lausanne 26,..

NESTLÉ HEALTH SCIENCE 2016 Aim To undertake a trial to compare Resource® ThickenUp™ Clear against their current starch based thickener and address the current difficulties. Method Nestlé Health Science provided samples of Resource® ThickenUp™ Clear to the Stroke Unit to trial this thickener The trial consisted of numerous evaluation components: Taste test – included staff and patients with dysphagia ...

Eat10 – A quick and easy screening tool, validated to identify those at risk of Dysphagia.

Resource ThickenUp Clear Clinical Evidence

NESTLÉ HEALTH SCIENCE 2015 Aim To collect user feedback and fluid intakes of residents on a thickening powder for management of dysphagia to support a possible change from their current starch based thickener to Resource® ThickenUp™ Clear in Four Seasons care homes in Northern Ireland. Method 2 week fluid intake chart data collection whilst on current thickener across 2 sites Nestlé Health Science deliver...

L. Rofes*, V. Arreola†, R. Mukherjee‡, J. Swanson§ & P. Clave*,† *Centro de Investigacion Biomedica en Red de enfermedades hepaticas y digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain. †Unitat de Proves Funcionals Digestives, Department de Cirurgia, Hospital de Mataro, Universitat Autonoma de Barcelona, Mataro, Spain. ‡Nestle Research Center, Nestec Ltd, L...

Rofes L, Arreola V, Mukherjee R, Clavé P Neurogastroenterol Motil 2014 Sep;26:1256-65. Aim: To re-validate the accuracy of the Volume-Viscosity Swallow Test (V-VST) for Clinical Assessment by using a new thickening agent with an exclusive formula (ThickenUp® Clear) on 120 patients with oropharyngeal dysphagia associated with age and neurological pathology. Results: The study sh...

Herentry K, et al. European Geriatric Medicine. 2011;2(S24-S206.). Excellent Compliance1: Does not affect colour, taste and odour of hot or cold liquids or foods. Flavourless & Odourless No lumps in various liquids Practically transparent in water 98% of professionals state that it helps improve compliance* Easy to Prepare6 The results obtained with Resource® ThickenUp® Cle...

Introduction Prescribed thickeners are used to thicken fluids to a more viscose consistency than normal, because drinking thicker fluids has long been thought to reduce the risk of aspiration for people with dysphagia. A recent systematic review has identified that thickening liquids can reduce risk of aspiration.1 Many older people live with dysphagia, and a recent review study2 fou...

Hear from independent Speech and Language Therapist, Sandra Robinson, on the role of thickeners, such as Resource® ThickenUp® Clear, when it comes to supporting those with dysphagia.

Hear from independent Speech and Language Therapist, Sandra Robinson, on the role of thickeners, such as Resource® ThickenUp® Clear, when it comes to supporting those with dysphagia.

Educational video demonstrating how to support someone with Dysphagia while they eat

Video demonstrating the swallowing process for thickened food or water

Video demonstrating the swallowing process if suffering from dysphagia

This webinar explores the scientific evidence behind the controversial topic of thickened liquids as an intervention for people with dysphagia. The impact of liquid thickness on swallowing safety, swallowing efficiency and risk of aspiration pneumonia will be reviewed, along with evidence regarding alternatives to thickened liquids. The webinar will wrap up with best practice recommendations for clinicians when recommending diet texture modifications for people with dysphagia.

The Nestlé Health Science dysphagia team have proudly partnered with independent Speech and Language Therapist Sandra Robinson and Research Outreach to create an informative article: Thickeners, the evidence for their appropriate use in dysphagia management. The research article explores the different ways in which dysphagia can affect an individual’s quality of life through physica...