Patients' awareness of symptoms of dysphagia

To assess geriatric patients' assessment of their clinical symptoms of dysphagia by means of a customized dysphagia screening tool and the usefulness of this assessment to health care professionals.

The screening tool was distributed to an appropriate cohort and the entries correlated with results of standard speech-language pathology clinical assessments.

A large long-term care/subacute rehabilitation facility.

There were 199 new admissions screened. The patients included 74 (37.2%) males and 125 (60.8%) females. Patients' ages ranged from 50 to 98 with the mean age of 79.9 years.

The screening tool used requires yes/no patient responses to 9 clinical indicators of dysphagia: difficulty keeping liquids in the mouth; coughing after drinking; shortness of breath while drinking; voice change after drinking; coughing after eating; shortness of breath after eating; food getting stuck in the mouth/throat when eating; voice change after eating; difficulty with saliva. After completing the questionnaire, the speech-language pathologist then conducted a standard bedside swallowing examination using the same 9 indicators.

The findings suggest that although patients are less discriminating than clinicians in recognizing swallowing problems, the screening tool as a generalized indicator of potential for dysphagia is consistent and reliable. Individual items should not be used as indicators of dysphagia, but as a whole, the screening tool completed by patients is a reliable indicator of potential for dysphagia.

Patients' awareness of their own swallowing impairment represents an important aspect of functional recovery. The findings of the study indicate that when patients self-identify a swallowing problem, the speech-language pathologist also identifies the existence of a problem, although not the same problem identified by the patient, with the same intensity or with the same manifestation.