Palliative care, amyotrophic lateral sclerosis, and swallowing: a case study

Area of Science:

• Neurology
• Speech-Language Pathology

Background:

• Investigates Speech-language pathology (SLP) interventions for dysphagia in amyotrophic lateral sclerosis (ALS) patients.
• Focuses on palliative care and enhancing quality of life (QOL).

Observation:

• A case study involved four ALS participants in outpatient SLP therapy.
• Assessments included the Swallowing Quality of Life Questionnaire (SWAL-QOL), structured interviews, and Videofluoroscopic Swallowing Study (VFSS).
• Participants were classified using FOIS, ALSSS, and DOSS scales.

Findings:

• All participants desired some level of oral food intake, even if minimal, alongside potential tube feeding.
• Dysphagia severity ranged from functional to mild-to-moderate (DOSS).
• Impact on QOL varied from discrete to severe, with some experiencing significant QOL decline even with mild dysphagia.

Implications:

• Patient preference for oral intake, even for pleasure, significantly impacts QOL.
• Exclusive tube feeding may cause discomfort.
• SLP interventions should consider patient preferences for oral intake in palliative care for ALS patients.