Shared decision making in dysphagia.

Area of Science:

• Clinical Nutrition
• Swallowing Disorders
• Healthcare Ethics

Background:

• The term 'risk feeding' is controversial due to its association with risk-taking and potential conflict with patient safety values.
• Quantifying risk in dysphagia and the effectiveness of interventions are complex, with potential negative impacts on quality of life.
• The traditional approach may lead to restrictive practices with limited evidence.

Purpose of the Study:

• To discuss the complexities surrounding the term 'risk feeding' in the context of dysphagia.
• To introduce and describe the Royal College of Speech and Language Therapists (RCSLT) framework for decision-making.
• To highlight the role of nurses within this new framework.

Main Methods:

• Critical review of the term 'risk feeding' and its implications.
• Description of the RCSLT's multidisciplinary, person-centered decision-making framework.
• Discussion of the principles of acknowledged risk and balancing personal values.

Main Results:

• The term 'risk feeding' is increasingly challenged for its negative connotations.
• The RCSLT framework, 'Eating and Drinking with Acknowledged Risk,' offers a person-centered approach.
• This framework aligns with the Mental Capacity Act 2005, emphasizing balancing risk and quality of life.

Conclusions:

• The concept of 'risk feeding' requires re-evaluation in clinical practice.
• The RCSLT framework provides a structured, ethical approach to managing eating and drinking with dysphagia.
• Nurses play a crucial role in implementing person-centered, risk-aware decision-making for patients.