Reevaluating Thickened Liquids for Dementia Patients
An elderly patient diagnosed with dementia finds herself in a hospital setting, struggling with the challenge of swallowing. In response to this issue, a speech pathologist proposes a solution: thickening the patient’s liquids using starch or gum. The speech pathologist carefully outlines the desired viscosity levels for the patient’s beverages, such as tea, water, or juice. Should these liquids be as thick as honey, or should they more closely resemble the consistency of apricot nectar?
Following the speech pathologist’s recommendations, a physician writes the appropriate orders, ensuring that upon discharge, the patient will continue to consume thickened liquids at her home or in a nursing facility. The rationale behind this practice is rooted in the belief that thicker liquids can help prevent patients from aspirating, thereby reducing the risk of aspiration pneumonia—a serious condition that can arise when food or liquid enters the lungs.
However, the effectiveness of this common practice has come under scrutiny. Many geriatricians have expressed skepticism over the years regarding the actual benefits of thickened liquids for patients with swallowing difficulties.
Now, a comprehensive study conducted by the Feinstein Institutes for Medical Research in Manhasset, New York, has brought new insights to the forefront. The research findings indicate that thickening liquids may not provide the protective benefits that were once assumed for patients facing these challenges.
This situation is not uncommon in the field of medicine, where long-standing practices are often accepted without question, only to be later challenged by new evidence. “There are plenty of things we do in medicine that have no evidence,” remarked Dr. Matthieu Legrand, an anesthesiologist and critical care physician at the University of California, San Francisco.
As the medical community continues to explore the implications of these findings, it raises important questions about the protocols we rely on and encourages a deeper investigation into their actual effectiveness.
