Resources: Timely Tips

As an SLP or healthcare professional treating patients with swallowing disorders, you know the physical challenges that this condition presents to dysphagia patients, including malnutrition, dehydration, and pneumonic episodes. While effectively treating the detrimental physical effects of this disorder is of the utmost importance, an equally critical, yet sometimes overlooked, aspect of the dysphagia equation is the psychological damage that can coincide with the physical challenges of the disorder.

Understanding the negative psychological effects of dysphagia.

Research indicates that dysphagia can destroy the social opportunities and pleasure of mealtimes, affect the quality of patients’ relationships with their caregivers and families, and undermine health and confidence. This is due in large part to the patient requiring assistance with eating or feeling embarrassed by eating difficulties. Patients with dysphagia can become isolated, feel excluded by others, and become anxious and distressed, especially at mealtimes. This, in turn, can negatively affect a patient’s dignity, self-esteem, and can detrimentally inhibit the individual’s ability to maintain rewarding personal relationships and a healthy lifestyle.¹

Dysphagia patients displaying symptoms indicative of depression, isolation and denial of their condition can sometimes experience psychological, social and physical damage. One study included a sample of patients, almost half of whom were less than 60 years of age, who were still actively working and enjoyed an intense social life. After being diagnosed with dysphagia, these patients were found to be more fragile, lacking self-confidence, limiting social relationships and, consequently, having a tendency to self-isolate. While many patients had previously considered mealtimes an opportunity to meet others and gather socially, most study participants no longer believed mealtimes to be a pleasant aspect of their day due to their new difficulties with swallowing.²

When in this state of mind, dysphagia patients will often conceal or deny their condition. One study found that only 36% of patients acknowledged that they had received a confirmed diagnosis of dysphagia, and only 32% acknowledged receiving professional treatment for their condition. Unless asked by their caregiver to explain their swallowing problems, patients were unlikely to take the initiative themselves to inform healthcare professionals or relatives of their difficulties.³

Identifying and addressing the psychological needs of dysphagia patients.

While dysphagia patients may not volunteer that they suffer from the disorder, it is of critical importance to attempt to identify signs of this illness so that appropriate solutions may be offered. By educating the patient, assessing him or her in the context of other illnesses and problems, and providing the patient with appropriate treatment options for dysphagia, health professionals can avoid the psychological, social and physical damage to the patient that would otherwise occur.

Studies show that dysphagia patients often become psychologically withdrawn due to being overwhelmed by their illness. Having access to healthcare professionals who provide information about effective treatment options can help dysphagia patients to minimize stress, build confidence in the treatment process, and to have a more positive outlook regarding his or her health.⁴

Dysphagia patients’ lives improved qualitatively upon being informed by doctors and healthcare providers about common psychological symptoms related to dysphagia, and as a result of rehabilitation therapy, they were also able to improve their swallowing.⁵

A well-informed patient is a more psychologically fulfilled patient.

Based on prevalent research, it is advisable for healthcare professionals diagnosing and treating dysphagia to provide these patients with a wealth of information and support resources so patients can live more comfortably, and with less stress.

This may be possible if healthcare professionals are aware of and better informed about this problem by exchanging information, especially with caregivers in direct contact with the patient, in order to work together and provide the patient with rapid and effective support, aimed at improving quality of life.⁶

1. Dysphagia affects all aspects of life. (Ekber, O., Hamdy, S.,Woisard, V., et al; Dysphagia, 2001)
2. Ekberg O, Hamdy S, Woisard V, Wuttge-Hanning A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia 2002;17:139-46. [PubMed]
3. Dysphagia affects all aspects of life. (Ekber, O., Hamdy, S.,Woisard, V., et al; Dysphagia, 2001)
4. Andreassen. S., et al., Journal of Clinical Nursing, 2006
5. Gustafsson B, Tibblin L. Dysphagia, an unrecognized handicap. Dysphagia 1991;6:193-9. [PubMed]
6. McOrnej CA, Bricker DE, Kramer AE. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: Conceptual foundation and item development. Dysphagia 2000;15:115-21. [PubMed]