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24.01.2022 A little about me . Once I knew what speech pathology as a career actually was, I knew it was for me. A career where you could work with children, adults and other professionals. Perfect! When I started working in speech pathology, I welcomed every opportunity to help any client who came my way. I learnt so much in my first government position. Once I started my family, I began to work only with children, by myself initially. Once someone else joined me, we had the luxury t...o also work in aged care. We could then work with the whole family. The importance of including this wonderful generation of our elders and other care professionals whose job is so vital and who have not always chosen the easiest career path, has been a wonderfully enriching experience. Our primary aim is always to ensure every one of our clients is safe and functioning at their absolute potential, regardless of their age and current abilities. www.safeswallowing.com.au See more

24.01.2022 Just imagine gulp, cough, gulp, cough, cough We all swallow between 500-700 times a day, even around three times an hour during sleep, once per minute while awake and even more during meals and taking medication. Imagine the discomfort of coughing almost every time you swallow. Around one million Australians have a swallowing difficulty. Our elderly loved ones swallow too, not only their meals and fluids but medications as well. They are at higher risk of a swallowing problem. Working in Aged Care is both rewarding and challenging. Choking is amongst the top 3 causes of death in Aged Care Facilities. The more we know about swallowing safety, the more comfortable we feel in caring for the elderly. Learn more www.safeswallowing.com.au

24.01.2022 Ever had a Coughing Fit whilst Eating? Having a coughing fit whilst eating isn’t any fun at all - for the person coughing or the people around them. In those circumstances we, as 'spectators', do our best to help the distressed person and after a while things usually settle down. I recall a good friend profusely coughing at a restaurant one night, having just eaten multiple hot chillies. She did recover, completely undeterred from eating more chillies into the night. Coughing... is our body’s way of telling us something has gone down the wrong way - telling us that food or drink are heading to the lungs instead of the stomach. It’s a great ‘bodily siren’. The lungs should only manage the intake of air. Our stomach handles the intake of food and liquids. If the body gets this wrong, the consequences can be dire. Sometimes, things do go amiss and there is no ‘bodily siren’, warning of impending danger. This is known as Silent Aspiration. For some, in fact up to 75% of those with swallowing difficulties, there are absolutely no symptoms or external warning signs of aspiration. The food or drink is heading straight for the lungs and no one knows. When food or drink make their way into your lungs, they can damage the tissues there. The damage can sometimes be severe. Aspiration also increases the risk of pneumonia. This is an infection of the lungs that causes fluid to build up in the lungs. Not only painful, pneumonia can lead to hospitalisation, further infection and even death, in the elderly. Don’t risk a lack of understanding about Safe Swallowing and what else you need to know to care for those who may be at risk of silent aspiration. Click on Shop Now

23.01.2022 My Mother Used to Say . My Mother used to say, ‘When you go grey, you become invisible.’ She felt the value and presence of our ageing generation diminished as you grew older. That was nearly a decade ago now, but I think things have changed since then. The older generation is far more in the spotlight now, with a large focus on aged care. We’ve become increasingly aware of the wonderful initiatives being implemented in our aged care facilities, not only to ensure their saf...ety but also that their quality of life continues and their value is recognised. I see wonderful stories of the incredible obstacles our elderly has overcome and their wise advice to the younger generation. Whether we’re an aged care worker, relative or friend, we want to convey our appreciation to them. They haven’t disappeared in our eyes. www.safeswallowing.com.au #agedcare #agedcarefacilities #agedcareeducation See more

22.01.2022 Really Enjoying Morning Tea I recently reviewed a resident in an aged care facility at morning teatime. I was checking to see if she was still safe on her modified diet of mildly thickened fluids and a soft, bite sized diet. The tea lady was making her second round and asked this lady if she would like another cup of tea. This was a resident in a beautiful setting; a heritage listed house that had been converted to an aged care facility. Morning tea was a social time for the... residents and an opportunity to interact with the other residents. The lady I was seeing was one of three sisters, like myself in fact, and her two sisters were residents as well. They chatted animatedly. It was lovely to see. Anyhow, back to the lady I was seeing. She did want another cup of tea which the tea lady prepared for her. It was prepared as a thin fluid, however. Thin fluids are dangerous for this resident; her swallowing ability had deteriorated to a mild degree and, as a result, swallowing thin fluids put her at risk of choking; of the liquid travelling to her lungs instead of her stomach. Of course, the tea lady did not have an understanding of this risk. It highlighted for me the need for all aged care staff to be familiar with an understanding of the swallowing mechanism and the best way to manage swallowing difficulties. Easily update your knowledge at Safe Swallowing Education at www.safeswallowing.com.au

21.01.2022 You'd be surprised Many times when we assess a resident who is struggling to eat or drink a normal diet that you and I manage easily, family and friends may think it’s such a shame to have their loved one’s meals modified, even slightly. There are several levels of food and liquid modification set by the International Dysphagia Diet Standardisation, from very minor changes to more significant ones. We all think the resident will be unhappy on a modified diet but more often t...han not, that couldn’t be further from the truth. Most residents realise the difficulty and discomfort they experience when eating. Therefore, when the speech pathologist explains the diet modification, they are extremely relieved to be able to continue to enjoy the food they like and to feel comfortable and safe eating or drinking it. We can’t let our preferences or mental projections stop the elderly from enjoying meals in the safest possible way. Understanding the modifications and their implications is essential. Find this vital information at www.safeswallowing.com.au

21.01.2022 Are you caring for an elderly parent? In an age where many of us work well towards and even past the previously accepted retirement age, the pressure to be and do everything for everyone in our family, seems to grow with every day. Many of us are sandwiched between two generations of caring for our ageing parents and looking after our grandchildren. Add to that the likely scenario of also working full or part time and we wonder how it can be possible to provide the best care ...and support all round, whilst ensuring we maintain an even keel for ourselves. Of course, we want to ensure our parents age safely and are surrounded by the love and very best care we can offer. This can place an enormous additional strain on us. Sometimes we are simply unsure of what is ‘normal’ in the ageing process and what we should be concerned about. I’ve seen many people who are being cared for both in and out of their homes, coughing on their meals or drinks. The most common response from well-meaning relatives is ‘Oh, that’s ok, they always cough at mealtimes.’ Please trust me, it’s not ok. Coughing is one of the signs that food or drink is heading towards the lungs, not the stomach. Food or drink in the lungs, causing germs to fester there, can lead to pneumonia causing immense pain when breathing, hospitalisation, even death, in the elderly. Knowing all the signs to look for to ensure your loved one is swallowing safely is vital to their care. Take the Safe Swallowing Course. For a similar cost of a packet of cigarettes, you can ensure you know what to look for to keep our loved one safe. Click on Shop Now

21.01.2022 Not so obvious Almost everyone at some time, has experienced food or drink ‘going down the wrong way’. That feeling and subsequent coughing fit, isn’t fun at all. As unpleasant as that coughing is, it’s the body’s protective mechanism to stop whatever you’ve swallowed going into your airway and down to your lungs. Food obviously doesn’t belong there because food in the lungs can cause an infection or pneumonia. For well over half of our elderly population with a compromised swallowing function, there are NO OUTWARD SIGNS that the food or drink ‘has gone down the wrong way’. The food simply SILENTLY heads down to the lungs and sits there until the resident becomes ill. Education about Safe Swallowing is essential in caring for our elderly population, in Aged Care or at home. Find this vital information at www.safeswallowing.com.au

20.01.2022 Good News I can’t tell you how gratifying it is to assess a resident or loved one being looked after at home, whose swallow has improved since their initial swallowing assessment. To be able to let them know they can return to a normal diet brings great joy all ‘round. The first several months after a stroke for example, is referred to as a spontaneous recovery period. During this time, patients naturally regain some use of their arm or leg, on the affected side of their bod...y. Their swallowing function can also improve spontaneously. On initial assessment, they may have had the consistency of their food and liquids modified to ensure their safety whilst eating. Our role, as speech pathologists is to assess the person’s swallow function and to recommend consistencies that support their oral intake going into their stomach, not their lungs. Food or fluid in the lungs can cause infection, pneumonia and even death. Being sure family and aged care staff know the signs of a swallowing problem and how best to support the person who has had a stroke, is a vital part of their role in caring for their loved one or resident. Learn more at www.safeswallowing.com.au

19.01.2022 Aged Care residents are often disconnected from their 'previous' lives and loves. Being able to offer them food from their own cultural background brings great joy to them. This is a wonderful initiative that not only brings joy to the resident but also their family members.

18.01.2022 The Gaffigans Comedy Family Raise Awareness of Swallowing Problems. https://swallowingdisorderfoundation.com/the-gaffigans-rai/

17.01.2022 My Hat’s Off to a New Staff Member I was recently asked to assess the swallowing function of a dainty and engaging resident at an aged care facility. Her care worker was alert to the fact that she was holding food in her mouth a little too long, before swallowing. Although new to that facility, the carer worker had been working elsewhere and had a solid understanding of swallowing safety. Even though the sign was a subtle one, he had a feeling that something just wasn’t quit...e right. Lo and behold, he was ‘spot on’. The resident only needed a minor alteration to her food consistencies to enable her to swallow more easily, without any need to delay her swallow by holding onto the food. She was visibly relieved to now comfortably eat her meal. My hat’s off to the care worker who was obviously chuffed at recognising this subtle sign of mild dysphagia. Education is not only empowering but essential in this basic function of daily living. Find out more www.safeswallowing.com.au See more

17.01.2022 How food looks plays a very important part in engaging those whose food texture needs to be modified, to enjoy eating. The presentation of this meal helps the resident want to eat. Great idea. Learn more about food and fluid texture and Swallowing Safety at www.safeswallowing.com.au Lots of free information.

17.01.2022 ‘Oh they always cough like that.’ Sometimes when assessing a resident at an aged care facility, I’ll hear another resident coughing during or after their meal. When I ask a staff member or relative if the resident is ok, I more often than not, get the answer ‘Oh, they always do that.’ Coughing is the body’s way of protecting the airway from substances that are heading to the lungs, but shouldn’t be. The fact that someone ‘always does that’ doesn’t mean it’s ok. In fact, it’s... one of the danger signs of a swallowing problem. Choking is one of the top 3 causes of death in our elderly population. Aspiration pneumonia can occur when food or fluid has gone into the lungs instead of the stomach. This infection can lead to hospitalisation and, in the worst case, can be deadly. Keeping our elderly safe and comfortable when eating and drinking, is easier than you think. We just need the right education. Find out more www.safeswallowing.com.au

16.01.2022 Put yourself at ease knowing you're informed about the swallowing safety of your residents or loved ones.

15.01.2022 A Story of Contrasts When endeavouring to increase people’s awareness and understanding of the risks of eating and drinking food and fluids not suitable to their current swallowing function, I’ve been met with vastly different responses. One, with many years’ experience in aged care, reported only ever seeing one resident choke. This was apparently due to the resident ‘stuffing her mouth with biscuits’. The other end of the scale was reported by a facility manager whose staf...f have been devastated by a similar incident and who have been on an earnest search for education to support their staff, to avoid any recurrence of this kind. Exposure to a choking incident is extremely distressing and can stay with you indefinitely. Even if only one resident, loved one, staff or family member, can be spared this nightmare, surely it’s worth the investment. Find out more at www.safeswallowing.com.au See more

13.01.2022 Loss of Dignity? I had a resident’s relative say to me the other day that it was such a loss of dignity having a modified diet for her mother. After my assessment, her diet had been modified to a soft and bite sized consistency and very mildly thickened liquid. Not much of a change from my perspective, but a significant one from the daughter’s. I could understand where she was coming from. I remember my own mother saying, when it had been suggested we have a carer come into ...her home to ensure she was safe bathing and doing some small household chores for her, ‘This is the beginning of the end then, isn’t it.’ It all depends on your perception, doesn’t it. Both lifestyle changes of a modified diet and someone popping in to help out, do require adjustment to a well-set routine. Both, as well, are put in place to ensure the absolute safety of the resident and my own mother some years ago. Mum and I talked about that and she understood her dignity was not at stake, her safety was. She would rather some external help than to be in a position that endangered her. A bit of help meant we three daughters would know she was ok and all four of us could enjoy one another’s company a lot longer. And that we did. The resident’s daughter and I asked her mother how she felt about the change to her diet. ‘Oh,’ she said, ‘I feel far more confident eating and drinking now, it all goes down much more easily.’ It felt good knowing she was relieved there was something that could help her. Understanding swallowing difficulties takes the pressure off you as a carer. Click on Shop Now www.safeswallowing.com.au

12.01.2022 Not every Cough is COVID Don’t get me wrong, I’m certainly not diminishing the possibility that a cough may be a symptom of COVID. I’m not a doctor. I do however have 35 years of experience as a speech pathologist, assessing the swallowing function of many, many hundreds, if not thousands, of elderly residents in aged care facilities or being looked after at home. Caring for our elderly is a big responsibility. Coughing during, immediately or some time after any oral intake,... can and frequently does represent a swallowing issue, also known as Dysphagia. The cough is the body’s protective mechanism to stop whatever was consumed from heading into the airways. We definitely don’t want food or fluid in the airways because it can cause choking, infection even life-threatening pneumonia. No one wants any of those outcomes. Knowing what to look for to help identify a swallowing problem is essential in caring for our elderly population. Swallowing issues can be managed. Education is such an easy step to take. Why not take it now, to reduce your worry or doubt. www.safeswallowing.com.au Shop Now.

11.01.2022 Food Refusal I recently assessed an elderly lady who had completely lost her ability to speak. The aged care facility was understandably concerned also, about her nutritional intake, as she was refusing to eat. She frequently closed her mouth tightly during each meal. She was losing weight, eating very little in spite of being fed. What was going on? She had already been placed on a pureed diet. On assessment, she took the first mouthful I presented to her, keen to eat. Her ...swallow mechanism was slow but efficient. She clenched her mouth closed when I presented the next spoonful of food. I asked her if she was still swallowing the first mouthful. She nodded. This continued throughout my assessment. She wasn’t refusing food because she had lost the capability to eat. Nor was she not hungry. She just needed a very extended amount of time to swallow each mouthful. She knew no other way to communicate that message other than clenching her mouth shut. It would have been easy to misunderstand her non-verbal behaviour and incorrectly assume she was unable to eat. This may have led to a discussion about palliative care. Knowing what to look for and how to interpret what is going on, especially with non-verbal residents, is essential for our care of them. Find out more www.safeswallowing.com.au

09.01.2022 ABOUT SWALLOWING DIFFICULTIES Swallowing Difficulties affect up to 1 in 25 adults Like breathing, swallowing is a reflex and essential to everyday life. Humans swallow at least 900 times a day: around three times an hour during sleep, once per minute while awake and even more often during meals. We swallow food, liquids, medicine and saliva. People who have trouble swallowing are at risk of poor nutrition and dehydration. ... With each swallow we hold our breath for around one second to make sure the food or drink travels down the correct tube to the stomach rather than the lungs. Swallowing uses 26 muscles and many nerves to coordinate the split-second timing needed to safely swallow. Mistimed movements can lead to food or drink ‘going down the wrong way’’. As we age, this reflex can deteriorate due to a number of conditions such as illness, damage to the brain or structures of the head and neck. Almost half of everyone who has had a stroke will have a swallowing problem. People who have had a head injury, those with Parkinson’s disease, motor neuron disease, dementia, cancer of the head and neck may also have swallowing problems. IMPACT The impact of having a swallowing problem is far reaching, not only for the person themselves but for their family and friends. Eating and drinking is an important part of everyday life. Not only do we need to eat and drink to live, but eating and drinking should be an enjoyable pastime and many social activities happen around eating and drinking. Swallowing problems can result in life threatening medical problems such as pneumonia, choking, poor nutrition and dehydration if not managed properly. Eating and drinking can be uncomfortable, stressful and frustrating for a person with a swallowing problem. Dysphagia Care Plan If the person suffering from a swallowing problem has been advised that they can’t have some types of food and drink, this can make eating and drinking in front of friends and family difficult and embarrassing. These problems can lead to anxiety, depression and social isolation. Carers Course Online The good news is that people who seek professional help can work on ways of eating and drinking that can reduce or remove these problems. IDDSI The wonderful work of the International Dysphagia Diet Standardisation Initiative (IDDSI) outlines the various levels of food and liquid modifications recommend for those with swallowing problems so they can swallow safely. This online course explains the dietary guidelines and how to identify a possible swallowing difficulty. https://www.safeswallowing.com.au/take-the-course

08.01.2022 This is a very informative and easy to follow course with very clearly defined symptoms and supports. A very important course for anyone working or living with the elderly. I would highly recommend this course.

08.01.2022 Do You Work with the Elderly? Yours is an incredibly special and demanding career, with predictably unpredictable events happening on every shift. The range of issues in our ageing population is forever increasing, as the largest generation ever, the Baby Boomers, finds its way from independent living to home care, to residential aged care or to high care. Putting aside general health issues such as heart disease, stroke, neurological disease and the like, Dementia alone aff...ects almost 50 million people worldwide and this is predicted to increase to 131.5 million people by 2050. Every three seconds someone in the world develops Dementia. In Australia alone, Dementia is the single greatest cause of disability in older Australians (aged 65 years or older) and the third leading cause of disability burden overall. People with Dementia account for 52% of all residents in residential aged care facilities. On the ground, there is little more personally distressing than witnessing your ageing loved one slowly slipping away from family members with this insidious disease. One of the immediate dangers of Dementia is the loss of ability to know how to eat and drink. It seems unimaginable that we could ‘forget’ how to do something that has been such an automatic and ingrained skill all our lives. Sadly, swallowing difficulties in this population are rife. Being aware of the signs to look for to protect and manage swallowing difficulties, also known as Dysphagia, is vital in your role as a carer. Here are 3 of the many signs to help you identify a potential life-threatening swallowing problem: Spitting food out of their mouth Taking longer to eat than most residents Excessive tongue movement or excessive saliva in their mouth Simple and effective education can reduce the risk of a choking incident and reduce your stress when caring for the ageing. Click on Shop Now to find out more www.safeswallowing.com.au See more

07.01.2022 Why Dysphagia Education and IDDSI Management is Important One Third of Residents at Risk of Choking Aged care facilities are in a position to do more to prevent their residents from choking and ensuring that their wellbeing is not affected by swallowing difficulties, also known as Dysphagia.... Ensuring you know what to look out for is vital for a resident’s general health. As many as a third of those in aged care facilities have swallowing problems. Many residents have developed infections simply because food has slipped into their airway. If they are not eating the right food consistencies and have developed an infection, they may become disoriented, causing their behaviour to deteriorate, resulting in them not remembering their current capabilities, become malnourished, even causing aggression or falls. It is vital all those working with the ageing population have access to accurate safe swallowing education. The consequences of a 'swallowing incident' can be disastrous - even fatal - to the health and safety of residents and the elderly being cared for at home.

07.01.2022 I don’t think anyone who knows me well, would describe me as a Pollyanna. One of my sisters for sure, has always tended to look at the world through rose coloured glasses. With a science background, I always thought she should have a more realistic approach to functioning in the real world. Whilst nothing happening this year around the world, could possibly be downplayed, there are so many things that people are finding to be grateful for. Me too. And it wasn’t at all hard to... spot them. Although my relationship with technology has previously been a bit ambivalent, I am eternally grateful for it; my world and reach about my passion for swallowing safety with our elderly has expanded. Plugging into the Aged Care community has opened my eyes to others’ passions and willingness to share on so many levels. To those of you who are front-line, working with our elderly population, what a job you do. I’m so deeply grateful for 2020, warts and all. Thank you all for a year to be grateful. See more

06.01.2022 Re-posted from National Foundation of Swallowing Disorders https://swallowingdisorderfoundation.com/my-failed-swallow/

06.01.2022 Looking Forward to the Upcoming Festivities Whether or not you and your family celebrate Christmas itself, December/January is a time of multiple holidays for much of the world. Amongst every culture, food is a must for inclusion, no matter the celebration. Special, traditional dishes signify the various focuses of that celebration, whether it be a cake for a birthday, a turkey for Thanksgiving, potato pancakes at Hanukkah or dumplings for good luck at Chinese New Year. Just... as important as the celebration, is an awareness of those of us living with swallowing difficulties. We’re fortunate indeed that those residents or loved ones can be aided by food or fluid modifications. Not being aware of those modifications or ignoring those suggested by a speech pathologist can quickly change a festive occasion into a distressing one. Let’s let everyone celebrating at this time of the year, fully enjoy every delightful moment and mouthful. Find out more www.safeswallowing.com.au See more

04.01.2022 It’s Amazing that such a Little Known Fact could cause such a Devastating Effect Working in Aged Care, you would realise that, amongst the top three most common causes of death in aged care facilities, is choking. Of those presenting with a swallowing difficulty (known also as Dysphagia), in 75% of cases, there is no ‘bodily siren’ of coughing, warning of impending danger. This is known as Silent Aspiration. For some then, there are absolutely no symptoms or external warning ...signs of aspiration. The food or drink is heading straight for the lungs and you just cannot tell. When food or drink make their way into your lungs, they can damage the tissues there. The damage can sometimes be severe. Aspiration also increases the risk of pneumonia. This is an infection of the lungs that causes fluid to build up in the lungs. Not only painful, pneumonia can lead to hospitalisation, further infection and even death in the elderly. Don’t risk a lack of understanding about Safe Swallowing and what you need to know to care for those who may be at risk of choking or silent aspiration. Ensuring Aged Care Staff have the right tools to identify this danger is a vital part of our important role in caring for the elderly. As a speech pathologist with 35 years’ experience in this training, I'm offering my online Safe Swallowing Education Course which is cost effective and completed in an hour. Facility managers are advised who has completed the Course and participants receive a Certificate of Completion. Find out more www.safeswallowing.com.au

02.01.2022 If you're working in Aged Care, you'd know that, second to falls, choking is the 2nd most common cause of death in ACFs. Having the right tools to identify this danger is a vital part of our important role in caring for our elderly. As a speech pathologist with 35 years experience in this training, I'm offering my Safe Swallowing Education Course free, to the first 5 people who PM me. Pls leave your email so I can forward the Course link (I won't email you for any other reason). Looking forward to increasing awareness of this little known fact.

02.01.2022 As we mentioned in the IDDSI April e-bite, staying at home has allowed them to work on updating and refreshing a number of their resources for you to use for your IDDSI implementation. A number of these updates were made to clarify their recommendations regarding the framework and testing methods; these were made in response to questions from the global community. IDDSI appreciates these questions to help determine where some clarification may be needed. We are happy to report that the updated the IDDSI flow test card, testing reference card and large all "at a glance" posters have been uploaded in the Resources section of our website: