Unthicken the Thickener

When we think about thickening liquids, it’s truly important to understand how beneficial SPECIFIC diet recommendations are…Can the resident tolerate shakes and supplements that are less viscous than most pre-thickened liquids? Can they tolerate straight tomato juice or apricot nectar? What about “mixed consistencies” like pills with liquid, noodle soup or even mandarin oranges? The best way to know what is safest is to test it out…One of the primary advantages to FEES-ing in post-acute care is that you can test anything, and you can test it over multiple trials. Enjoy these resources, they certainly put levels of thickened liquids into perspective. Because thicker isn’t always better!


thickener comparisons

viscosity chart common things liquids

viscosity levels for oral enteral feedings from nutrition411

thickener image

Alzheimer’s and Dementia


There are more than 3 million cases of people being diagnosed with Alzheimer’s Disease per year in the United States. Alzheimer’s, for those who do not know, is a progressive disease that destroys memory and other important mental functions and has no cure. Similarly there are also over 3 million cases of people being diagnosed with Dementia per year in the United States and it also does not have a cure. Dementia is a group of thinking and social symptoms that interferers with daily functioning.

If your in the healthcare industry and you work closely with individuals with alzheimer’s follow the link people to find helpful tips on communicating effectively with those who suffer from alzheimer’s


feeding.tubes.advanced.dementia from American Geriatrics Society

It has been commonly seen that Alzheimer’s and Dementia can hinder the swallowing process. The link below provides details on common asked question concerning Alzheimer’s/ Dementia and feeding.

assisted_oral_tube_feeding Alzheimer’s Assoc position on feeding tubes


Patients suffering from Alzheimer’s can experience sundowning which is the restlessness, agitation, irritability, or confusion that worsens as the daylight fades. Read the article provided below on hoe to better handle sundowning






Mouth Care Tips

The topic for this weeks blog is healthcare. I have included a few youtube videos, one explains how to use the Oral Health Assessment Tool (OHAT) and the other explains mouth care training of both residents and for staff training.

https://www.youtube.com/watch?v=MHdVralbWYQ shows how to use the OHAT

https://www.youtube.com/watch?v=AVsMmppYXrI is excellent for staff training, even addresses mouth care for residents with care-resistant behaviors.

Shefali Patel which gives 101 information on mouth care. Patel is a speech therapist who is the founder and primary clinician at Ganga Learning & Rehab. She is certified in PROMPT training, Vital Stim Therapy, interactive metronome, and NICU. Patel has over seventeen years of work experience in health care. She if found of methods that include: yoga, acupressure, aromatherapy, brain gym, the listening program and among many others. Below is an article she wrote out in regards to mouth care using the lung washing method. For information on Patel visit her website at www.speechct.com.

Lung washing is actually a process, where the diseased lung is flooded with saline solution and cleansed while the healthy lung ventilates the body. This twice-a-day lung scrub is a super tip to keep your resident’s lungs cleaner and freer of harmful oral bacteria. Without further delay….here’s how to do it in three simple steps:

  1. Open your mouth
  2. Stick out your tongue
  3. Wipe it using a tongue cleaner, three scrubs.   Please do not forget to repeat at bedtime.  Oral health maintenance is so important for limiting complications associated with aspiration especially in our medically fragile elderly population.

The connection between the tongue and the lung?  First, the harmful oral bacteria (harmful enough  to cause heart disease and even kill a growing fetus) as well as the biofilm on the tongue contains toxins that our digestive system spews up onto the tongue overnight.  These toxins can easily infiltrate the lungs. In individuals with dysphagia (swallowing disorders), especially as a result of neuro- and immune-comprising diseases like Parkinson’s, Dementia, CVA, COPD and others, the risk of  pulmonary infections such as pneumonia is already high. Add to that pre-existing risk a fresh supply of bacteria infiltrating the lungs from the tongue daily and and you get pneumonia  It’s no surprise that for U.S. adults pneumonia is the most common cause of hospital admissions other than women giving birth.

Second, there is no second as important as the first.  The first is enough:  Oral hygiene is incomplete without tongue scrubbing. A couple scrapes a day keep the doctor away!  You may not want to use the underside of the metal spoon (it works, though!) so take a look at a U-shaped thin stainless steel scrapper (Ayurveda is one, available on Amazon).

In addition to scrubbing away bad breath (halitosis), increasing dental hygiene and improving your taste by better exposing those taste buds, your overall body health gets a deep acupressure massage. all by tongue scrubbing. How?

Screen Shot 2016-05-11 at 2.57.50 PM.png

The tongue is a mapped out to reflect all the internal organs just like your hand.  All energy meridians pass through the tongue and hence the Shastras of the East recommend scrubbing your lung…I mean your tongue three times, twice a day!

Shefali Patel CCC SLP


SDX Resources

The healthcare industry has a habit of releasing written work that is geared towards  professionals in the field, not taking into consideration that there are people who want to be informed that are not familiar with most medical terms. Here at SDX we have a desire to inform the public in anyway we can. While doing research there were a few articles that I found to be very informative and more importantly easy to read, I have listed them below.

Follow this link to read more about medications and swallowing with regard to Dysphagia. Articles are from the American Speech- Language and Hearing Association


Here is a list of medications that impact swallowing and why. The list was put together by the state of Connecticut, you may want to consider posting the flyer throughout your facility to keep yourself and others informed.



Important points for the SLP: Beers now includes proton pump for inhibitors as potentially in appropriate due to increased risk for bacterial infection….Why? Low acid means a bacteria-friendly environment! Aspirators of refluxate on PPIs are likely to get pneumonia because their stomach content is HIGH in bacteria. Read more below

Beer Criteria