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Global initiative aims to improve safety for residents with dysphagia


The implementation of a new international framework for naming and describing texture modified foods and thickened liquids will reduce the risk of choking among aged care residents, a dysphagia expert tells Australian Ageing Agenda.

The International Dysphagia Diet Standardisation Initiative (IDDSI) has developed standardised terminology in 28 languages for texture modified foods and thickened liquids.

IDDSI aims to improve the safety of more than 500 million people worldwide with swallowing difficulties, known as dysphagia, and reduce risks associated with choking on food and aspirating on liquids.

Behind falls, choking is the next most common cause of preventable deaths in aged care in Australia, according to Monash University research published in the Medical Journal of Australia last year (read our report here).

Julie Cichero

IDDSI co-chair Dr Julie Cichero provided an update on the framework at Speech Pathology Australia’s national conference in Adelaide on Tuesday ahead of its 1 May 2019 implementation across Australian healthcare sectors.

The new framework provides a common language that will reduce the risk of older people choking, Dr Cichero told Australian Ageing Agenda.

“The IDDSI framework has four levels of drink thickness and four levels of texture modified foods informed by systematic review and international stakeholder surveys,” Dr Cichero told AAA ahead of the conference.

The current Australian standards, which are 10 years old, only have standardised terminology for three levels of drink thickness and texture modified food each.

Other key features of IDDSI include a person-focused rather than profession-centred approach and global terminology suitable for all cultures and care settings, said Dr Cichero, a member of Speech Pathology Australia.

“It is accompanied by practical and valid measurement techniques to improve safety in ensuring that what is prescribed is what is received,” she said.

Standardised colours of labels have also been chosen to address the needs of those with red and green colour blindness.

The IDDSI was developed by a group of volunteers worldwide from professions including speech pathology, nutrition and dietetics, medicine, occupational therapy, nursing, patient safety, engineering, and food science and technology.

Dr Cichero said their goal was to provide a common language to reduce choking deaths and other complications from dysphagia that could easily occur when labelling and names varied between care settings, states and countries.

She highlighted that choking was the second highest preventable cause of death in aged care and a 2015 NSW Ombudsman report into the deaths of people with disability in residential care that found confusion over the current terminology may have contributed to choking-related deaths.

“People over the age of 65 years have seven times higher risk of choking on food than children aged one to four years of age,” Dr Cichero said.

“If we are all speaking the same language and we can measure and ensure we have the right drink thickness and the right food texture for the person with swallowing difficulties each time they have a meal, we can reduce this risk.”

The IDDSI standardised terminology was implemented in New Zealand in January this year and, along with Australia, is due to be implemented in the UK and Canada next year.

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One Response to Global initiative aims to improve safety for residents with dysphagia

  1. Simon Gould June 5, 2018 at 4:54 pm #

    In recognition that second highest preventable cause of death in aged care (8%) and as quoted “People over the age of 65 years have seven times higher risk of choking on food than children aged one to four years of age,” We have introduced a new anti-choking device (LifeVac) that has already saves 11 lives after first aid has failed. Correct preparation of food, proper supervision and prompt first aid can reduce the risk but these measures sadly do no not always work.The LifeVac device is registered on the NDIS and can be used by carers and the individual themselves for the emergency relief of choking. We believe every aged care facility and disability carer should be equipped with this device.

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