First community-based dysphagia management programme to help people with swallowing difficulties

5 November 2009 – From October 2009, the elderly and people with disabilities are able to receive affordable professional speech therapy services in community-based organisations to help them with their swallowing problems. Launched by the Society for the Physically Disabled (SPD), the Dysphagia Management Programme (DMP) is the first community-based swallowing management programme.

Dysphagia is a condition whereby a person has difficulty moving food from his/her mouth to the stomach. Research has shown that swallowing dysfunction occurs as one ages due to changes in the swallowing anatomy and also arises due to medical conditions such as stroke and Parkinson’s disease. The prevalence of dysphagia is estimated to be about 30% to 50% in the intermediate- and long-term care (ILTC) sector based on overseas studies. In light of the growing elderly population in Singapore, the number of cases of dysphagia in Singapore is likely to increase.

Through the DMP, SPD aims to plug a service gap which was revealed in a survey it conducted in May 2007 among professionals working with elderly clients. The survey showed that there was a gap between the demand and current services available for speech therapy services for the elderly population. Nursing home staff were found to have limited knowledge of managing clients with swallowing problems and ILTC facilities were found to have minimal access to services for dysphagia management.

The new dysphagia service will enhance the quality of care for the clients and residents of community and ILTC institutions such as nursing homes and day rehabilitation centres. Professional speech therapists under the DMP conduct screenings and assessments and formulate intervention strategies to help people with swallowing difficulties. They also train caregivers and staff of ILTC facilities to identify clients with swallowing difficulties and equip them with the skills to manage the condition.

Treatments under the DMP include conventional methods and/or electrical stimulation. The DMP aims to help 250 people with swallowing difficulties and 250 caregivers and staff of ILTC facilities by October 2011.

The programme is offered both as an outpatient treatment to individuals at the SPD Rehabilitation Centre or at the clients’ homes, or as an on-site consultancy and therapy service package to institutions such as nursing homes or day rehabilitation centres. Individual clients pay a highly-subsidised rate of $32 to receive services at SPD’s Rehabilitation Centre. This is significantly less than the charges at private clinics where clients can expect to pay up to $150 for similar services. Further subsidies are also available for needy clients on a means testing basis. The DMP is supported by the Ministry of Health (MOH) which is helping to fund a large part of the $500,000 pilot programme for two years.

Dysphagia management in the community will be one of the topics to be highlighted at the one-day Reinventing Community-Based Geriatric Rehabilitation symposium to be held on 7 November 2009 at the SPD Ability Centre. Jointly organised by SPD and Ang Mo Kio-Thye Hua Kwan Hospital, the symposium brings together rehabilitation professionals to share their experiences and discuss issues pertaining to the sector, as well as ways to build the sector’s capability to cope with rising demands. It also aims to increase awareness of the best practices in geriatric care and understanding of trends and services, and to advocate for continual improvement in the sector by providing a platform for the sharing of knowledge and resources. Participants include representatives from community hospitals, community rehabilitation providers and allied health training institutions.

Mr Kunal Kanti Ghosh, assistant director of clinical services at the SPD Rehabilitation Centre said, “By co-organising this symposium and setting up the Dysphagia Management Programme (DMP), we look towards partnering other healthcare organisations and strengthening the professionalism of the ILTC sector, thereby meeting real needs and serving the elderly and people with disabilities in better ways.”