Dysphagia Management (Compensatory, Rehabilitative, IDDSI)
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Management aims for safe, adequate nutrition and hydration with the least restrictive plan the person accepts. Match each strategy to the physiology seen on instrumental assessment, confirm that it helps that person, and revisit it as swallowing changes.
Compensatory vs. Rehabilitative Strategies
| Feature | Compensatory | Rehabilitative |
|---|---|---|
| Goal | Safer or more efficient swallows now | Lasting change in swallowing physiology |
| Effect | Only while the strategy is used | Builds over weeks of practice |
| Examples | Postures, bolus and diet changes, pacing, airway-protection maneuvers | Shaker, EMST, MDTP, effortful swallow and Mendelsohn practice, Masako exercise |
Some maneuvers do both: the effortful swallow and Mendelsohn can be used during meals (compensatory) or practiced to change physiology (rehabilitative).
The rest of this outline 5
- IDDSI Framework (International Dysphagia Diet Standardisation Initiative)
- Swallowing Maneuvers and Exercises
- NPO (Nothing Per Os) Considerations
- Common Traps
- Sources to Know
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