Increasing disorder and therefore rely on healthcare professionals

Increasing life
expectancy and consequently, a higher demand of care for the elderly
demographic, illustrates nurses are more than likely to come across individuals
with swallowing deglutition disorders. In a study carried out in the community
by Wright et al. (2015), 792 individuals participated, in which 60% of those
participants stated they experienced difficulties in swallowing tablet or
capsule forms of medication (Wright et al, 2015). These statistics highlight
the prevalence and applicability of this condition in individuals who are
unlikely to have a formal diagnosis of a deglutition disorder and therefore
rely on healthcare professionals on admission to assess and act accordingly.

In accordance with
the NMC code, nurses have a duty of care to ‘accurately assess signs of
worsening physical health in the person receiving care’ (NMC, 2015:13) and ‘take
measures to reduce as far as possible the likelihood of mistakes and/or harm’
(NMC, 2015:14) – this means nurses are accountable for ensuring patients can
safely swallow their prescribed medications.

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Throughout my
training, I have encountered many individuals who have had difficulty in
swallowing their prescribed oral medications resulting in nurses being unsure
of whether to omit the medication, alter the dosage form i.e. crush the tablet
and/or patients being non-compliant. Because of this, I have observed the
potential harmful outcomes that can arise in this situation when patients are
given their routine medications, such as: patients aspirating with the
likelihood of developing aspirate pneumonia, the nurse-patient therapeutic
relationship being altered if patients encounter difficulties i.e. choking, and
the side effects of omitting medicines i.e. omitting Parkinson tablets, can
have a vast effect on the patient’s ability to maintain their independence.

I have chosen to
focus on the elderly demographic of 65 years and above as there are on average
11.8 million people over the age of 65 years in the UK with the population
expected to rise by over 40% before 2035 (Age UK, 2017). It is also estimated
of the 18.7 million individuals admitted to hospital in the UK last year, 7.6 million
were 65+ years and 4million of these admissions were patients with long term
illnesses (Age UK, 2017). In addition to this, individuals aged 65 years and
over were the highest category of people in the UK to experience medication
errors as an inpatient on older people’s wards in 2014/2015 (Age UK, 2017). Therefore,
from previous experiences as a student nurse and recent literature I have read,
I have decided to conduct this literature review on the prevalence of
medication modification in geriatric patients with deglutition disorders.