I have always been interested in conditions which affect the quality of life of older people. I suppose I fell into being interested in dysphagia because I have a great interest in incontinence. Many people who struggle with incontinence also struggle with swallowing difficulties such as people with Parkinson’s disease, Strokes, Dementia and even just being unwell in hospital when the body and brain become more vulnerable and do not function effectively. I realised that the more I looked for swallowing difficulties in people I saw, the more I found. This was not limited to people I saw within my care of the elderly role but also on my acute on call medical role where many people are admitted to hospital with situations of an unsafe swallow such as with throat, mouth or oesophageal cancer, or as a consequence of treatment such as radiotherapy or people who have survived to adulthood with cerebral palsy. The joy of being a care of the elderly doctor is that I always work within a team, and the two team members I always consider are a speech and language therapist and a dietitian. One thing is also for certain – the population is ageing and therefore so are the numbers who have diseases that can affect the swallow.
I chat with people lots on my ward rounds and am always interested in how they live with swallowing problems. Of course it is important to keep people safe in terms of their swallow but I always wondered if we could make things taste more pleasant and exciting. It is also very difficult watching someone who can’t swallow properly make decisions about continuing to eat food ‘at risk’ or make a sacrifice and not be able to eat again. Eating is such a joy both personally and culturally so losing the ability to eat freely is a very hard concept to understand for most people.
People who have swallowing difficulties requiring changes in consistency are often served bland food which has been ‘whizzed’ and it always looks a bit ‘beige’ but there are currently limited options and these people cannot just pop out to local restaurants as their needs are not catered for. I have friends who are dairy intolerant or have allergies to shellfish and most restaurants bend over backwards to accommodate their needs – so why not for people with swallowing difficulties?
The mission for Eating with Dignity fits with what I believe and therefore here I am.
Dr Vikky Morris BSc MBBS FRCP
Consultant Care of Older People and Acute Medicine