Title

Privilege and discharge decisions for psychiatric inpatients with dysphagia

UMMS Affiliation

Department of Psychiatry; Center for Mental Health Services Research

Date

10-1-1992

Document Type

Article

Medical Subject Headings

Activities of Daily Living; Airway Obstruction; Behavior Therapy; Combined Modality Therapy; Death, Sudden; Decision Support Techniques; Deglutition Disorders; *Hospitalization; Humans; Patient Care Planning; Patient Compliance; *Patient Discharge; Risk Factors

Disciplines

Psychiatry

Abstract

Psychiatric patients have an increased risk for choking compared with the general population because of risk factors such as medication side effects and food gorging. A state hospital program for managing patients with dysphagia, or difficulty swallowing, includes interventions such as modified diets, mealtime monitoring, and adjusting psychotropic medications. Clinicians may find it difficult to make decisions about privileges and placement for dysphagic patients who do not comply with dietary modifications in unsupervised settings. For many such patients, close supervision and even placement on a locked ward may seem necessary. The authors recommend a risk-benefit approach: clinicians must balance the safety afforded by restrictions against the benefits of increased privileges or placement in a less restrictive setting. Quality of life and patients' preferences must also be considered.

Rights and Permissions

Citation: Hosp Community Psychiatry. 1992 Oct;43(10):1023-5.

Related Resources

Link to Article in PubMed

PubMed ID

1398566