Informed refusal?
Author: Moira Wares
Magazine issue: Summer 08
Page numbers: 4-6
Date: 31 May 2008
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Looking back on five years of managing a dysphagia caseload in a special school, Moira Wares became concerned about an emerging pattern of adolescent clients with complex needs starting to clench their teeth together and turn their head away when offered food. She decided to investigate the literature to help her plan how to approach future cases. Moira considers the influence of oral-motor problems, acute events, gastroesophageal reflux, nausea, constipation, dental problems, medication and reduced endurance as well as psychological issues such as negative feeding experiences, mental health problems and fear. She sets out her plans in light of the evidence and questions her previous view of gastrostomy.
