Preserving Taste, Memory, and Dignity: Innovative Therapy for Patients with Dysphagia at Casas André Luiz .The human eating history begins simply and evolves throughout life. For most people, eating goes beyond a physiological need, becoming a source of pleasure and social interaction. However, not everyone can enjoy this privilege. There are individuals who face extreme difficulties, such as the inability to ingest food orally. While the majority of the population is born with normal bodily functions, some people deal with limitations caused by neurological, motor, or sensory problems. At Casas André Luiz, for example, the population served predominantly has neurological deficiencies, which often compromise the respiratory system and, consequently, the digestive system, leading to the need for oral food restrictions.
What is dysphagia?
Dysphagia is characterized by difficulty or inability to swallow. This condition can arise due to anatomical or functional anomalies that affect the phases of swallowing (oral, pharyngeal, or esophageal). Factors such as neurological injuries, lack or excess of saliva, incoordination of orofacial movements, intellectual disability, and aging can aggravate the condition. In more severe cases, oral feeding must be interrupted, and devices such as nasogastric or nasoenteric tubes are used to ensure the patient’s nutrition.
Alternative feeding methods
Nasogastric and nasoenteric tubes are indicated for temporary use, usually for up to six months. For severe neurological conditions, gastrostomy or jejunostomy are chosen, surgical procedures that insert tubes directly into the stomach or jejunum (part of the small intestine), allowing for safe and efficient nutrition. With the interruption of oral feeding, risks arise such as aspiration pneumonia, which can be fatal, and the gradual loss of taste memory, that is, the ability to recognize flavors, smells and temperatures of food.
The importance of taste memory
Taste memory is crucial for oral and respiratory health. In addition, taste and smell sensations have a significant emotional and social impact. Thinking about living without feeling the pleasure of food is challenging. To preserve these sensations in patients who cannot eat orally, Casas André Luiz offers tactile-thermal-gustatory stimulation therapy. This approach aims to keep taste memory active and minimize the risk of saliva aspiration, in addition to providing sensory pleasure.
How tactile-thermal-gustatory stimulation works
This therapy is indicated for patients who will not be able to reintroduce oral feeding in the short or medium term. The treatment uses sensory stimuli, such as flavors, textures, temperatures and movements, to maintain active oral perception. Intraoral exercises include stimulation of the tongue, lips, cheeks and other phonoarticulatory organs. Tools such as cotton swabs, spatulas, brushes and materials with various flavors (gelatin, juices, yogurt, purees) are used. The stimuli help to preserve taste functions, promoting a better quality of life for patients.
Contraindications and challenges
Not all patients can undergo tactile-thermal-gustatory stimulation. Cases of severe aspiration, global motor impairment or lack of prior stimulation during prolonged periods of restricted feeding are contraindications. However, for many, the treatment is a way of maintaining sensory connection with the world, even without the possibility of eating orally.
Impact on quality of life
Maria Cristina, diagnosed with spastic quadriplegic cerebral palsy, is an example. Admitted to Casas André Luiz since 1969, she needed a gastrostomy in 2008 due to recurrent pneumonia. Before the introduction of tactile-thermal-gustatory therapy, patients used to almost completely lose the ability to sense tastes, smells and temperatures after about a year without oral feeding. Today, quality of life has improved significantly. In addition to preserving taste functions, the therapy provides moments of pleasure and interaction.
The importance of care and attention
The professionals at Casas André Luiz, such as social workers and therapists, emphasize the emotional and sensory impact of therapy. Each smile and expression of patients when faced with new stimuli shows how valuable these sensory experiences are. Therapy not only promotes health, but also reinforces the dignity and well-being of those treated.
Conclusion
Currently, approximately 10% of the 1,600 patients at Casas André Luiz benefit from tactile-thermal-gustatory stimulation therapy. This treatment is performed with care and dedication, providing moments of flavor and pleasure to those who can no longer eat orally. With this, Casas André Luiz reaffirms its commitment to the health and quality of life of its patients, preserving taste memories and promoting well-being.
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