Aiko Osawa

By Aiko Osawa and Shinichiro Maeshima

Swallowing disturbance often causes by stroke and may predispose patients to malnutrition and dehydration, as well as increases the risk of such complications as suffocation and aspiration pneumonia. As an initial evaluation, the water swallowing test can be easily carried out, but not all of the aspiration can be excluded. Therefore, videofluorography (VF) and videoendoscopic examination (VE) of swallowing should be performed to find a safety method of oral intake for providing visualization of the pharynx and larynx dysfunction. Clinical severity scale is important because once the severity is determined, the treatment strategy is also known. Swallowing training can be divided into indirect training without food (basic training) and direct training with food (eating training). In general, it is important to select conditions and training diets that are easy to swallow and have a low risk of aspiration while using indirect training and direct training that aim at gradually improving the level of oral intake.

Part of the book: Voice and Swallowing Disorders

By Koki Kawamura, Shinichiro Maeshima, Aiko Osawa and Hidenori Arai

The coronavirus disease 2019 (COVID-19) pandemic has had a major impact on society and our lives. Many older people and those with underlying medical conditions have refrained from social activities and become housebound, increasing the risk of frailty. Therefore, we developed the Home Exercise Program for Older People, a multidisciplinary program that makes it easier for older people to exercise at home. We also provide outpatient rehabilitation for not only those affected by COVID-19, but also older people with frailty who have become confined under the COVID-19 pandemic. In this chapter, we overview the situations and lives of older people in Japan under the COVID-19 pandemic and discuss preventive strategies.

Part of the book: COVID-19 Pandemic, Mental Health and Neuroscience