Choking can happen to anyone at any time. Among the true medical emergencies that require immediate assistance, choking can cause brain damage and death within minutes — often before emergency professionals have arrived on the scene. Elderly people, especially those with disabilities, are especially prone to choking as muscles in the oral cavity weaken, mind-body coordination decreases and individuals forget to eat slowly and chew properly.

To prevent choking tragedies among the rapidly growing population of elderly people with developmental disabilities, the YAI/National Institute for People with Disabilities (YAI/NIPD) Network has established a cross-disciplinary Choking Committee to train staff in residential and day programs on how to prevent and respond to choking situations.

The committee comprises individuals from throughout the YAI/NIPD Network. Members include Fred Feibusch, Director, Kathleen Ziccardi, Nursing Administrator, Paula Gibly, Senior Coordinator, Florence Cino, Nursing Supervisor, and Deniz Altan, Brooklyn Regional Psychology Supervisor, of the YAI/NIPD Residential Department; Melissa Donner, Senior Speech Language Pathologist of Premier HealthCare; and Cheryl Jones, Senior Supervisor of the YAI/NIPD Brooklyn Respite Program.

Identifying Risk Factors

In order to enable staff to diminish choking situations for their consumers, the committee has developed an innovative risk-assessment tool that staff use to review their consumers on a regular basis in order to identify individuals who may be at a higher risk for choking.

“Direct service professionals have so much knowledge about their consumers and their behaviors and habits,” said Kathleen Ziccardi. “When we are able to provide supports, such as the risk-assessment tool, for staff members to utilize, lives can be saved.”

The tool is composed of 54 questions, such as whether a consumer has poor oral intake, experienced a recent weight change, eats while watching TV, has missing teeth or exhibits binge eating.

“Based on the answers provided by staff within the residence, doctors, nurses and speech and language pathologists may re-assess and make recommendations regarding levels of supervision during meal time, food preparation, food consistencies and goal setting,” said Melissa Donner.

“Developing the tool involved a great deal of time and contributions from people throughout our Network,” said Fred Feibusch. “We were able to utilize the expertise of people from a variety of disciplines, so we were able to create something useful and unique for people with developmental disabilities in residential and day settings.”

Responding to Emergencies

The Choking Committee is in the process of developing a training video to give direct service professionals the skills and knowledge to appropriately handle choking situations that may arise in their programs. The video and the risk-assessment tool will both encourage staff members to be alert and vigilant of warning signs that individuals may develop swallowing difficulties and also to react quickly and effectively in emergency situations.

The YAI/NIPD Network is proud to initiate advances in services for all people with developmental disabilities that foster their safety, well-being and independence.

December 2006