Alex Sherman (Dietitian), Domenico, and Theresa Cavanagh (Speech Pathologist)

3 March 2025

81-year-old Domenico suffered a stroke in November last year which left him with severe oropharyngeal dysphagia - a swallowing disorder that makes it hard to move food from the mouth into the throat.

Dom was unable to manage swallowing even his own saliva after the stroke and was put on a pureed diet and thickened fluids to make swallowing safer.

After the stroke Dom also lost his appetite and drive to eat. Despite being provided a nourishing diet and supplements, he started to lose weight and muscle tone and slowly became malnourished.

After consultation with the medical team, speech pathologists and Dom’s family, our Dietetics team advocated for a two-week trial of nasogastric feeding, whereby a thin tube is inserted through a person's nose, down their throat, and into their stomach, allowing liquid food, water and medicine to be delivered directly to their stomach. This is method is used when a patient can't eat normally due to swallowing difficulties or for other medical reasons.

The feeding tube aimed to improve his nutrition and prevent further loss of weight. During the two-week trial, Dom met 100 per cent of his nutrition requirements and began to feel energetic again. He had enough energy to actively participate in his dysphagia rehab sessions with the Speech Pathology team. However, Dom still struggled to regain function in his throat and the treating team discussed the possibility of inserting a permanent gastrostomy tube as a long-term nutrition support option, which is a feeding tube passed directly through the abdomen into the stomach.

This conversation proved to be a turning point for Dom who was determined to regain his independence. The Dietetics team developed a new nutrition plan for Dom and educated Dom and his family about ways they could boost nutrition intake and fortify his diet. The team built a weekly table of foods Dom would need to eat to meet his body’s requirements and Dom was able to check items off this list each day.

Come time for the next clinical review, Dom was doing well enough to remove his feeding tube!

With the help of Dom’s treating team, he was able to safely discharge from the hospital and return home with his wife Maria, where our Better at Home team, a hospital in home healthcare service, continued to support him and his family.

Dom continues to tick off items in his weekly table of supplements, and can now enjoy his favourite foods again, albeit with slight modifications to allow safe swallowing!