Role of the Respiratory Therapist in the Care of a Person with Dysphagia

Prevention of Respiratory Complications

Dysphagia increases the risk of aspiration and aspiration pneumonia. The respiratory therapist plays a key role in:

Monitoring respiratory function
Detecting signs of silent aspiration
Responding promptly to respiratory distress
Preventing aspiration-related lung infections

Respiratory therapists are often among the first healthcare professionals to recognize the respiratory consequences of untreated dysphagia.

Care of Patients with a Tracheostomy

For individuals with dysphagia who have a tracheostomy (as in my own experience), the respiratory therapist is essential for:

Managing the tracheostomy tube (maintenance, replacement, monitoring)
Optimizing breathing and oxygenation
Assessing the impact of the tracheostomy on swallowing
Collaborating with speech-language pathologists during speaking valve trials
Ensuring safety during oral feeding trials

They play a central role in coordinating breathing, swallowing, and communication.

Respiratory Assessment Related to Swallowing

Although respiratory therapists do not assess swallowing itself, they evaluate:

Cough strength (an indicator of airway protection)
Ability to clear secretions
Presence of abnormal secretions that may indicate aspiration
Respiratory tolerance during meals

These observations help guide the healthcare team’s decisions regarding diet modifications, thickened liquids, and positioning strategies.

Interdisciplinary Collaboration

Respiratory therapists work closely with:

Speech-language pathologists
Dietitians
Nurses
Physicians
Occupational therapists

They provide critical information regarding breathing patterns, cough effectiveness, secretion management, and aspiration risks. Their input is essential for adjusting dietary recommendations and safe swallowing strategies.

Patient and Family Education

Respiratory therapists support individuals with dysphagia by teaching:

How to recognize signs of aspiration
How to protect the airway
How to safely use thickening agents and speaking valves
How to manage secretions and coughing
How to reduce the risk of pneumonia

Their educational role is especially important in home and community settings.

Contribution to Safe Nutrition and Hydration

Although not their primary responsibility, respiratory therapists contribute to safe eating and drinking by:

Monitoring respiratory consequences of meals
Reporting aspiration episodes
Adjusting respiratory interventions before or after meals
Supporting supervised feeding and swallowing trials

They are key partners in preventing serious complications.

The respiratory therapist protects the lungs, monitors breathing, prevents complications, and supports the healthcare team in the safe management of dysphagia.