Speech-Language Therapy Considerations for Gastrostomy Indication in People with Neurodegenerative Diseases

Abstract

Caring for people with neurodegenerative diseases and dysphagia poses various clinical challenges. Gastrostomy (GTT) is a possible intervention in such cases, and speech-language therapists (SLTs) play a key role in recommending this form of support. This study aims to analyze the considerations of SLTs in Chile regarding GTT indication in people with neurodegenerative diseases and dysphagia. Methodology: This is a quantitative and exploratory study. A survey was conducted among 30 Chilean SLTs with at least five years of experience working with people with neurodegenerative diseases and dysphagia. Results: There is variability in the participants' considerations when recommending GTT. The severity of dysphagia, most commonly assessed using the FILS scale, emerges as the most influential factor in decision-making. Psychosocial aspects, such as the person's willingness and family support, also play a significant role. The interdisciplinary team typically includes neurologists, geriatricians, and intensivists. From an ethical perspective, there is a consensus that the final decision should involve the affected person and their family. Discussion–Conclusions: There is a need to develop standardized protocols for GTT indication. The importance of actively involving individuals and their families in the decision-making process is highlighted, as well as the need to ensure access to ethics committees in complex cases. The study has some limitations, such as its small sample size, which points to the need for further research.