Dysphagia refers to difficulty swallowing, ranging from mild discomfort to severe inability to safely consume food and liquids. To objectively measure its severity, clinicians use assessment tools like the Functional Oral Intake Scale (FOIS). This scale provides a standardized method for evaluating a patient’s functional oral intake, guiding interventions and dietary recommendations.
What is the Fois Dysphagia Scale
The Functional Oral Intake Scale (FOIS) is a 7-point scale designed to quantify dysphagia severity by assessing an individual’s functional oral intake of food and liquids. It provides a structured way to document changes in eating abilities. The scale ranges from Level 1, indicating no oral intake, to Level 7, representing a total oral diet without restrictions.
Each level corresponds to a specific description of a patient’s ability to consume food and liquids orally, considering consistency and special preparations. For example, lower levels (1-3) indicate tube dependence, with varying degrees of minimal or consistent oral intake. Higher levels (4-7) categorize patients as having total oral intake, with distinctions based on dietary modifications or avoidance of certain foods. This structure allows healthcare professionals to categorize patients reliably and communicate consistently about swallowing status.
Using the Scale for Assessment
Clinicians use the FOIS by observing a patient’s eating and drinking abilities and conducting a clinical interview. This assessment evaluates the patient’s capacity to safely consume various food and liquid consistencies, such as purees, soft solids, or thin liquids. Observations may include identifying signs of swallowing difficulty, like coughing, choking, or strained effort during meals.
The assessment considers both what the patient can swallow and how safely and efficiently they do so. For instance, if a patient frequently coughs or shows signs of aspiration (food or liquid entering the airway), their score reflects a higher level of dysphagia. Trained healthcare professionals, such as speech-language pathologists, administer the FOIS to ensure accurate application. The score serves as a baseline for tracking progress and adjusting treatment plans.
Understanding Your Score
Understanding your FOIS score involves recognizing what each level signifies for dysphagia severity and daily eating. A score of 1 indicates no oral intake, meaning the patient is entirely dependent on alternative feeding methods, such as a feeding tube. Scores of 2 or 3 suggest tube dependence with minimal or consistent oral intake.
Scores from 4 to 7 indicate total oral intake, with distinctions based on dietary modifications. A score of 4 means total oral intake of a single consistency, like pureed foods, while a score of 7 represents total oral intake without any restrictions. Lower FOIS scores often suggest a higher risk of complications such as malnutrition, dehydration, or aspiration pneumonia (food or liquid entering the lungs). These scores guide healthcare providers in determining the need for further assessment, recommending specific dietary modifications, or referring patients for swallowing therapy.