Multidisciplinary Team Approach for Safe Resumption of Oral Intake: Clinical Strategies and Outcomes

Background: Deterioration of swallowing function markedly impairs quality of life, a problem particularly significant in Japanʼs rapidly aging population. Dysphagia management remains challenging due to limited clinical resources and lack of an organized support system. Objective: To illustrate the effectiveness of multidisciplinary collaboration in facilitating the transition from home parenteral nutrition (HPN) to complete oral intake. Case Presentation: A 66-year-old woman with severe dysphagia secondary to submandibular gland inflammation and prolonged impaired consciousness was maintained on total parenteral nutrition (TPN) during hospitalization because oral intake was deemed impossible. After discharge on HPN, a multidisciplinary home-care team─comprising physicians, nurses, registered dietitians, and certified dysphagia nurses─ initiated structured dietary and swallowing interventions. The patient restored full oral feeding within one year through structured assessment and staged texture advancement. Results: Swallowing ability improved from Repetitive Saliva Swallowing Test (RSST) 0, Modified Water Swallowing Test (MWST) 0 and Kuchikara Taberu Balance Chart (KTBC) 22 to RSST 3, MWST 4 and KTBC 53. Oral intake reached 1200 kcal/day, allowing discontinuation of HPN. Conclusion: Coordinated multidisciplinary collaboration with continuous information sharing between care settings enabled safe restoration of oral intake in a patient previously judged unable to eat orally. Regular reassessment of swallowing function is crucial to identify patients with recovery potential.