Drooling Over an App
Sometimes there's a beautifully simple and inexpensive solution to a troublesome problem. The problem is drooling, and the solution has been installed on my iPad for months, but I've only recently come to appreciate the power of a little app called Swallow Now
Every time you hear the click, you swallow - so simple, yet so effective. This interval timer can be set from 5-180 seconds. It also has options to use vibration or the Bluetooth earpiece on the iPhone to discretely cue the users to swallow their saliva. A spontaneous swallow of saliva happens about once per minute during waking hours in people with normal sensation. For those with decreased sensation, setting the app to go off every 30-60 seconds cues patients to swallow their saliva before it spills from their lips. This app is a perfect solution for stroke survivors with unilateral facial droop and numbness, as well as those with Parkinson's, MS, and other neurological conditions that reduce sensation.
After using this app for a period of time, users can develop a more consistent and frequent swallowing pattern that eliminates or reduces drooling, one of the most embarrassing sequelae of these conditions. Medications used to reduce saliva production can have undesired side effects; adding a medication to an already complicated regimen just for drooling also has its risks. This behavioral training program is a wonderful alternative and can be just as effective.
My patient just moved to rehab from acute care where she learned to rely on Yankauer suction for her saliva while being tube fed. Without suction available at the new facility, she quickly learned to dab at her lips with a towel or napkin. On day 2 of rehab, I tucked the iPod into her seatbelt and she successfully did not drool for hours, though her habit of wiping was still there. We're working on breaking that habit now, but I know that if this program had been implemented much earlier in her care, the results could have been even better.
Pros: The price ($2.99) is very reasonable. The sound it emits when the interval is reached is a very subtle wood-block knock; just loud enough to be heard without being too invasive. Nobody even needs to know you're using this app--the vibrate and Bluetooth options enable discrete use.
Cons: You have to turn off the sleep-mode on your device for it to keep working, which drains the battery pretty quickly. The app also advises that the vibration mode should not be used long-term, as that drains the battery even faster. You can't use any other app while using this one, limiting your device to a single-function; ideally it would run in the background. The sliding timer bar can be difficult to set to an exact number.
Note: This app is also sold as part of the Speech Pathology Toolkit, a multi-function app that contains a voice recorder, delayed auditory feedback, sound level meter, speech amplifier, and text-to-speech for $23.99. A promotional copy of this app was provided by the developer.