Support for Caregivers of Older Adults

• Feeding and swallowing difficulties are called dysphagia (dis FAY juh).

• Older adults are at risk when they have multiple medical conditions or take multiple medications with side effects causing swallowing problems.

• Swallowing problems can lead to poor health.

Causes of Swallowing Problems

Feeding and swallowing difficulties may be caused by:

• Disease or injury to the brain or nervous system
• Some examples include: stroke, brain injury, spinal cord injury, Parkinson’s disease, Lou Gehrig’s disease.
• Structural changes to the face, mouth, or neck
• These may be the result of surgery or cancer.

Risks from Swallowing Problems

• Aspiration – food or fluid enters the lungs
• When the person shows no outward signs (e.g. cough or throat clear) it is called silent aspiration.
• Choking – a blockage of the airway
• Poor nutrition and hydration
• Chest infections, development of chronic lung conditions

Signs and Symptoms

• Choking and coughing when eating or drinking or immediately after a meal
• Food left in the mouth after swallowing
• Trouble chewing
• Effortful or painful swallowing
• Food or fluid spilling from the mouth or nose
• Feeling as though food is stuck in the throat
• Regurgitation or vomiting
• Congested chest, lots of phlegm, recurring chest infections
• Unintentional or unexplained weight loss
• Poor food and fluid intake
• Long meals/feeding times
• Lack of enjoyment in eating

When to Seek Medical Advice

• Talk to your doctor when you
• have swallowing difficulty
• are concerned about signs and symptoms
• suspect or observe related problems such as compromised nutrition or hydration, or recurrent or chronic chest congestion or infections
• want a swallowing assessment.
• A doctor’s order is required for a swallowing assessment.
• Your doctor will complete a referral form which is sent to a speech – language pathologist or swallowing program.

Tips for Safe Swallowing

• Your speech – language pathologist will provide you with recommendations based on your swallowing test results.
• A modified diet may be necessary. Solid textures and fluid consistencies may be altered.
• Exercises and / or swallowing strategies and maneuvers may help.
• Some general strategies while waiting for an assessment:
• Take or present food or drink when awake and alert
• Wear dentures and other aids, e.g. hearing aids and glasses
• Sit as upright as possible
• Place food within reach and sight
• Allow enough time to complete a meal
• Complete one bite or sip or swallow before taking the next
• Provide supervision and cueing when helpful
• If feeding another person, sit at eye level and present food or fluid at midline
• Monitor for signs and symptoms of difficulty
• Remain sitting for 30 minutes following the meal
• Maintain regular oral care

Link to Related Topics

• Digestive Problems
• Hydration
• Nutrition