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7 Tips for Managing Dysphagia in Elderly Loved Ones


Difficulty swallowing food or liquids creates a serious and potentially fatal problem for seniors. Knowing tips for managing dysphagia in elderly loved ones is essential. Also known as dysphagia, this condition often leads to malnutrition, dehydration, or aspiration pneumonia. Experts estimate that this condition affects at least 15% of seniors and nearly 70% or more of nursing home residents. Our 7 expert tips for managing dysphagia in elderly people offers timely information caregivers need.

Dysphagia, a major cause of problems with swallowing, affects an estimated 6 million senior adults in the United States. Dysphagia (pronounced dis-fay-gee-ah) usually results from the weakening of mouth and throat muscles. Typical causes include aging, diseases like multiple sclerosis (MS), cancer, or Alzheimer’s, or from a medical trauma like a stroke.

How dysphagia is diagnosed

A dysphagia diagnosis is typically evaluated by a speech pathologist using a swallow test. The test requires the patient to swallow a contrast solution made of barium. Then the patient receives liquids of various consistencies to swallow from thin such as water to thicker honey or nectar, and finally a thicker pudding.

During the test, a continual x-ray shows the swallowing of each liquid. The x-rays demonstrates if the patient aspirates fluid into the lungs, a dangerous condition that causes pneumonia and other serious problems.

Sometimes other tests are needed such as an endoscope, an esophageal muscle test, or other imaging scans.

When the assessment is complete, doctors may recommend managing the diet with thickened liquids and purees, rather than continuing thin liquids. The thicker substances help prevent aspiration pneumonia.

When caring for someone with dysphagia, keep in mind these 7 tips for managing dysphagia in elderly people.


7 tips for safely managing dysphagia in elderly loved ones


1. Taking medicine

Any medications usually taken with water now need to be taken with a thickened beverage. Many elderly find these difficult to drink. An alternative is to crush them up and mix into a thicker food such as pudding or applesauce. To further disguise the taste of the pills, use a stronger flavored food such as chocolate or vanilla pudding or berry-applesauce.

Important: Some pills contain the label ‘not to be crushed,’ so always talk with the pharmacist about the medications your loved one needs. Ask how to proceed and if their pills can be crushed, and if you should avoid mixing them with anything specific. Sometimes they offer a change to a liquid version known as an ‘oral suspension’ of the medication. This can then be thickened for ease and safety of use.

2. Avoiding straws

Elderly sometimes find straws easier to use, especially if they are prone to spilling due to shaky hands. However, depending on the patient’s condition, a speech pathologist may suggest avoiding them for a dysphagia patient. While the straw is a helpful aid, they tend to increase flow rate of liquids in the mouth. The faster flow rate makes it more difficult for the patient’s weakened muscles to get the liquid down ‘the right pipe,’ leading to choking or aspiration.

3. Staying hydrated

Keeping your elderly loved one hydrated is important for good health. However, with a dysphagia diagnosis, all liquids, including water and other drinks, must be thickened. Because drinking thickened liquids takes longer than drinking non-thickened ones, managing healthy hydration requires even more patience and keener attention from you.

Thickening agents may come as gels or powders that are mixed in with a beverage – typically found in drugstores or online.


4. Skipping ice cream and gelatin

Many elderly adults enjoy a dessert or snack of Ice cream or gelatin. However, both of these cause problems when the person has dysphagia. The problem with these favored foods is that they often melt in the person’s mouth, turning them into a thin liquid. This melted liquid might cause aspiration or choking.

Note, for people with dysphagia, it takes their tongue and jaw longer to get foods to the back of the throat for swallowing. This leaves more time for things like ice cream  to melt into a thin liquid, making it dangerous.


5. Getting enough nutrition

Getting enough calories and nutrients challenges many elderly and dysphagia patients find it even moreso. Ask your loved one’s doctor about meal replacement drinks or supplements that are thick enough or may be thickened to the right consistency.

Over the counter drinks are often too thin and loaded with sugar and artificial ingredients, making them useless for the dysphagia sufferer.

Your doctor can offer some choices. However, by getting creative, you and your loved one might find the perfect combinations in your home.

Nutritious choices

Consider nutritious choices such as Greek yogurt, avocado, peanut butter, almond butter, and soft cheeses. These can be enjoyed as they are as a snack or dessert, or used within meals to boost calories and nutrition.

Other foods that work well include pureed winter squash, beans, and steamed vegetables. In fact, adding super vegetables such as broccoli, kale, and spinach is a quick way to increase nutrition. Also, fruits mash or puree well and can be enjoyed alone or as an addition.

Add any of these foods to soups and stews to thicken them and increase their nutrition. Creamed soups kept thick are often well-received by elderly loved ones and provide a warm comfort to them.

Ask your doctor about adding protein powders to the meals or snacks, too. Often, our older loved ones need additional protein to keep the muscles building and strong.


6. Posture

Important! Please always ensure that the dysphagia patient sits completely upright when eating and drinking. This helps food and drink go down more easily. When using a hospital bed or recliner, you might need to adjust their sitting position to ensure they are upright when eating and drinking.


7. Timing

Eating takes effort and energy. For people with dysphagia symptoms that accompany chronic illnesses like MS or Parkinson’s, extreme fatigue and weakness often makes eating for more than 15 minutes at a time completely exhausting.

The more tired your older adult is, the more challenging they find swallowing food and drink correctly. In fact, a speech pathologist often recommends that older adults eat and drink for short amounts of time spread out throughout the day.

Of course, a dysphagia diagnosis takes caregiving to the next level. Add to that,  managing care for an aging parent or older adult who already has other chronic conditions. Timing becomes more critical in these cases. You might need to break the meals into very small snacks throughout the day.


In Summary

Always seek your doctor’s help in assessing and managing dysphagia or other swallowing issues. In most cases, he provides current, fact-based information to help guide you.

Using his advice and the 7 tips for managing dysphagia in elderly loved ones, know that you are helping your loved one live a happier and healthier senior life.

Of course, speak with your  doctor right away if you notice any additional trouble swallowing or if you notice any dysphagia symptoms.

Read More

Managing Meals for Elderly

Why Do Elderly Have Trouble Swallowing


Managing Dysphagia in Elderly


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