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Dysphagia: When swallowing is an issue

April 5, 2019

 

 

Did you know that approximately 6 million seniors in the US have difficulty swallowing? As people age, their throat and mouth muscles tend to weakening, often resulting in a condition called dysphagia. Dysphagia can be caused by dementia, diseases such as cancer, Parkinson’s, or multiple sclerosis, gastro-esophageal reflux (GERD), or from strokes or similar medical traumas.

 

If your loved one is choking often, even with liquids, talk to their doctor about testing for dysphagia. Dysphagia can lead to serious complications including:

  • Dehydration

  • Malnutrition

  • Infections

  • Aspiration pneumonia

Patients with dysphagia have nearly twice the chance of dying while hospitalized than patients who do not have swallowing difficulties. According to an article published by University of Wisconsin-Madison School of Medicine and Public Health, in a five-year study, patients diagnosed with swallowing problems had an average hospital stay that was 3.8 days longer, hospital bills that averaged $6,243 higher, and following discharge, were 33 percent more likely to need nursing-home care.

 

“This is a huge quality-of-life issue for patients,” explains David Francis, MD, assistant professor of surgery and an otolaryngologist with UW Health. “Imagine not being able to eat food when you are hungry, or take a drink when you are thirsty. Much of our daily lives revolve around dining.”

 

The good news is that there are a variety of ways to treat dysphagia, provided it has an early diagnosis. From changing the consistency of the foods or liquids so they are not aspirated into the lungs as easily to protecting the airways by teaching new ways of swallowing.

 

Here are some issues faced by seniors suffering from dysphagia:

 

Medications

 

One of the issues that often arises involves safely taking medications when someone has dysphagia. Adding the pills to pudding or applesauce makes them more palpable if they can be crushed. Note: it is essential that you speak with the pharmacist before crushing any pills, as some are labeled “not to be crushed.” Additionally, there can be problems with the medications if they are mixed with certain substances, so always ask first!

 

If pills have to be swallowed whole, they’ll generally have to be taken with a thickened drink.

 

Straws

 

While you might think straws would make it easier for the patient, this is usually not the case. Straws tend to move the liquid into the mouth more quickly, making it harder for the patient to direct it to the right pipe. Obviously, this can lead to choking.

 

Nutrition

 

Proper nutrition is a particularly difficult challenge for those suffering with dysphagia. Often, well-meaning caregivers will add Ensure or Boost to the diet. Unfortunately, this isn’t the best option, as these drinks are full of sugar and artificial ingredients (read the labels!). Replace these “fake” nutrition drinks with milk blended with bananas, squash, or peanut butter.

 

According to an article in DailyCaring.com, here are some ways to incorporate whole foods and nutritional ingredients into a dysphagia diet:

  • Add high fat foods such as Greek yogurt, avocado, peanut butter (yes, peanut butter!), coconut cream, and soft cheeses.

  • Puree foods like fruits, steamed vegetables, beans, and winter squash. These will pack on lots of necessary nutrients. Add them to thickened soups for even more nourishment.

  • Blend heavy creams or ice cream with other ingredients to thicken them.

  • Add protein powders or therapeutic drink mixes to the diet to help seniors maintain their weight. As always, check with their medical team before doing so.

Hydration

 

It goes without saying that hydration is a key element in maintaining good health. When you’re dealing with someone with dysphagia, remember to always thicken their drinks, including water. Keep in mind, it takes longer to drink thickened liquids, so your patience is a key factor here. Ask their doctor for recommendations regarding thickening agents.

 

Posture

 

During your growing up years, you may have heard the phrase, “Sit up straight!” multiple times by your parents. Now it’s time for payback. While they were simply caring about your posture, you now need to care about theirs. It is vital that a senior with swallowing difficulty sits up straight each and every time they are given something to eat or drink.

 

If they are too weak to sit up properly, the caregiver must hold their head up in order for the food and drink to go down correctly.

 

Timing

 

Fatigue can be a factor when it comes to eating for the elderly. That’s why it’s important to give them food and drink throughout the day rather than three large meals they may have been accustomed to. Eating for more than 15 minutes or so just might be too exhausting, particularly for those with chronic illnesses.

 

 

Now that you know the challenges and problems associated with dysphagia, it’s time to consult with your loved one’s doctor or a speech pathologist. A diagnosis is just the first step. In many cases, the rest is up to you.

 

 

 

 

 

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