Breathing, blinking, swallowing – these are some of the essential and automatic reflexes our bodies do hundreds of times a day, often without us even noticing. When we eat and drink, our natural swallow reflex is a complex, yet unremarkable function and we mostly do it without any concentration or focus. Sadly, this natural swallowing function changes over time and becomes more difficult for many elderly people who have a condition known as dysphagia.
Dysphagia is a significant problem because it affects how a person eats, drinks and takes vital medications. If someone affected by this condition does not seek or receive a proper diagnosis or medical treatment, they may simply avoid eating food and fluids, and this can quickly lead to many other serious complications including malnutrition and dehydration, weight loss, respiratory infections and even severe health issues.
Dysphagia is common among elderly people, affecting around 20 percent of people over 50 years. This is because it is a symptom of other diseases and conditions that impact cognitive function, such as a stroke, brain tumour, Motor Neuron Disease Parkinson’s disease and dementia.
The signs of dysphagia can develop gradually as a progressive disease advances, making detection difficult.
There are several early warning signs families and carers can look out for. Be watchful for changes in behaviour.
Does your elderly relative:
complain of being unable to swallow?
stop eating or drinking, or avoid social events involving meals?
cut food into smaller pieces or avoiding certain foods?
cough, gag or splutter when they eat or drink?
bring food back up (vomit or regurgitate) immediately after eating?
appear to produce excess saliva, drool or gurgle when they speak?
lose weight without significant change in health or circumstances?
have respiratory infections more often?
have slurred speech?
experiencing the sensation of food getting stuck in the throat or chest?
have frequent heartburn or reflux?
If you detect one or many of these signs occurring for your elderly relative, see your doctor for a referral to an Accredited Speech Pathologist or a swallowing specialist as the next step. A Speech Pathologist is trained in assessing swallowing difficulties, especially among the elderly, and can recommend the correct management strategy to help.
The strategies for managing dysphagia usually involve changing the way food and drinks are prepared so they are easier to swallow, without causing choking. This is called ‘texture modification’. It involves making food smoother with less need to chew. In the case of fluids, modifying the texture means making it thicker so it moves slowly down the throat. There are different levels of texture modification depending on the severity of the condition. For further information about texture modification levels, see the International Dysphagia Diet Standards.
A swallowing assessment will determine the highest level of texture that a person can safely manage and swallow.
Many people already enjoy foods that are naturally soft, such as mashed potato, yoghurt, soups, creamy pasta, eggs, custard and mousse, so they shouldn’t miss out on their favourites.
The important thing is to ensure food is nutritious and delicious, so dysphagia doesn’t become a barrier to good health and the positive wellbeing that comes with the enjoyment of food.
If you are concerned someone close to you may be having difficulty swallowing, please suggest they see a health professional for a medical assessment.