Some seniors suffer from swallowing problems that severely impact health and wellbeing. This problem can make mealtimes nerve-wracking and challenging for seniors and caregivers alike. If you know an older adult who struggles with this problem, keep reading to learn how you can help.
Updated April 21, 2022.
Swallowing Problems In Seniors
Swallowing is a complicated bodily process that begins not when you eat but when you first look at food. This prompts your salivary glands to start producing saliva, and when your food or beverage reaches the soft palate in the rear of the mouth, it triggers the involuntary reflex known as swallowing.
Of course, most people don’t think twice about swallowing when they eat or drink. But as we age, our mouth and throat muscles naturally weaken, making it difficult to eat certain foods. For some, this issue may only require a few diet changes. But for those who suffer from dysphagia, neural and muscle functioning complications can make eating and drinking a major, long-lasting concern.
It’s one thing if your loved one occasionally struggles to swallow. But it could be a sign of dysphagia (or difficulty swallowing) if it happens consistently.
Dysphagia is a significant health concern. Left untreated, it can lead to many problems such as:
- Appetite loss
- Weight loss
- Lower medication efficacy
- Aspiration pneumonia
This condition can occur to anyone regardless of age but is most common in seniors. According to a 2021 study published in Mayo Clinic Proceedings, dysphagia affects 10% to 33% of older adults. Researchers also noted that it often occurs to those “who have experienced a stroke or neurodegenerative diseases such as Alzheimer’s or Parkinson disease.”
Signs of Dysphagia
There’s a difference between occasionally having difficulty swallowing and dysphagia. You should talk to your loved one’s doctor right away if swallowing problems are a common occurrence or you notice the following signs of dysphagia:
- Coughing while drinking or eating
- Choking on liquids, medication, or food
- A “gurgly” voice, particularly after meals or drinking
- Trouble swallowing food and liquids
Of course, not everyone can eat with an aging loved one. Whether you’re a long-distance caregiver or just live across town, you can ask your loved one these questions to determine if you should take action:
- Do you frequently cough or choke after a meal or drink?
- Does your food often feel like it’s going down the “wrong tube” or the “wrong way”?
- Does it feel like your food frequently gets stuck in your throat?
- How much time do you usually take to eat?
- Do you feel like eating is less enjoyable at times?
- Have you lost weight without meaning to?
Causes Of Dysphagia
Dysphagia can occur from any number of swallowing problems, so it’s critical to address it with your loved one’s doctor. Some of the most common causes of dysphagia include:
- Wrong-sized dentures
- Poor oral health
- Age-related muscle weakness
- Acid reflux
- Alzheimer’s, dementia, or other cognitive disorders
- Mouth, throat, or esophageal cancers
Sometimes, elders may have swallowing problems because their salivary glands do not produce enough saliva or they have dry mouths. Several things can disrupt saliva production:
- Medication: There are more than 400 medications that lower saliva production or change its chemical makeup, so it becomes less effective. Anti-depressants, hypertension, incontinence, and allergy medications often have side effects that can impair salivary glands.
- Diabetes and Parkinson’s: These diseases can cause dry mouth, and Parkinson’s can cause muscles used for chewing and swallowing to weaken.
- Cancer treatment: Radiation and other cancer treatments for the head or neck can block or completely stop saliva production. Chemotherapy can cause saliva to thicken, which causes the mouth to feel sticky or dry.
- Injury: Nerve damage in the head or neck can impair the body’s ability to regulate salivary production.
How Is Dysphagia Diagnosed?
A speech pathologist and registered dietician can diagnose swallowing problems.
First, the speech pathologist will conduct a swallow test to determine whether or not your loved one’s swallowing problems are actually dysphagia. For the assessment, patients undergo an X-ray after drinking a contrast solution comprised of barium. Next, the patient drinks various liquids during the X-ray, including water, nectar thick, honey-thick, and pudding thick. This test identifies signs of aspiration, which can lead to pneumonia and other complications. Aspiration occurs when liquid enters the stomach instead of the lungs.
Once diagnosed, treatment will vary based on the underlying cause. A speech therapist can make suggestions to address the problem, such as:
- Adjusting your loved one’s posture while eating and drinking
- Strengthening exercises for throat and neck muscles
- Safer ways to swallow food and beverages
- Food preparation techniques to make swallowing more manageable, such as pureeing
- Mixing thickeners in liquids to promote swallowing
Then, a dietician can recommend the best types of foods to avoid the risk of choking and make it easier for your loved one to swallow. In addition, a dentist may assess possible underlying oral health issues, such as poorly-fitting dentures, oral hygiene, gingivitis, or thrush.
How To Manage Swallowing Problems At Home
Watching your loved one struggle with swallowing problems is heartbreaking, but these suggestions may help:
- Choose soft, moist foods that are easy to swallow, such as oatmeal, soup, tuna salad, or noodle casseroles. Additionally, canned fruits contain lots of water and can help with hydration.
- Stay away from crumbly foods, like crackers, since they can cause choking or gagging. If dry foods are the only option, use non-spicy sauces to soften them.
- Avoid grainy foods like rice, and opt for something like mashed potatoes instead.
- Avoid spicy and salty foods since they can exasperate dry mouth by irritating the tissues and absorbing moisture.
- Steam vegetables instead of serving them uncooked. You can easily flavor steamed vegetables with spices or pasta sauce.
- Puree food for seniors who have particularly dry mouths.
- Chew sugar-free gum or suck on sugar-free candy between meals to promote saliva production.
- Drink eight cups of water every day. Swallowing problems often make it difficult for elders to notice thirst, making it easy to become dehydrated. Dehydration also impedes saliva production.
- Avoid ice cream or gelatinous deserts because they can liquify while eating and possibly cause aspiration when swallowed.
- Crush and mix oral medications with pudding or applesauce, or take with a thickened drink. Stronger, sweeter flavors can help cover some of the bad taste.
- Don’t use straws, as they increase the volume of liquid in the mouth, raising the risk of choking.
- Allow plenty of time to eat, and avoid rushing your loved one.
- Reduce distractions such as the TV.
- Eat with friends and family if possible, since the company can put your loved one at ease and encourage a more leisurely mealtime.
Does Your Loved One Suffer From Swallowing Problems?
Difficulty swallowing, or dysphagia, is a serious concern that commonly affects older adults. Dysphagia can be caused by various factors, from neurological disorders to muscle weakness in the mouth and throat to incorrectly-fitted dentures.
There are a few things you can do to make eating and drinking easier. Some simple diet changes, focusing on better posture while eating, and giving your loved one plenty of time to eat are just a few things you can do at home in addition to following a professional treatment plan.
Seeing a loved one struggle with swallowing problems is alarming. However, if you have concerns about your loved one’s safety at home, we can help. Our care coordinators can connect you with a home health professional who has the training and expertise to help your loved one during mealtimes. Call 1 (888) 541-1136 or email firstname.lastname@example.org to book a meeting.
For more resources for seniors and caregivers, visit the Blog.
This article was originally published on August 24, 2020, and updated on April 19, 2022.
- DailyCaring Editorial Team. (n.d.). Why do seniors have trouble swallowing? DailyCaring.com. Retrieved April 21, 2022, from https://dailycaring.com/why-do-seniors-have-trouble-swallowing/
- Hegg, J. (n.d.). Tips For Seniors And Caregivers Managing Dysphagia. DailyCaring.com. Retrieved April 21, 2022, from https://dailycaring.com/7-helpful-tips-for-seniors-and-caregivers-managing-dysphagia/
- Keller, M. (2011). Dealing With Dysphagia. TodaysGeriatricMedicine.com. Retrieved April 21, 2022, from https://www.todaysgeriatricmedicine.com/archive/winter2011_p8.shtml
- Mayo Clinic Staff. (n.d.). Dysphagia. MayoClinic.org. Retrieved April 21, 2022, from https://www.mayoclinic.org/diseases-conditions/dysphagia/symptoms-causes/syc-20372028
- Thiyagalingam, S., Kulinski, A. E., Thorsteinsdottir, B., Shindelar, K. L., & Takahashi, P. Y. (2021). Dysphagia in older adults. Mayo Clinic Proceedings, 96(2), 488–497. https://doi.org/10.1016/j.mayocp.2020.08.001