What is Dysphagia?

There are three phases of swallowing that occur when we eat and drink. The oral phase occurs when we suck, chew, and move food and liquid into the throat. Next, the pharyngeal phase takes place when we start to swallow and squeeze food down the throat. Lastly, the esophageal phase squeezes food down into the stomach where we digest it. The definition of dysphagia is difficulty or discomfort in swallowing, as a symptom of disease. People with dysphagia will have difficulty with one or more phases of swallowing. While it’s normal to occasionally cough or feel uncomfortable while swallowing, those with dysphagia experience this difficulty a lot of the time. There are a number of different causes of dysphagia which affect people of all ages but is more common in older adults.

Causes of Dysphagia in Older Adults

According to the Mayo Clinic, there are a number of conditions that can weaken or damage the muscles we use to swallow, causing us to choke, gag or cough. While anyone can experience dysphagia, older adults are at a higher risk of developing this condition. There are some illnesses and diseases that increase this risk for older adults. Certain neurological disorders such as multiple sclerosis, muscular dystrophy, Parkinson’s disease, Alzheimer’s disease and other forms of dementia can cause dysphagia. Sudden neurological damage, like that caused from a stroke, brain or spinal cord injury can affect our ability to swallow and increase the risk for developing a swallowing disorder. Even some cancers, especially those that require radiation treatments have been linked to dysphagia in older adults. While these conditions increase the risk of dysphagia, natural aging and normal wear on the esophagus can also cause the condition to develop.

Symptoms of Dysphagia

In addition to having problems swallowing or being unable to swallow completely, there are some common symptoms of dysphagia, according to NHS:

• Coughing or choking when eating or drinking
• Bringing food back up, sometimes through the nose
• A sensation that food is stuck in your throat or chest
• Persistent drooling of saliva
• Being unable to chew food properly
• A gurgly, wet-sounding voice when eating or drinking
• Repeated chest infections
• Weight loss over time

Tips for Managing Dysphagia at Home

To diagnose dysphagia, a speech pathologist will typically administer a swallow test, which involves ingesting a contrast solution and then swallowing liquids of different consistencies while being continually x-rayed. The test looks for aspiration, where liquid goes to the lungs instead of the stomach. While there are different treatments and exercises to help treat dysphagia, there are a few things you can be doing at home, especially if you are caring for someone with this condition:

• Use thickened liquids. If you or your loved one takes oral medication with water, start using a thickened liquid instead. If the medication allows, you might also consider crushing the pill and mixing it with pudding or applesauce to mask the flavor.
• Avoid straws. Typically speech pathologists will suggest avoiding straws because they are more likely to increase the amount of fluid that flows into the mouth, increasing the risk of aspiration or choking.
• Alter your eating habits. Instead of eating large meals, the Mayo Clinic recommends eating smaller meals more frequently. In addition, make sure to cut food into small pieces, chew until the food is similar to applesauce in its consistency and eat slowly.
• Experiment with a new dysphagia diet. Experiment with different foods to find what works best for you. Some people have difficulty with super thin liquids like coffee and juice, while others struggle with sticky foods such as peanut butter.
• Limit alcohol and caffeine consumption. Both alcohol and caffeine can cause your mouth to become more dry, making it difficult to swallow.  

Dysphagia Treatment

If you’re experiencing continuous problems with swallowing, you should always consult your health care provider before making any changes yourself. Before your appointment, you may consider making a list of your symptoms, even those that seem unrelated to swallowing. Write down any new life occurrences such as recent diagnoses, changes in the home or other major life changes. In addition to your list of medications, be sure to think about any questions you might want to ask your health care provider. Most treatments for dysphagia, including speech therapy, are included in the standard Medicare coverage.

Your physician may also recommend doing swallowing exercises at home to strengthen the tongue in order to improve swallowing. According to Johns Hopkins Medicine, tongue strengthening exercises are often used in coordination with other treatments such as dietary changes, changes in eating positions, medication and in severe cases, surgery. These swallowing exercises are easy to do at home and may provide some relief when done consistently. During these exercises a speech pathologist may ask you to do the following exercises, as noted by Johns Hopkins Medicine:

• Stick out your tongue as far as you can and put pressure on it with a tongue depressor or spoon. Push your tongue with the flat object while also using your tongue to push back. Hold for a few seconds and then repeat.
• Extend your tongue as far as possible to the corner of your mouth while pushing against a depressor. Hold for a few seconds and then repeat on the other side of your mouth.
• Extend your tongue behind your teeth. Curl your tongue back toward the back of your mouth. Hold and repeat.

Living Well at Maplewood Senior Living

Getting older has a lot of benefits, but it also comes with its own set of unique challenges. At Maplewood Senior Living, we strive to ensure that all residents have the resources they need to live a full and healthy life. This includes a high-quality medical team that prioritizes resident wellness and offers support to family members and other loved ones. To learn more about our offerings, medical and otherwise, please contact us or schedule a tour today!