Difficulty in Swallowing: Understanding Dysphagia in Seniors

Eating is a pleasure for most of us, but the experience can become unpleasant when swallowing becomes difficult. Have you ever come across the term ‘dysphagia’ when browsing through articles and social media feeds?

Dysphagia is a condition where one has difficulty swallowing. Read on to learn more about this condition and how proper speech therapy can help prevent dysphagia and strengthen the muscles to regain your swallowing ability.

Jump to the following section:

• What is dysphagia
• What you can do to prevent dysphagia
  
• When you should seek help
• How does dysphagia affect your loved ones
• What are some tips for coping with swallowing problems
• How can seniors overcome swallowing difficulties
• Client profile: Speech Therapy

What is dysphagia

Dysphagia is a medical term for swallowing difficulties, where some people have problems swallowing certain foods or liquids, while others can’t swallow at all. There are three main stages of dysphagia, namely oral (mouth), pharyngeal (throat) and esophageal (food pipe). Dysphagia can happen at any or all stages of swallowing from the mouth to the stomach. In the long run, Dysphagia can have devastating effects on health including risks of choking, aspiration pneumonia, dehydration, malnutrition and poor quality of life. In more serious cases, it can also make taking medication more difficult.

Some common symptoms of dysphagia include:

• Inability or difficulty swallowing solid foods and/or liquids
• Pain and feeling of discomfort in the throat when swallowing
• Choking or coughing while drinking and eating
• Unpleasant sensation of having something stuck in the throat
• Shortness of breath while eating or swallowing
• Persistent drooling of saliva
• Spilling of food/drink from the mouth
• Unable to chew food
• A gurgly, wet- sounding voice when eating or drinking
• Pocketing food in the mouth
• Unexplained weight loss

What you can do to prevent dysphagia

Typically, dysphagia is caused by other health conditions which affect one’s nervous system such as a stroke, head injury, multiple sclerosis, Parkinson’s disease, dementia and cancer. Hence, one should try to keep healthy and avoid any preventable medical conditions.

When you should seek help

However, while these are some symptoms of dysphagia, many other conditions also share these common symptoms. Therefore, if your loved ones present any of the symptoms mentioned, it is best to consult a doctor for a proper diagnosis.

How does dysphagia affect your loved ones

It is common for seniors with dysphagia to avoid the consumption of food or liquid when they experience difficulty swallowing. This can affect their intake of fluid and nutrition as they suffer from a low appetite, and this may result in other forms of health complications eventually.

Here are some of the common health complications of dysphagia and how it can affect the daily life of your loved ones:

• Dehydration is a common complication due to decreased fluid intake as they would usually tend to avoid drinking fluids to prevent choking or coughing
• Having difficulty eating leads to lower intake of food which will result in malnutrition, weakening their immune system and making them susceptible to other infections
• Low appetite can lead to weight loss which may affect the quality of life as they become frail and more susceptible to falls
• Aspiration pneumonia is a condition caused by a lung infection when food or liquid enters the respiratory system during the process of swallowing.
• Anxiety and depression may affect your loved ones as they may feel embarrassed and frustrated by their condition

Caregivers can help look out for the above complications and seek medical assistance before further deterioration. Keep scrolling to learn about tips to cope with dysphagia and how you can help your loved ones regain their eating abilities.

What are some tips for coping with swallowing problems

Caring for your loved ones with dysphagia may require more attention, especially when it comes to eating or drinking. It is highly recommended that you seek professional advice from a doctor or a speech therapist.

Here are some practical tips you can use to ensure that your loved ones stay hydrated and well nourished:

• Ask or try to find out the reason(s) for reduced oral intake
• Modify the food (pureed or small pieces) so that it is easier for them to manage
• Monitor their fluid intake and encourage them to drink fluids regularly throughout the day to prevent dehydration
• Help them maintain an upright posture during meals to prevent food from entering the windpipe which may lead to infections
• Provide them with food of higher nutritional value and ensure a balanced diet of carbohydrates, calcium, fibre, protein and vitamins

How can seniors overcome swallowing difficulties

Dysphagia can be a daunting condition as it affects the quality of life of your loved ones, with complications that can lead to other health conditions. But with proper care and support, your loved ones can continue to lead fulfilling lives and even resolve their swallowing problems.

Recovery of swallowing function takes time and determination, and NTUC Health can be there to support your loved ones through the journey. It is important to provide emotional support to your loved ones as they may feel frustrated and helpless during the process.

Our team of speech therapists at our Rehabilitation and Physiotherapy centres can help personalise dysphagia treatment plans for your loved ones, which exercise and strengthen weak facial muscles, as well as their throat and mouth. Rehabilitation with our speech therapist can improve and restore functions such as swallowing and speech.

Home therapy and tele-rehabilitation give older adults with difficulty travelling to our centres an option to undergo speech therapy sessions in the comfort of their own homes, with visits by our team of therapists. Keep encouraging your loved ones on the road to recovery. Let them know you are there for them and offer help whenever possible!

Client profile: Speech therapy

Mr Teo Kian Huat, 87 years old, lives with Parkinson’s disease, old infarct (area of dead tissue caused by loss of blood supply) and Ischemic Heart Disease (IHD), which led to swallowing difficulties. Due to his condition, Mr Teo constantly felt discomfort in his throat area, with more phlegm and frequent coughs.

In October 2020, Mr Teo was referred to NTUC Health's Speech Therapy service for speech assessment and therapy to help manage his swallowing problems. A speech therapist was assigned to Mr Teo to assist him with sessions focusing on maintenance exercises, strategies that help him swallow safely, and providing his caregiver training and education on how to manage Mr Teo’s condition.

Throughout the 2-year process, our speech therapist ensured that the sessions continued to allow Mr Teo to tolerate limited oral feeding without compromising his lungs, as well as making sure his caregiver knew how to feed him safely.