Swallowing strategies for the elderly

Swallowing can become a challenge for people living with dementia and distressing for loved ones caring for them. If this sounds like something you’re trying to deal with, there are a number of strategies that may ease the process and make mealtimes better for everyone.

There are various reasons why swallowing can become an issue, from forgetting how to do it to no longer being able to use those muscles. Overcoming this challenge can help to ensure a person living with dementia doesn’t experience weight loss, which can lead to other complications.

Each person is unique and their problems with swallowing may manifest in different ways. It’s important to distinguish strategies to fit the individual and find solutions that will work for them.

Adopt a soft, moist diet

One of the first things you can do to aid a person living with dementia in swallowing is to change the types of food you serve them. Avoid hard and fibrous food that can be difficult to chew and replace it with softer, wetter options that will prove less of a challenge.

Add moist accompaniments to a dish, such as gravy or sauces, which will aid in swallowing. Always provide a drink alongside meals and encourage the person living with dementia to take small sips frequently to help the food go down.

People living with dementia sometimes experience a dry mouth, which can be the result of medications or living in a warm environment. It can be worth talking to their GP about whether medications can be tweaked to help prevent this common side effect.

Stimulate swallowing

If a person living with dementia regularly forgets to swallow, keeping food in their mouth or spitting out lumps, there are some strategies that can help encourage them. Firstly, you can talk gently to them, reminding them to swallow their food.

Another technique is to place an empty spoon in their mouth between bites of food. This action can help to stimulate a swallowing response and ensure the previous food has gone down before they try and eat any more.

Alternating between different flavours, textures and temperatures can be an effective way to encourage swallowing. As well as varying these elements in the foodstuffs being offered, provide cold water for a similar sensation.

Oral care

A painful mouth or gums can make eating difficult and if a person living with dementia can’t chew their food comfortably, swallowing can become even harder. If an individual has already lost weight, their gums may have shrunk and their dentures will not fit properly.

Understanding this and discovering such discomfort can be complicated if a person living with dementia can’t communicate these issues. Make sure they have good oral care practices and that they’re seen regularly by a dentist.

Look out for any clues that they’re having problems with their mouth. This could include bad breath or saying there’s a nasty taste, both of which are indicators that there’s something amiss that should be treated.

Encourage participation

All throughout our lives, food is seen as an enjoyable and social exercise, so it’s important to continue that when people are living with dementia. Encourage the individual to participate in the processes of preparing and eating food as much as possible.

Such engagement will give them more control and help them to focus on eating and swallowing. This approach can be modified to ensure it’s safe, with the types of foods and utensils offered to the person living with dementia appropriate for their condition.

Encourage participation right from the beginning of the eating process by asking the person living with dementia what they’d like to eat. The way this question is framed will depend where they are with the disease, varying from an open-ended query, through to some options or even a statement that only requires a nod of assent.

Utilise adapted equipment

Having the right equipment will help a person living with dementia to eat and this goes for drinking too. While it’s important to stay hydrated, sips of water can also aid in swallowing, but not if it’s too difficult to pick up a cup or use a straw.

No-spill cups with large handles and one-way straws that stop liquid from flowing the wrong way are good examples of equipment that has been especially adapted. Cutlery that is easy to grip and plates that make food clear to see will also help a person living with dementia be able to feed themselves.

With the adapted equipment to hand, gentle encouragement to swallow and suitable foods available, you’re upping your chances of mealtimes going smoothly. Help is available with all areas of dementia care, with those looking after loved ones able to get the support they need.

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