Safe Swallowing Strategies
As a medical speech pathologist, one of the most common issues that is encountered within the geriatric population is difficulty swallowing, also known as dysphagia.
Dysphagia can happen for different reasons and can be serious if not treated. But there are safe ways to eat and drink for people with difficulty swallowing.
First, let's understand how swallowing works. It has 4 stages: oral preparation, oral transit, pharyngeal transit, and esophageal transit.
Oral Preparation: This is when you chew your food and mix it with saliva in your mouth.
Oral Transit: The food or drink moves from your mouth to the back of your throat.
Pharyngeal Transit: The food or drink goes through the throat (pharynx) and into the esophagus.
Esophageal transit: The food or drink travels through the esophagus and into the stomach.
To swallow safely, you need strong and coordinated muscles for each stage. If you have trouble swallowing, a speech pathologist can help accurately diagnose your swallowing impairment. We can then create a treatment plan that will specifically target your swallowing impairment in order for you to be able to eat and drink safely.
Now, let's look at some safe swallowing strategies. Remember to talk to your doctor and speech-language pathologist before trying any of them.
Strategy #1: Change Food
Changing the texture and consistency of your food and drink can make swallowing easier. You may need softer foods or thicker liquids. Here are some examples:
Soft or Pureed Foods: Foods with a smoother texture, like mashed or blended options, are easier to handle in the mouth. This reduces the risk of choking.
Thickened Liquids: Thin liquids, like water or juice, can be hard to control and may go into the lungs by mistake. Adding thickening agents can make them easier to swallow. The thickness can vary based on what you need.
Always work with a speech pathologist or healthcare professional when changing food and drink textures. They will consider your muscle strength, coordination, and any other conditions. Together, you can decide the best textures for you and get recommendations for specific foods and drinks.
Strategy #2: Take Small Bites and Sips
Taking small bites or sips can often make eating safer. It also reduces fatigue and lets you eat or drink for longer. Here's why it works:
Prevent Choking and Aspiration: Smaller bites or sips mean less food or liquid in your mouth at one time. This makes it easier to control and lowers the risk of choking. It helps the food or drink go down your throat safely.
Improve Swallowing: Swallowing needs many muscles in your mouth, throat, and esophagus to work together. Taking smaller bites or sips helps these muscles work better. It reduces strain and fatigue, making swallowing easier and more comfortable.
Enjoy Meals for Longer: If swallowing is hard for you, it might take longer to finish a meal or drink. Taking small, frequent bites or sips lets you eat or drink without overwhelming your swallowing. This helps you enjoy meals, feel less frustrated, and stay hydrated and nourished.
Remember, the pace of eating and drinking should match your abilities. Some might need more time between bites or sips. Others may need extra help, like specific maneuvers or adjustments in how they sit (see next strategy). Your speech pathologist or healthcare professional can give you personalized guidance based on your needs.
Strategy #3: Sit and Position Yourself Well
Sitting properly during meals is important for safe swallowing. Positioning your head and body in specific ways helps your muscles work together and reduces the risk of choking or aspiration. Here are some examples:
Sit Up Straight: Sit with your head in a natural position, upright in a chair. Typically, being seated at a 90 degree angle is best when eating or drinking. This uses gravity to help food and liquid move down your throat and into your stomach. Avoid lying down while eating, as it increases the chance of food or drink going into your airway by mistake.
Chin Tuck: For those who struggle to control the food or manage saliva, tucking your chin slightly toward your chest while swallowing can help. This closes off your airway, guiding the food or liquid toward your esophagus and reducing the risk of aspiration. It is important to know that a chin tuck is NOT for everyone with a swallowing issue; it can actually be contraindicated for many patients with difficulty swallowing. Please work with your speech pathologist to know whether or not this is the right position for you.
Head Turn: Some people have trouble with one side of their throat due to damage to their vocal cords. Turning your head to the stronger side can make swallowing easier and give you better control over the food or liquid. Your speech pathologist or our expert team members can help you figure out your strong side and guide you on the best head position.
Good Seating: Comfortable and supportive seating during meals is important for good posture and stability. Make sure your chair provides proper back support and that you're at the right height relative to the table. This reduces fatigue and helps you stay in control while swallowing.
Remember, positioning recommendations can vary based on your specific swallowing difficulties. Working closely with a speech pathologist or healthcare professional is essential to get personalized guidance that suits you.
Safe Swallow Strategy #4: Exercise Your Swallowing Muscles
Exercising the muscles involved in swallowing can make them stronger and improve coordination. This helps with safer and more efficient swallowing. Here's why it's important:
Stronger Muscles: Just like other muscles in your body, the swallowing muscles can benefit from regular exercise. Strengthening them helps with the force and coordination needed for swallowing. It gives you better control over the food and reduces the risk of choking or aspiration.
Improved Muscle Coordination: Swallowing involves many muscle movements, including those in your tongue, throat, and esophagus. Doing specific exercises can improve coordination among these muscles, making swallowing smoother and more efficient. By practicing targeted exercises, you can coordinate your muscles better for improved swallowing.
The type of exercises will depend on your specific swallowing difficulties. A speech pathologist or healthcare professional can guide you on exercises that suit you. These might include tongue exercises, swallowing maneuvers, or exercises for throat and larynx muscles. Consistency and regular practice are key to getting the best results. Follow the exercise program your speech pathologist gives you and keep practicing to see improvements.
People with dysphagia face challenges in safely swallowing food and drinks. This can make eating a chore and take the enjoyment out of food. By changing the texture of food, taking small sips, sitting properly, and doing muscle exercises, people can improve their swallowing and decrease the risk of choking. With these strategies and help from professionals, people with dysphagia can feel more confident, have a better life, and enjoy meals without as much worry. Remember, you don't have to deal with dysphagia alone – reach out for help and start on a path to safer and more enjoyable meals.
