swallowing problems in old age

Dysphagia – Swallowing problem in the elderly

Older adults are at increased risk for developing dysphagia due to a number of age associated phenomena.  By targeting high risk groups and intervening with compensatory and rehabilitative approaches, it is hoped that the ultimate burden of dysphagia on the old age population will decline.

Causes for dysphagia:

  1. Dehydration
  2. Malnutrition
  3. Aspiration pneumonia
  4. Dental diseases
  5. Intake of various medicines
  6. Arthritis of facial joints
  7. Neurological disorders like: stroke, head trauma, parkinson’s disease, Alzheimer’s etc.

Signs and symptoms:

  1. Material spills from the front of the mouth
  2. Patient cuts food into small pieces
  3. Changes in or loss of taste
  4. Increase in secretions or phlegm
  5. Patient bites his tongue
  6. Food is in the mouth but the patient does not swallow
  7. Food sticks in mouth
  8. Patient is avoiding certain foods and
  9. Consuming extra fluids to wash food down during meals.
  10. Regurgitation or vomiting

Treatment of swallowing problems:

Multidisciplinary treatment approach plays an important role in the care of complex older adults with dysphagia.This approach helps address the medical, functional and psychosocial consequences of the problem.

  • Postural techniques: Exercises for facial muscles. If you have a problem with your brain, nerves, or muscles, you may need to exercise to  aid facial muscles work together to help you swallow. You may also need to learn how to position your body or how to put food in your mouth to be able to swallow better.
  • Environmental modifications:
    1. Eat slowly. Allow enough time for a meal.
    2. Do not eat or drink when rushed or tired.
    3. Take small amounts of food or liquid in the mouth
    4. Concentrate on swallowing. Eliminate distractions like television.
    5. Avoid mixing food and liquid at the same time.
    6. Place food on the stronger side if there is unilateral weakness.
    7. Add condiments like butter, sauces, tart sauces to moisten the food, enhance taste and hence ease degglutition
    8. Change certain foods you eat. Your doctor may tell you to eat certain foods and liquids to make swallowing easier.
  • Dilation. In this treatment, a device is placed down your esophagus to carefully expand any narrow areas of your esophagus. You may need to have the treatment more than once.
  • Surgery. If you have something blocking your esophagus (such as a tumor or diverticula), you may need surgery to remove it. Surgery is also sometimes used in people who have a problem that affects the lower esophageal muscle (achalasia).
  • Medicines. If you have dysphagia related to heartburn, or esophagitis, prescription medicines may help prevent stomach acid from entering your esophagus.