Supporting people who have difficulty swallowing

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It is important to find out if the people you are providing care for have difficulty swallowing. If they do have difficulty swallowing you need to understand how you can help them.

Problems with swallowing can be caused by many things. For example:

  • neurological conditions that affect the nerves, such as Parkinson's disease, stroke or dementia
  • blockages or irritation in the throat
  • in some cases ill-fitting dentures, tooth problems or mouth ulcers may cause swallowing difficulty

Swallowing difficulties can lead to malnutrition, dehydration and an increased risk of choking if they are not managed properly.

Dysphagia

Dysphagia is a disorder of swallowing. People with dysphagia may have difficulty holding food or fluid in their mouth, chewing, moving food to the back of the mouth, swallowing at the right time, protecting the airway when swallowing, clearing food from their throat or getting food or fluid to pass down in to the food pipe.   

What to look out for

It is important to check if the person you are providing care for has difficulty swallowing. You should look out for the following symptoms:

  • not being able to chew properly
  • drooling
  • food spillage
  • coughing
  • choking
  • swallowing repeatedly to clear food from the throat
  • hoarseness, slurred or nasal speech
  • swallowing with gurgling noise
  • bad breath
  • undigested food followed by chest pain

How to help

If someone you care for has difficulty swallowing you can refer them to a Speech and Language Therapist (SALT or SLT).

Difficulties with swallowing may make it harder to eat a nutritious diet, making mealtimes stressful for the individual and carers. SALTs may help by modifying the types, size and consistency of a person's food. They can also suggest nutritional supplements such as milkshakes, juices or soups that are easier to swallow and are fortified with nutrients.

It is important to maintain good oral hygiene for people with swallowing difficulties to prevent complications and infections.

SALTS feedback and oral hygiene plans, like all other interventions, should form part of the person you are caring for's care plan. All staff in a care home, including agency and temporary staff, should be able to spot and stop any potential problems e.g. hard sweets being offered to someone who has swallowing difficulties.

Support

Leeds Community Health Care Speech and Swallowing team

The Leeds Community Health Care Speech and Swallowing team External link  website includes links to the SALT referral forms and links to swallowing information leaflets and menu and diet information.

Tel: 0113 843 3126

Email: speechandswallowing@nhs.net

Resources

International Dysphagia Diet Standardisation Initiative (IDDSI).

The IDDSI web site External link  has lots of useful resources regarding food texture and dysphagia.

Leeds Community Healthcare has produced a Dementia and Swallowing leaflet (PDF, 77KB) External link

PrescQIPP bulletin -  Care homes - Assisting people with swallowing difficulties

ThePrescQIPP bulletin bulletin Assisting people with swallowing difficulties External link looks at treatment strategies for adults with swallowing difficulties in both care homes and domiciliary care settings. It includes dietary modification by prescribing thickeners and other options such as environmental modifications, safe swallowing advice, and the application of swallowing strategies