Popular Science | How can elderly people with swallowing dysfunction eat safely? Keep these 5 tips in mind

"Unchewable rice cakes", "unswallowable particles", "soups that cause choking"... are the "invisible killers" of elderly people with swallowing dysfunction. Because rice cakes are soft and difficult to chew, they are easy to remain in the oropharynx and even get stuck in the respiratory tract, causing suffocation; hard particles such as peanuts, chestnuts, and candies are difficult to chew into crumbs and are easy to stick to the throat, causing lasting discomfort; soups mixed with meat particles, vegetable leaves, etc., due to the different solid-liquid flow rates, are easy to enter the airway and cause choking...

Learning to swallow safely and effectively can help elderly people with swallowing disorders reduce or avoid the dangers of aspiration pneumonia and suffocation. Rehabilitation therapists have five suggestions on how to swallow safely and effectively:

1. Choose the right food texture and form

Food texture : Choose food that is uniformly soft and has appropriate viscosity. It should not become loose or clumping easily, and it should be smooth, easy to deform and not prone to residue when passing through the throat.

Food form : According to the degree and location of swallowing difficulties, choose food forms that are easy to swallow. The order of eating can start with hydrogel training food and gradually transition to fine puree, fine fillings, soft food, general food and liquid.

2. Adjust your swallowing posture

Swallow with your head tilted back : Stretch your head and neck when swallowing, improving the decreased ability to push the food bolus due to insufficient tongue strength.

Lower your head to swallow : Place your lower jaw close to your sternum, move the bottom of the epiglottis upward, and make the epiglottal valley shallower, which helps reduce the amount of residual fluid during the pharyngeal phase.

Lateral swallowing : When swallowing, turn your head to the healthy side and use the pharyngeal constrictor muscles on the healthy side to push the food bolus forward to avoid food remaining in the pyriform sinus on the affected side.

3. Use appropriate eating utensils

Spoon: Choose a shallow, small, flat spoon, preferably one that can be rotated at an angle.

Cup: Choose between a notched cup or a flow control cup.

Bowl: Choose a bowl with a suction plate.

4. Pay attention to the environment and posture when eating

Environment: The surroundings should be quiet while eating and the patient should stay focused.

Patient position: sitting or semi-recumbent.

Feeder position: At eye level with the patient.

Food intake: Feed according to the patient's mouthful size, generally 5-10ml of paste food and no more than 20ml of liquid. Feed after one mouthful, and check the mouth for any residue after each mouthful.

5. Oral care after eating

Oral cleaning: You can rinse your mouth with clean water or saline to remove residual food and prevent bacterial growth.

Maintain posture: Keep sitting or semi-recumbent for more than 30 minutes after eating, and do not tap your back or suction sputum within 30 minutes. By following the above recommendations, patients with dysphagia can swallow more safely and effectively, thereby ensuring nutritional intake while reducing the risk of complications.

At present, many people around us have swallowing disorders, especially the elderly. For elderly patients with swallowing disorders, on the one hand, they need to be guided in the correct eating posture, and on the other hand, they need to choose appropriate food according to the patient's swallowing and eating ability. At the same time, they need to pay attention to controlling the eating speed during the eating process.

If you want to know more detailed methods of rehabilitation training for dysphagia, you can go to the speech therapy room (ST) of the rehabilitation medicine department of the nearest hospital for consultation. The rehabilitation therapist will develop a rehabilitation strategy to help elderly people with dysphagia eat more smoothly, safely and comfortably.

END Author: Xu Shihan (Rehabilitation Therapist at Jiangwan Hospital, Hongkou District, Shanghai)

Reviewer: Luo Zhendong, Honorary Director of the Rehabilitation Medicine Department of Jiangwan Hospital, Hongkou District, Shanghai, Standing Committee Member of the Medical and Health Integration Working Committee of the Chinese Rehabilitation Medicine Association, Publicity Department of Jiangwan Hospital, Hongkou District, Shanghai