[Medical Q&A] How to help elderly people with swallowing disorders eat safely?

Author: Zhao Tianxue Beijing Friendship Hospital, Capital Medical University

Reviewer: Zhang Wei, deputy chief nurse, Beijing Friendship Hospital, Capital Medical University

Many elderly people have dysphagia, which manifests as difficulty swallowing food, frequent coughing, and repeated low-grade fever after coughing for a long time. So, if an elderly person at home has dysphagia, how can you help him eat safely?

1. Choice of tableware

(1) Spoon: The spoon surface is small and shallow, with a capacity of about 5 ml. The spoon body is smooth and round, and the handle is thick and long.

(2) Bowl: A high-sided bowl with a suction cup, preferably with a non-slip mat.

(3) Cup: A notched cup should have the notched surface close to the nose when drinking water.

2. Food Choice

(1) Follow the doctor’s advice and choose food according to the degree of dysphagia assessed by the hospital.

(2) Prepare sticky rice porridge, rice paste, or soft-boiled noodles for the elderly to avoid the risk of choking.

(3) For the elderly who choke on drinking water, you can add a thickener to the water and avoid using a straw when drinking water.

(4) Avoid eating sticky foods such as glutinous rice balls or rice cakes.

(5) Pay attention to the combination of color, aroma and taste to enhance the appetite of the elderly.

3. Preparation before meals: Remind the elderly to go to the toilet first to avoid interrupting the meal process.

4. Dining environment: Do not talk to the elderly while they are eating to avoid food entering the trachea due to talking.

5. Body position during meals

(1) Let the elderly sit upright as much as possible and eat at the dining table.

(2) For bedridden elderly people, they can lie in a 30° supine position with their head flexed forward. For elderly people with hemiplegia, a pillow can be placed on the shoulder of the hemiplegic side to reduce the risk of aspiration.

(3) Do not let the elderly lie down immediately after a meal; try to maintain the same posture as during the meal for 30 minutes.

6. Tips for eating

(1) Do not put too much food into the mouth each time. Eat it in small bites at first, and then gradually increase the amount of food according to the elderly’s eating habits.

(2) Place food in different positions of the elderly person’s mouth according to their condition. For example, if the right side of the elderly person’s face is weak, place food in the left side of his mouth.

(3) If choking occurs during a meal, wait for a while until the elderly person's breathing stabilizes before eating. If the choking is severe, stop eating to avoid risks such as aspiration and choking.