Coping with Swallowing and Eating Difficulties

Swallowing seems an innate function for younger people, but our swallowing ability is actually a function that often declines with age. It’s often frustrating for older adults when a meal that’s always been enjoyable suddenly proves challenging because of swallowing difficulties.

Deterioration in swallowing function is sometimes attributed to weakened or absent teeth, loss of moisture in the mucosal surfaces of the mouth and throat, or decreased muscle strength in the throat that slows swallowing and increases the difficulty of swallowing hard or dry solid foods, according to Today’s Geriatric Medicine. Swallowing Difficulties in Older Adults

Dysphagia is a term used to describe “problems with neural control or structures in any part of the swallowing process.” Swallowing difficulties are often a consequence of a medical condition, such as stroke, diseases that impact the nervous system (such as Alzheimer’s or dementia, Parkinson’s disease, or multiple sclerosis), and even surgeries affecting the head and neck.

When swallowing difficulties are a more serious concern

If you notice your loved one is no longer enjoying mealtime or has difficulty eating, it’s a good idea to discuss these changes with their physician because sometimes swallowing difficulties can be a sign of a more serious problem or even lead to a more serious condition such as aspiration pneumonia. Aspiration occurs when food or liquid enters the windpipe, causing coughing and choking during eating. This frequently occurs in older adults with later stages of Alzheimer’s disease or dementia, who, over time, lose their ability to perform activities of daily living (ADLs), including eating. If aspiration happens frequently, the person is at risk of developing aspiration pneumonia. When decreased swallowing function is the result of a neurological disease, cancer, or stroke, it is often difficult to prevent the eventual loss in function.

How to preserve swallowing function

Maintaining an adequate nutritional intake is a concern for older adults, even without swallowing difficulties, so difficulties with swallowing or dysphagia only exacerbates this challenge. Often, normal changes in swallowing ability occur gradually, and older adults simply adapt to these changes over time. The Swallowing Disorder Foundation outlines several strategies which you can have your loved one use to maintain swallowing ability and prevent minor swallowing difficulties from becoming more severe, including:

  • taking good care of their teeth
  • practicing good oral hygiene
  • chewing carefully
  • taking smaller bites

If your loved one often experience coughing during swallowing, having them tuck their chin to their chest prior to swallowing can help to protect their airway. There are also swallowing tests that can help diagnose the problem so that appropriate treatments can be prescribed from physicians or speech-language pathologists.

Liquid thickeners and other solutions for swallowing difficulties

Older adults who have swallowing difficulties may be referred to a speech therapist who can help older adults retain as much swallowing function as possible through the use of targeted exercises. For older adults who have difficulty swallowing liquids, thickeners are helpful for reducing aspiration. Thicker liquids travel more slowly down the throat, giving the person’s muscles and nerves more time to complete the swallowing process before the liquid enters the lungs and places the person at risk of pneumonia.

Ensuring their loved ones continuing to receive proper nutrition should be a top priority for caregivers. Often older adults who have trouble swallowing may avoid eating because it’s no longer enjoyable. Foods with a thicker consistency, but are not solids, such as Jell-o, yogurt or pudding, are often good choices. Other foods that are naturally easier to chew and swallow, such as oatmeal, beans and pasta, are also good to incorporate into meals.

Parentgiving offers several valuable tips for coping with swallowing difficulties, including:

  • avoid foods that crumble, like crackers, which can lead to gagging
  • make sure your loved one drinks enough water (6 to 8, 8-ounce glasses each day) to help maintain moisture in the mouth and throat
  • offer gum or candies between meals, as this helps to keep the mouth moist by inducing glands to produce saliva
  • puree or blend foods to break them down into a smooth consistency that is easier to swallow.
  • choose moist foods, mashed potatoes is a good starch option, whenever possible over dry, rough foods such as grains.
  • steam foods such as vegetables for a softer, easier-to-chew consistency

If your loved one is experiencing difficulty swallowing, talk with their physician to determine if further tests are needed to pinpoint a cause and rule out more serious conditions. Whether swallowing difficulty is a normal progression of aging, caused by a chronic disease, or the result of a stroke or similar event, there are strategies you can use to ensure your loved one receives adequate nutrition. A speech therapist or speech-language pathologist can help you formulate a specific treatment plan to help your loved one retain as much swallowing function as possible and develop modifications to ensure your loved one continues to receive adequate nutrition and avoids the negative consequences of poor nourishment and dehydration.

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