Dysphagia in Dementia: Causes & Symptoms

What Is Dysphagia in Dementia?

The inability to swallow that frequently arises as dementia worsens is known as dysphagia. Dysphagia in dementia develops because dementia affects the brain’s capacity to regulate the muscles used for swallowing and chewing. Patients with dementia may experience difficulties with safe swallowing, like coughing or choking during meals, taking longer to eat, or avoiding food and beverages.

Dysphagia, or difficulty swallowing, is common in dementia patients because the disease affects muscle control and cognitive functions related to eating. Managing dysphagia includes recognizing early signs, adapting diets, and providing supportive care to ensure safety and prevent aspiration.

Why Do Dementia Patients Have Swallowing Problems?

Dementia patients often experience dysphagia due to the disease’s impact on the brain and nervous system, which impairs muscle control needed for swallowing. Cognitive decline can cause patients to forget how to swallow or not recognize the need to do so. Dementia weakens mouth and throat muscles, complicating chewing and swallowing. Behavioral changes like rapid eating and medication side effects like dry mouth further increase difficulties. These issues can lead to serious complications, including malnutrition, dehydration, and aspiration pneumonia.

Causes of Dysphagia in Dementia

Management of dysphagia requires addressing these underlying causes through treatment, dietary changes, and collaboration with medical professionals:

• Neurological Impairment: The normal process of swallowing is disrupted by dementia, which affects the brain’s capacity to control the swallowing muscles.
  
  
• Cognitive Decline: Patients with dementia may become less able to detect the need to swallow or may lose the ability to do so, which can contribute to dysphagia.
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• Muscle Weakness: It may become more difficult to chew and swallow food or liquids if dementia causes the mouth and throat muscles to weaken.
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• Delayed Swallow Reflex: The body’s reflexes are slowed down by dementia, which delays the swallowing process and raises the possibility of aspiration or choking.
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• Behavioral Changes: Changes in behavior during meals can interfere with safe swallowing and make dysphagia worse.
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• Medication Side Effects: Some medications used to treat dementia cause dry mouth, decreased salivation, or muscle relaxation, which can impair the ability to swallow properly.

How to Manage Dysphagia in Dementia Patients

To guarantee safe swallowing and appropriate nutrition, dementia, and dysphagia management requires a proper strategy. Choking hazards are decreased by meals with thickened drinks, and soft or pureed foods. Meals must be supervised to promote gradual eating and tiny bites. Keeping hydrated with thickened fluids and establishing a consistent mealtime pattern helps patients concentrate and lowers their anxiety. Aspiration risks are reduced and digestion is better when patients are positioned upright during and after meals. If serious problems develop, prompt medical intervention is necessary.

How to Feed a Dementia Patient With Dysphagia

Feeding a dementia patient with dysphagia involves patience and compassionate care to ensure their safety and comfort. Offer foods with modified textures and thickened liquids to minimize choking risks. Encourage small, slow bites. Keep the patient seated upright during meals and for at least 30 minutes afterward to support digestion and prevent aspiration. Attentive supervision throughout the meal promotes a safe, comfortable eating experience.

Common Signs of Dysphagia in Dementia

Recognizing these signs is essential for caregivers to seek medical advice and an appropriate care plan to manage dysphagia in dementia patients:

• Frequent Coughing or Choking: Persistent coughing or choking during or after eating and drinking may indicate difficulty swallowing and potential aspiration.
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• Difficulty Swallowing: Taking longer to chew or swallow food, appearing to struggle, or showing signs of discomfort during meals.
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• Avoidance of Eating or Drinking: Reluctance to eat or drink, due to the discomfort or fear of swallowing.
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• Unintended Weight Loss: Significant, unexplained weight loss due to reduced food and fluid intake.
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• Changes in Voice: A wet or gurgly-sounding voice after eating or drinking may signal food or liquid is stuck in the throat.
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• Frequent Chest Infections: Recurrent respiratory infections may occur if food or liquid enters the lungs.
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• Drooling or Pocketing Food: Excessive drooling or holding food in the mouth without swallowing can indicate swallowing difficulties.
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• Dehydration and Malnutrition: Signs like dry mouth and reduced energy may be from insufficient intake of fluids and nutrients.

Early Signs of Swallowing Problems in Dementia

While signs of dementia and trouble swallowing can be subtle, it’s important to identify them to promptly intervene. One of the first signs is coughing or choking during meals, indicating trouble getting food or beverages down the throat. Dysphagia patients may have a slower rate of chewing or swallowing. Changes in eating patterns are signs of swallowing difficulties. A gurgly voice may indicate food or liquids are not being swallowed correctly. Early swallowing problems might include drooling or holding food in the mouth.

What Are the Dangers of Dysphagia in Dementia?

Dysphagia in dementia can increase the risk of aspiration (food or liquid entering the airway), which may lead to aspiration pneumonia. Choking is another immediate danger, which can cause panic and distress for both the patient and caregivers. Recognizing and managing dysphagia in dementia patients is important to mitigate risks.

Best Diets And Foods That Are Easy to Swallow for Dementia and Dysphagia Patients

For dementia and dysphagia patients, a diet should prioritize safety, nutrition, and ease of swallowing. Ideal foods include pureed vegetables, mashed potatoes, blended soups, and moist proteins like ground chicken or fish with gravy. Soft fruits like bananas and applesauce, smooth dairy like yogurt and pudding, and oatmeal are also suitable. Thickened liquids reduce aspiration risks, and ensure hydration and small, frequent meals support nutritional intake. Consulting with a healthcare provider or dietitian ensures the diet is personalized to meet the patient’s needs.

How Speech Therapists Help Dementia Patients With Dysphagia

Speech therapists assist dementia patients with dysphagia by creating personalized plans to improve swallowing safety. They assess difficulties, teach techniques like chin tucks to reduce aspiration, and provide muscle-strengthening exercises. Therapists guide caregivers on meal pacing and a calm eating environment while recommending diet modifications. This supports a better patient quality of life.

How Caregivers Can Assist Dementia Patients With Dysphagia

Dementia dysphagia treatment includes caregivers creating a safe and supportive eating environment for patients. Caregivers provide foods and liquids with modified textures to reduce choking risks, while encouraging slow, small bites and creating a distraction-free space for eating. Caregivers position patients upright during and after meals to allow proper digestion and prevent aspiration. They monitor for signs of swallowing difficulty and seek medical guidance as needed.

Preventing Aspiration in Dementia Patients With Dysphagia

The proper strategy is needed to prevent aspiration in dementia patients who have dysphagia and the risk can be decreased by keeping the patient upright for half an hour after meals. Pacing meals to give enough time for swallowing is helpful. Check for aspiration symptoms including coughing, choking, or changes in voice quality. Working with medical specialists and providing instruction in feeding methods minimizes aspiration risk.

When to Seek Medical Help for Dysphagia in Dementia Patients

Seeking medical help for dysphagia in dementia patients is essential when certain signs appear. Significant weight loss, repeated respiratory infections, aspiration pneumonia, and persistent coughing or choking require medical attention. Difficulty swallowing leading to dehydration or malnutrition is a concern for dementia dysphagia life expectancy. A wet or gurgly voice after eating or frequent chest infections signal serious issues needing professional evaluation. Palliative care in dysphagia and dementia focuses on comfort and quality of life, ensuring swallowing difficulties are managed compassionately.

Tools to Help Dementia Patients With Dysphagia Eat Safely

There are tools and strategies to help dementia patients with dysphagia eat safely. Adaptive utensils, like weighted or angled spoons, can make eating easier. Nosey cups or cups with cut-out rims allow patients to drink without tilting their heads back, reducing aspiration risk. Plate guards or high-sided plates help patients scoop food more easily. Thickening agents added to liquids make them easier to swallow. Combining these tools with caregiver support can improve the eating experience for dementia patients with dysphagia.

As a reflection of Stellar Care’s ongoing dedication to providing compassionate patient care, we provide compassionate support for dementia patients with dysphagia through our caring approach that offers safety, comfort, and nutrition. Our dedicated care team ensures your loved one’s well-being and dignity are maintained.