10 Tips to Manage Dysphagia At Home - Homage

10 Tips to Manage Dysphagia At Home

Dealing with swallowing problems can be a challenging task for caregivers. Learn these vital tips to manage dysphagia at home.

oleh Calvyn Ee

What is Dysphagia

The term dysphagia refers to difficulties with swallowing food and drink; in more severe cases, a person with dysphagia is unable to eat or drink anything at all. This happens when the swallowing process, a complex system involving various muscles and other structures in your body, is disrupted due to certain factors.

In a nutshell, the food you eat is chewed into a soft ball (bolus) that is easily swallowed. As you swallow this bolus, the structures at the back of our mouth and throat cover the entrance to the windpipe, ensuring it goes down the oesophagus and into your digestive tract.

Dysphagia is usually divided into three categories:

  • Oral cavity dysphagia: Issues typically include tongue weakness or difficulty in chewing
  • Oesophageal dysphagia: Health complications involving the throat, such as a narrowed oesophagus (known as a stricture) or oesophageal tumours
  • Oropharyngeal dysphagia: Health complications involving the oesophagus, including certain neurological disorders (i.e., multiple sclerosis) or cancers

Risks of Dysphagia

A person can become malnourished or dehydrated since they cannot eat or drink properly. As food and drink are how the body sources the nutrients needed to keep it functioning optimally, dysphagia does present serious risks if it’s not taken care of immediately. Gradual/sudden weight loss will also be a persistent issue.

Choking on food or drink can also happen, which can be fatal if it goes untreated or unnoticed. Of major concern is the subject of aspiration. Aspiration occurs when something, usually food or drink, enters your airway or lungs by accident. Various structures in your digestive system generally work together to prevent food and liquids from entering the airways. When aspiration occurs in a normal person, the normal reaction is to cough to force the food or liquid out of the airways.

However, for persons with dysphagia, silent aspiration is a big risk that can happen. Silent aspiration occurs when food or liquids enter the airways or lungs but there aren’t any obvious signs or symptoms to indicate it’s happening or has happened. This can lead to aspiration pneumonia, which is a serious lung infection.

It’s essential that you take good care of yourself or your loved one if either one of you has dysphagia. The prevention of risky complications can help improve their odds of recovery and ensure they are able to eat and drink well in time.

Do’s and Don’ts of Managing Dysphagia at Home

Here’s a useful guide to help you to effectively manage dysphagia symptoms and/or risks, ensuring you or your loved one won’t have difficulties getting the nutrition you need and preventing problems from arising.

Keep an Eye on Your Loved One

It’s very important that you keep a close eye on your loved one as they’re eating or drinking. If you’re feeding your loved one, keeping an eye on them is a given. Even if it may be food or drink that they don’t have difficulty swallowing, or if they may be able to eat or drink without requiring supervision, anything can change without prior warning. There’s no harm in being a little extra careful for your loved one’s sake.

Eat and Drink At Their Own Pace

On that note, there’s no need to rush them into finishing their meal or drink. If anything, doing so can be harmful, as your loved one might choke or experience silent aspiration if they try to consume more food or liquid than they should. Tell your loved one to take their time; make sure they slowly chew their food thoroughly and drink liquids slowly.

Look Up Dysphagia-Friendly Recipes

Soft food diets are usually recommended for those with dysphagia. Every aspect of a meal needs to be carefully prepared to avoid instances of choking or silent aspiration, which is why a soft food diet – usually consisting of purees, congee, or other foods that are easily swallowed – is ideal.

There are four diet levels with their own set of restrictions based on medical recommendations.

  • Tahap 1 - Dysphagia-Puréed: tekstur seragam, puding seperti, memerlukan keupayaan mengunyah minimum
  • Tahap 2 - Dysphagia-Mekanikal Diubah: makanan yang padu, lembap, semisolid, memerlukan beberapa mengunyah
  • Tahap 3 - Dysphagia-Advanced: makanan lembut yang memerlukan lebih banyak keupayaan mengunyah
  • Biasa: semua makanan dibenarkan

Ideally, you would want to maximise the amount of nutrients your loved one can get from real food instead of relying on supplements. Supplements are useful to boost one’s intake of important nutrients for the body, but you can get a lot more from real food (while also spending a lot less on expensive supplements).

Serve Smaller Portions

It’s important that you or your loved one gets sufficient nutrients with every meal, but dysphagia does prevent proper consumption of food and drink. It’s better to have smaller bites per meal so as to avoid choking or silent aspiration, and this may vary depending on the severity of dysphagia. It’s also a good idea to have smaller meal portions in a day so you can still provide sufficient nutrition all day long.

 As your condition improves, you can slowly increase the amount of food and drink served per meal. Be ready to make changes to your meal plan as and when it may be needed. We do have a handy selection of dysphagia-friendly recipes that you can make use of, or even tweak to your loved one’s liking.

Plan Meals Carefully

It’s always a good idea to plan meals accordingly. For one, you can diversify what your loved one has for meals so they won’t feel like they’re having the same thing every day. Additionally, you can ensure that your loved one is eating right, preventing any instances of malnourishment or dehydration. Having light, healthy snacks in between meals can also be a small morale booster, too.

If you need some advice, consider speaking to your speech pathologist or dietitian about how you can plan healthy meals for your loved one at regular intervals.

Sit Upright When Eating or Drinking

Make sure your loved one sits as upright as possible. Doing this ensures that when they eat or drink, the food or liquid goes down their oesophagus with minimal difficulty. Even if your loved one is bedridden, it’s always important to have them sitting upright to prevent choking or silent aspiration. Consider propping them up with pillows if they can’t sit upright properly. If one side of the body may be impaired, you might need to add extra support to that side.

Take note that your loved one tilts their head forward with their chin slightly forward when eating or drinking. Contrary to common belief, tilting your head backwards actually makes it more difficult to swallow as food or drink could directly enter your airways.

Useful Eating Tips

Some cases of dysphagia may be characterised by facial weakness, where one side of the face may have difficulties with muscle coordination and so forth. You’ll need to slowly familiarise your loved one with using their stronger side to maximise the amount of food they can ingest.

Additionally, when feeding your loved one, make sure to position yourself at the same level as they are or just below eye level. This can help maintain an appropriate head position that’s comfortable for them as they eat or drink (while avoiding the risk of choking or aspiration).

Minimise Distractions

Distractions can hinder you or your loved one from eating or drinking properly if they’re doing it unsupervised or otherwise. While it’s fine to let them watch TV while they rest, you should make it clear that distractions while eating need to be reduced so focus can be maintained on eating or drinking. Have all eating and drinking done in a space that’s relatively quiet and free from any kind of distracting items, including smartphones and portable radios. You should also set a good example and not use any such items while in your loved one’s presence, especially if you’re feeding them!

Tongue-Strengthening Exercises

These exercises are important to help build up tongue strength and mobility when you or your loved one has dysphagia. Depending on your dysphagia, certain exercises require specific muscles or structures to be worked out and ensure that food and drink can easily go down your oesophagus without difficulty. You’ll receive instructions on how to perform these exercises with the help of a medical professional, usually a speech language pathologist.

Some exercises you may perform include:

  • Tongue base strengthening: Take a breath and hold your breath tightly. Then, press your tongue against the roof of your mouth as tightly as you can while squeezing your throat as you swallow, before exhaling. Repeat this 25 times a day every six days a week. Ideally, you should do this for a period of five weeks.
  • The shaker technique: Lie flat on your back, shoulders planted against the surface, and raise your head slightly off the ground. Raise your head high enough so that your eyes can see your toes. Hold this position for a few seconds and then place your head back down. Repeat this about 30 times; you should aim to do this exercise at least three to six times a day.
  • Effortful swallowing: This ideally requires someone to supervise the exercise. You need to gather as much saliva in the middle of your tongue and in your mouth. As you keep your mouth closed, carefully swallow all the saliva at once like you would swallow a pill.
  • Tongue presses: Stick out your tongue as far as you can. Use a spoon or something flat to push against your tongue. Hold for a couple of seconds, then repeat 5 times.

You can also find other kinds of beneficial exercises online.

Get Medical Help

It shouldn’t have to be stated again, but when you need help or advice, it always pays to get a medical professional’s sound advice to properly look after yourself or your loved one at home. Your doctor will usually cover all the important information you’ll need to know, but it doesn’t hurt to check in with them from time to time, or if you’re worried something unexpected might arise and you worry that you’re unprepared for such a situation.

Consider preparing a list of questions to ask or important things to note for when you see your doctor. These may help inform them of whether changes may be needed for the treatment plan.

  • Have symptoms been happening continuously or occasionally?
  • Have symptoms worsened or are they getting better?
  • Has anything changed in what you or your loved one can consume?
  • Are you or your loved one still having difficulty swallowing food or liquids?
  • Do you or your loved one bring food back up (regurgitate) often after swallowing it?
  • Have you or your loved one coughed up/vomited blood recently?
  • Do lifestyle modifications help with easing difficulties in swallowing?

Getting a Part-time Caregiver to Help

Dysphagia care can require a great deal of personal attention so your loved one can eat and drink safely. If you need assistance while you’re away from home, our trained Care Professionals are ready to help assist with activities of daily living, feeding, and escorting you to your medical appointments. From 1 hour to 24-hour care needs, we can lend a helping hand and give you much-needed respite from your daily caregiving duties.

Download our app now to find out more and start booking quality care for your loved one.

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