Dementia is an umbrella term for several diseases that affect cognitive functions such as reasoning, judgment, and memory. While there are many issues associated with dementia, there is particular concern about a growing number of seniors with easing and swallowing difficulties known as dysphagia. Dysphagia affects about 45% of those diagnosed with dementia such as Alzheimer’s. Caregivers play an important role in managing eating and swallowing in seniors, especially those diagnosed with dementia. If your loved one has been diagnosed with both dementia and dysphagia, here are a few ways to manage the latter.
What are the Sign and Symptoms of Dysphagia?
Before we look at how you can provide the right care for a loved one, we need to understand how to recognize the condition. It can be difficult to tell if someone is suffering from dysphagia because the clues are often very subtle. The first symptom to look out for is coughing when eating or drinking. You might also hear a gurgling sound and physical struggle as the person tries to swallow.
The second symptom is food spilling from the mouth or the nose. This happens because they are unable to swallow and because they do not want to spit the food, they try to hold it in, which does not always work. You will also notice tears in their eyes from the struggle.
If this goes on for some time, you will notice that your loved one starts avoiding certain foods and drinks. Doing so leads to other issues such as weight loss and dehydration. They may also have recurrent chest infections or pneumonia which can be very serious in these instances.
Managing Dysphagia: Positioning
Managing dysphagia is mostly about making it as easy as possible for the senior to eat and swallow. Because you are trying to help a senior or loved one with dementia, you have to be careful when positioning them to ensure they can hold that position for the duration of the meal.
The optimal sitting position for eating and drinking for those with dysphagia is upright, at a 90-degree angle. Try as much as possible to get them out of bed and onto a seat because sitting on a bed can lead to slouching, which is bad. They should also not lean to the side while eating.
Once done, you should stay with them to ensure they remain upright for at least 30 minutes after the meal. This helps aid in digestion and has been shown to reduce instances of regurgitation and acid reflux. The speech-language pathologist (SLP) who helped diagnose your loved one with dysphagia might also have additional positioning tips, so be sure to talk to them too.
Minimizing Distraction During Mealtimes
Another way to manage dysphagia in seniors with dementia is to remove all distractions when they are eating. Environmental distractions are already challenging enough, and you do not want them interfering with eating in seniors, especially those with dysphagia.
It is also important to ensure the surrounding environment is clear. Avoid placing unnecessary items on the table or close to your loved one when they are eating as they may distract and confuse them. Ensure that you only bring the utensils you both need.
Lastly, avoid serving too many dishes at one time. Some people can get confused by more than one dish so keep things simple and bring in one or two at a time.
Diet and Texture Modification
Many people with dysphagia struggle with the texture of their foods which can present significant risks and danger. Changing the texture of their foods and drinks can help with control of the food inside the mouth, easing chewing and swallowing challenges. Food and beverage thickeners have been shown to help immensely. You could try the SimplyThick thickener from SimplyThick which is great for the thickening of both foods and drinks. These thickeners reduce the risk of choking and ease swallowing.
The best thing about high-quality thickeners like this is that they do not change the appearance of normal food. Those with dementia want consistency in their lives and changing the look of the food they are used to introduces turmoil that you will have to deal with as the caregiver. Additionally, not changing the appearance of their food too much leads to enjoyment as it is easier to recognize and remember these foods. Your SLP may also provide you with a combination of exercises and strategies to help your loved one swallow these thickened foods easily.
Managing Feeding and Swallowing
Once the positioning environment and food are ready, it is time to eat. Here, you can help your loved one by insisting on the correct feeding and swallowing techniques. Always insist that they take small bites and sips. If you are feeding them, be patient with them and ensure you keep the pace consistent to avoid rushing them.
Next, always ensure they have swallowed all the food and drink in their mouth before giving the next bite or sip. Also, do check their mouth between bites to ensure there is no accumulation of food as you feed them or as they eat. Check on and under the tongue and inside the cavities of the cheeks.
Try to see the best time for them to eat. You should provide meals or feed them when they are alert and concentrating. Because of this, it is better to give them smaller meals than three big meals at times when they will not be fully committed to eating.
Lastly, ensure proper oral care throughout the day. Poor oral health can make complications such as pneumonia worse in those with dysphagia. Ensure their dentures are cleaned before each meal and that they brush their teeth after each meal.
Ensuring a senior with dementia is well fed is already challenging enough and things get even more complicated if they also have dysphagia. Fortunately, you can help them manage their dysphagia by employing some simple techniques that make it easy to eat, drink and swallow. Do not hesitate to get in touch with a doctor if you need more advice or if anything goes wrong.