Swallowing is a vital part of every person’s life that can often be taken for granted. We need this process to help consume food, beverages and medications. Without it we would not survive.
Swallowing is a complex process that involves various muscles, glands and nerves. As people age, many will find that they have trouble swallowing, or have “dysphagia”, for any number of reasons.
Some older adults’ teeth are often weak or absent. Some will find that the mucosal surfaces in the mouth and throat are less moist, while others will have a loss of muscle strength in the mouth and throat that will impair the swallow and increase the risk of safety issues.
These symptoms describe a medical condition called dysphagia, where a person has difficulty in swallowing solids or liquids, which may lead to various health concerns.
A person with dysphagia has problems with neural control or structures in any part of the swallowing process – they may either have problems forming a bolus (the chewed up mass of food to be swallowed) in the mouth or have difficulty moving the bolus from the mouth to the stomach safely.
Swallowing difficulties can occur at any age but is more common in older adults, particularly because of conditions that are more likely to occur in the older adult.
There are many causes of dysphagia which can include dementia, stroke, Motor Neurone disease, Parkinson’s disease, Alzheimer’s disease, head and neck cancer, head injury and as well as many other conditions.
Dysphagia has been estimated to affect 13% of older adults living in the community, approximately 25% of hospitalised individuals and up to 60% of residents living in aged care facilities.1
The condition can vary in severity and lead to serious health problems such as malnutrition, dehydration, respiratory infections and pneumonia.
As people with dysphagia may have trouble obtaining the optimal level of nutrition and hydration, adapting their eating and drinking is an important step to managing the condition. Thickened fluids and modified food textures are often part of the nutrition care plan.
What to do if the person you are caring for can’t swallow normal food or fluid?
There are specialised thickeners and pre-thickened fluid products available, such as the RESOURCE® THICKENUP® range, which are specifically developed for those who require consistency modification because of challenges with swallowing.
How can you figure out what thickness is the right one for the person you care for?
Often for people with swallowing difficulties, modified texture foods are required, and an appropriate texture may be pureed. Many nursing homes provide pureed food where appropriate, and it is important that such meals are appetising, in both taste and visual appearance, to the resident.
To make pureed foods more appealing, food moulds can be used to make the dish offered resemble “real food”. For example, mushed up peas, carrots or potatoes can be put in a mould so that they look like whole peas, carrots and potatoes are being served, as shown in the picture below.
Nestlé Health Science in collaboration with Puree Food Molds have created an easy to follow brochure full of mouth-watering nutritious puree food recipes, which use both thickening products and food moulds.
By modifying food and beverages for those people who require a modified diet, swallowing can be safe and comfortable for the person with dysphagia. This is important to ensure that people with swallowing difficulties get the nutrition and hydration they need for maintaining health and wellbeing.
As dysphagia can lead to other health problems, it is important to involve a team of experts, including a speech pathologist and dietitian, to devise an appropriate management plan to ensure optimal health.
For more information on dysphagia, please visit the ‘What is dysphagia?”.
RESOURCE® THICKENUP® Hydration and RESOURCE® THICKENUP® Clear are food for special medical purposes for the dietary management of people with swallowing difficulties. Must be used under medical supervision.
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Moulds may be a good start, however are not the end of the story.
Too often I see moulded components put on a plate – separated out, which is not always how we dish out a normal meal.
Thickeners are used to various degrees of expertise. I have tasted some very pasty unappetising meals.
Reheating can also “murder: the meal and be the final nail in the coffin.
Lets focus on the quality of the meal when received by the recipient and when they are ready to take their first bite.
This looks & sounds like a wonderful idea