Oct 30, 2021
Alzheimer's Disease Care: Swallowing Problems Part I: The Basics with Melissa Batchelor
Typically, around 85% of people will experience swallowing problems, medically known as dysphasia, at the end-of-life. What this means is that your loved one, or someone you care for, has trouble swallowing food, liquids, or both.
This is a 4-part series on Alzheimer's Care and Swallowing Problems, and this episode is focused on The Basics.
In Part 2, I will talk about how to Modify Textures + Flavor Building.
In Part 3, I will review what Adaptive Equipment is and how to use it; and in
In Part 4, I will talk about Maximizing Independence in Eating.
If you missed an episode, you can check them out where you found this one – or on my YouTube Channel, MelissaBPhD.
✔️ MAIN POINT 1: WHAT IS A SWALLOWING PROBLEM
What is Dysphagia?
- Some people will have trouble swallowing certain foods or liquids;
others can't swallow at all
- Signs of dysphagia
– Coughing or choking when eating or drinking
– Bringing food back up, sometimes through the nose
– A sensation that food is stuck in your throat or chest
– Persistent drooling of saliva
Complications of Dysphagia:
- Malnutrition
- Dehydration
- Aspiration Pneumonia
Treating Dysphagia:
- Speech-Language Therapy to learn new swallowing techniques
- Change consistency of food and fluids to make them safer to swallow
- Alternative forms of feeding – Tube Feeding or Handfeeding
✔️ MAIN POINT 2: SWALLOWING PROBLEMS: WHO, WHAT, AND WHY
▪ Demographics
▪ Estimated that 9 million Americans experience difficulty swallowing
▪ 1 in 5 older adults; 40% of those living in nursing homes or assisted living facilities
▪ Alzheimer's Disease: 80%
▪ Parkinson's Disease: 60%
▪ Underlying Health or Chronic Conditions
- Nervous System
▪ Stroke, Head Injury, Parkinson's Disease or Dementia
- Cancer
▪ Mouth or Throat Cancer
- Gastroesophageal Reflux Disorder (GERD)
- Other Conditions:
▪ Trouble with swallowing or chewing
▪ Have trouble moving or have lost feeling in parts of your mouth, such as lips or tongue
▪ Tooth pain; Missing teeth
▪ Psychosocial Considerations
▪ Impaired social and psychological well-being
▪ Increased worry about choking in front of others
▪ Caregiver fear/ anxiety
▪ Caregiver burnout in managing the needs of unfamiliar disease
▪ Lack of comprehensive guidelines for the management of dysphagia in older adults.
✔️ MAIN POINT 3: LEARNING THE LINGO TO ADAPT FOOD AND FLUIDS
Diet Consistencies:
- Regular Diet
- Mechanical Soft Diet
– These foods require less chewing than foods on a regular diet.
– Foods may require different textures and thicknesses, such as chopped, ground, or pureed foods
- Pureed Diet
– Minced, Pureed, or Liquidized
- Foods don't require chewing, such as mashed potatoes or pudding
- Can also blend or stain other foods to make them smoother
- Liquids, such as broth, milk, juice or water, may be added to foods to make them easier to swallow.
Liquid Consistencies:
- Pudding Thick (Extremely thick)
- Honey Thick (Moderately thick)
- Nectar Thick (Mildly Thick)
- Thin (Slightly thin)
If you have questions, comments, or need help, please feel free to drop a one-minute audio or video clip and email it to me at melissabphd@gmail.com, and I will get back to you by recording an answer to your question.
About Melissa Batchelor, Ph.D., RN, FNP-BC, FGSA, FAAN:
I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my Ph.D. in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.