Swallowing problems can have roots anywhere along the digestive tract from the mouth to the stomach, stemming from issues with the mouth, throat, esophagus or the area where the esophagus and stomach meet. Dysphagia is most common in older individuals and is seen in up to 38 percent of elderly individuals living on their own and up to 68 percent of seniors in long-term care, according to the American Speech-Language-Hearing Association (ASHA).

Some of the main causes of dysphagia identified by ASHA include:

• Stroke
• Dementia
• Traumatic brain injuries
• Neurological conditions like Parkinson’s multiple sclerosis and ALS (Lou Gehrig’s Disease)
• Developmental disabilities
• Head and neck cancers and treatment for those cancers
• Missing or decayed teeth
• COPD and other pulmonary illnesses
• Post-surgical complications or weakness–including following heart surgery

According to ASHA, some of the signs that your loved one may have a swallowing disorder include:

• Drooling
• Food remaining in the mouth after swallowing
• Inability to close the lips, leading to food leaking from the mouth
• Pain when swallowing
• Wet or gurgly sounding voice after eating or drinking
• Coughing during or just after eating or drinking
• Extra time and effort needed to chew and swallow

While choking is often at the forefront of caregivers’ minds, there are some other complications from trouble swallowing that may not be as obvious. Many seniors experience weight loss or dehydration because they’re not getting enough to eat or drink. According to ASHA, some patients may actually avoid certain foods or drinks because they’re too hard to manage, leaving them vulnerable to malnourishment.

There’s also a connection between trouble swallowing and pneumonia. When food gets caught in the respiratory tract instead of being swallowed properly, it can cause what’s known as aspiration pneumonia. According to the NIH, it’s the most common cause of pneumonia in the elderly and is on the rise, another important reason to get a handle on dysphagia.

There are two main routes for helping individuals with trouble swallowing, and the choice generally hinges on the patient’s diagnosis. The first involves working with muscles and nerves to help improve swallowing function, while the second involves making adjustments to work around dysphagia to help patients get the nutrition they need. In either case, physical and occupational therapists, along with speech/language pathologists, offer hope and relief to patients experiencing trouble swallowing and their caregivers. With a cadre of qualified therapists on staff, short-term rehab is often the best setting to tackle dysphagia.

Other ASHA-recommended therapies include oral-motor exercises designed to stimulate the lips, jaw, tongue and other parts of the head and neck, strengthening the tongue and throat to help restore swallowing function long term. Therapists can also help patients change posture to help facilitate swallowing–including adjusting head, neck and chin position. These exercises are generally conducted by a trained speech/language pathologist or physical therapist.

Some of the therapies designed to work around dysphagia include using utensils differently,  changing the amount of food eaten with each bite and the pace of eating and making diet modifications to get optimal nutrition while avoiding problem foods.

Neuromuscular electrical stimulation, which involves stimulating the nerves of the neck to create muscular response is another valuable therapy tool approved by the FDA for more than 15 years. It’s generally not used alone but can be beneficial in some patients (including stroke survivors) as part of a multi-pronged approach to swallowing therapy.

At Evergreen Health and Rehab, our team of physical, occupational and speech/language therapists has extensive experience in helping patients and families manage swallowing difficulties. Whether swallowing therapy is part of an overall rehab program for stroke recovery or chronic illness or a key focus of treatment, our team is there to support you in tackling this sometimes overlooked complication that can make such a big difference for patient health.