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Understanding Dysphagia
By Jeri Logemann, Ph.D., Charles A. Stewart, M.D., Jane Hurd, MPA,
Diane J. Aschman, MS, Nancy L. Matthews, MA

(Page 1 of 4)

At the age of 78, Maxine was a poster girl for an active senior lifestyle. She loved being the unofficial social director of her assisted living community in the Texas Hill Country, organizing shopping trips to San Antonio and calling the numbers at the daily bingo game. Physically, Maxine was in great shape. She took a brisk walk every morning and had a regular annual physical exam. Her only chronic health problem was mild Parkinsonís, which she controls with daily medication.

Since Maxine especially enjoyed sitting with her special friends at dinner, she was very concerned when she began to experience prolonged coughing fits at the table. At first she thought the problem might be simply trying to talk, eat, and breathe at the same time Ė so she decided to listen more and speak less. Things got better for a while, though her friends did notice how quiet and subdued she seemed.

Eventually, Maxine began to skip going to dinner and ate in her room instead. She also began to have difficulty swallowing her medication and vitamins. Sometimes she needed a whole glass of water to get them down. Worried, she began to have trouble going to sleep, which made her look tired. This change was very apparent to Maxineís daughter when she came to visit from out-of-state. Maxine had always been so upbeat and positive. Now, for the first time, she seemed confused and depressed.


What we donít know can hurt us.

Dysphagia is the medical term for difficulty or inability to swallow. Although itís rarely talked about, dysphagia can have an immediate negative impact on quality of life. Eating, after all, is a pleasurable group activity. A good meal satisfies more than just the appetite. This may be especially true for residents of independent or assisted living communities, for whom mealtimes are a highlight of the day. Beyond the social issues, dysphagia can also have serious health-related consequences, including malnutrition, dehydration, and aspiration pneumonia.

Yet difficulties in swallowing are not a natural result of aging. They are treatable and preventable, with recognition of the problem as the first step. However, there is evidence that dysphagia is often undiagnosed or untreated: a recent study in Los Angeles County found incidence of swallowing issues in approximately 11 percent of seniors in assisted or independent living facilities. Administrators in these facilities confirm that residentsí swallowing disorders are often unnoticed until the condition has become fully established. At that point, a feeding tube may become necessary. As a result, the resident may need to be transferred to a skilled care environment where appropriate support can be provided. Ignored or unidentified, dysphagia can lead to a basic loss of independence and self-sufficiency.


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