ARTICLES / General /
Understanding Dysphagia /
Jeri Logemann, Ph.D., Charles A. Stewart, M.D.,
Jane Hurd, MPA,
Diane J. Aschman, MS,
Nancy L. Matthews, MA
While it’s important to educate care
providers about dysphagia, it’s also crucial
that seniors themselves learn to recognize
symptoms and seek treatment. For this to happen,
a number of longstanding barriers need to be
Many people with symptoms of dysphagia fail to
report them to physicians or caregivers, often to
avoid embarrassment. They may fear loss of
independence, or reduced enjoyment from meals.
In its early stages, individuals may be unaware
of the signs and symptoms of dysphagia, or may
choose to ignore them.
Dysphagia may be seen as a “normal” part of the
A person may be unaware of the mechanics of
swallowing and of safe swallowing strategies.
Individuals may not realize that there is a
clinical specialty dealing with swallowing problems,
and that help is readily available.
Most importantly, people may see swallowing
issues as insignificant, and remain unaware of the
The Happy Ending
With her daughter’s help, Maxine’s story began to
turn around. Her daughter arranged for Maxine to
visit her primary care physician, who referred
Maxine to a speech and language pathologist in the
outpatient department of a local medical center.
Janice, the SLP, asked Maxine about her medical
history and her current medical status. Then Janice
performed a “tabletop clinical evaluation,”
examining Maxine’s facial and throat muscle
strength, and watching her swallow measured amounts
of water, pudding, and Lorna Doone cookies. This
wasn’t at all an unpleasant or threatening
experience. In fact, Maxine began to feel better
right away because Janice assured her that there
were definitely ways to improve her swallowing even
if she were found to have a dysphagia.
Janice recommended that Maxine’s doctor refer her
to the medical center’s radiology department for an
x-ray procedure called modified barium swallow, or
MBS. Maxine was impressed by the fact that the
radiologist would watch her swallowing in real time
and could see exactly where she was having a problem
- but she was also apprehensive about having to
swallow the small amount of barium. But it turned
out to be no problem, and no more uncomfortable than
the “tabletop clinical evaluation,” and Janice was
with her the whole time.