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Social Aspects of Dysphagia

By Jennifer Bradley, Staff Writer

 

On average, a person swallows 600 times a day. Every swallow requires four stages, 25 different muscles and five nerves. Drinking water or eating is something most people take for granted, while others struggle with these basic abilities on a daily basis.

Swallowing disorders (dysphagia) can be caused by a variety of issues including medical, neurological, structural, or complications with medication.  Because of this, each loved one has individual needs and concerns, especially when in social settings.

Embarrassment from loss of control or gazing onlookers may cause a loved one to become unwilling to be in a public venue, or even at a family gathering. As a caregiver, itís important to keep instilling a sense of self and independence for a loved one, yet help them deal with swallowing concerns as they arise.

Quality of Life

Thereís no denying that eating is a social activity. Changes to a personís ability to eat will surely have a large impact on the enjoyment of dining with others. Dysphagia can cause poor nutrition, dehydration, risk of aspiration and overall isolation.

Symptoms include:

  • coughing during or right after eating or drinking;
  • wet or gurgling sounding voice during or after eating or drinking;
  • extra effort or time needed to chew or swallow;
  • food or liquid leaking from or getting stuck in the mouth;
  • recurring pneumonia or chest congestion after eating; and
  • weight loss or dehydration from not being able to eat enough.

Anxiety about these symptoms becoming noticeable causes a loved one to worry and have fears of swallowing, especially in social settings. 

Quality of life is something a caregiver can maintain for a loved one by understanding, changing positioning, making proper food choices and helping with safe swallowing strategies as well as diet modification. 

Foods which are stringy, floppy, or coarse and those that require a controlled movement are hard for someone with dysphagia to consume. Some examples include bacon, lettuce, peanuts, raw foods and peanut butter.

Itís easier to take medications in a liquid form, or crushed and mixed with pureed fruits. Cooking, mashing, liquidizing and thickening foods as necessary are ways to make them easily swallowed by a loved one with dysphagia.

While eating out or at a social gathering, a caregiver should plan ahead. Call the host or restaurant and explain the situation, so itís not a big deal in front of a loved one. This eliminates extra stress on both parties, and makes the outing as smooth as possible, and even ďnormal.Ē Without planning, it could be a major upset if the host is not aware.

Strategies

While these tips may seem simple, they are also time-consuming and overwhelming for someone with dysphagia. A caregiver can help by involving a loved one in the process of food preparation, or just picking where to eat and what to eat on an outing. It helps build self-esteem, but also promotes saliva flow, which will help in swallowing when itís time.  

A big strategy is patience, and taking enough time when eating with a loved one. Rushing through a meal is an open invitation for aspiration or choking. Encourage a loved one to eat small amounts and if possible, smaller, more frequent meals. Sometimes fatigue and weakness reduce swallowing ability and causes distress in a loved one.  

The posture a loved one has during eating and drinking is extremely important if they suffer from dysphagia. Sitting upright will help both breathing and swallowing, as will having both feet flat on the floor. After meals, itís necessary for a caregiver to help a loved one remain upright for 30 to 45 minutes, to reduce the chances of reflux issues occurring. 

A therapist may recommend simple fixes such as before swallowing, having a loved one lower their chin toward the chest to reduce the chance of food going down the ďwrong tube.Ē  Also, small mouthfuls will give more control over the chewing and swallowing, to reduce the possibility of the food slipping to the back of the throat before itís properly chewed.

Sometimes a variety of ďtoolsĒ may help as well, such as a special straw that prevents liquids from falling to the bottom once sucked up. Therapeutic cups are available to take along which will aid in a loved one only receiving a small, measured amount of the drink during each swallow.

While social conversation is a big part of a meal-time gathering, it can be dangerous for a loved one with dysphagia.  Talking is connected with breathing, and if a person is excited to share something, itís easy for them to forget about the food or drink they need to swallow at the same time. 

Emotions

Most people donít like to hear, talk or implement changes in their diet or daily routines. Many times itís associated with a loss of some sort, whether it is overall freedom or enjoyment of foods they have come to expect over the years, especially at holidays and family celebrations.

While a loved one may say that they are now back to eating ďbaby food,Ē a caregiver can help overcome these negative images by reinforcing the importance of these changes for mere survival.  Ensuring nutrition and hydration are essential to life, and based on the severity of the swallowing problem, the changes may not be permanent.

Whether through a modified diet, therapy or just an increased awareness, a loved one can prevent more serve complications down the road and also live a fulfilling social life with dysphagia.  A caregiver can help them realize that there are good foods and enriching experiences available to them, with a little time spent on research and preparation.

 

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