Why do dementia patients have swallowing issues
Dementia can affect many different parts of the brain, including the part responsible for swallowing. This is known as dysphagia. Dysphagia can cause some people living with dementia to be afraid to eat as they fear that they will choke or that it will be painful to swallow. The Alzheimer’s Society says that “A person with dementia may have difficulties with chewing food. They may forget to chew or they may get tired easily.” They may also leave harder foods on the plate because they find it harder to chew, keep food in the mouth without swallowing, or chew continuously. Other reasons that they may be reluctant to chew or swallow include:
Ill-fitting dentures
This could make chewing painful or uncomfortable
Inability to taste
May make someone reluctant to eat
Mouth ulcers
Oral hygiene is essential to avoid discomfort
Sight issues
An inability to see food and coordinate eating
How to help if the person is spitting out food
If the person is spitting out chunks of food, it could be because they are finding chewing difficult or are afraid to swallow it. A fear of choking is very real for some people living with dementia and ensuring they are in a comfortable position to eat may help them to approach eating. The Alzheimer’s Society agrees. “If the person is drowsy or lying down, they may struggle to swallow safely which may cause them to choke.” Sitting someone up or adjusting their position to a comfortable and safe one to attempt eating may make the difference between them being reluctant to eat and trying it. Cutting food into more manageable-sized pieces may also help, but it’s important to encourage the person to do this for themselves first to avoid depriving them of their independence. If the problem becomes pronounced and the person is refusing to eat and subsequently losing weight, the GP may refer them to a speech and language therapist who can recommend measures. These may include suggesting softer foods that are easier to chew and swallow, or, if it’s necessary, pureed food.
What do if the person forgets to swallow
As the brain becomes more affected by dementia, the person may forget the entire process of eating and may not experience hunger or thirst. This is why the people caring for them must continue to encourage them to attempt to eat and drink. Otherwise, weight loss may occur, which could harm their overall well-being. The NHS suggests several ways to assist someone who is struggling to swallow, including:
Small bites and small sips should be encouraged, one at a time
Use a slow pace and safe feeding techniques such as ensuring the person is upright
Make sure they are fully awake and alert
Try giving verbal prompts to swallow and clear their mouth if possible
Mirroring another person’s eating technique may help them
Keep them involved as much as possible
What to do if food stays in the mouth
If food stays in the mouth when attempting to eat and the person seems reluctant to swallow it’s important to try and work out why. Only by trying to understand the person’s reality and what they are experiencing can we hope to help them. Getting angry or frustrated with someone who isn’t eating won’t help the situation. Instead, we have to try and work out what is worrying them or why they don’t want to swallow. Each person living with dementia is an individual and deserves to be treated with dignity and respect and helping them to live well with their dementia is just one of the ways we can support them. Asking the GP to refer them to a speech and language therapist may help their ability to swallow by suggesting the best types of food consistency to ensure they get all of the nutrients they need. They will also support with posture and suggest other strategies to assist the person in swallowing.
The Alzheimer’s Society also tells us that “As people get older they often begin to lose their sense of taste and smell, which can lead to food tasting less pleasant. People with dementia may begin to want more sugar and salt in their food, and it’s common for them to begin eating more sweet foods.” Balancing their diet is important so that they don’t become at risk of other health problems such as diabetes; however, adding more flavour may help the person to rediscover their enthusiasm for eating.
How Helping Hands can help with dementia care
Because Helping Hands have been supporting people living with dementia since we were established in 1989, we are the UK’s most trusted home care provider. We’ve helped thousands of people to live as well as possible with their dementia, always focussing on the positives and ensuring they remain at the centre of their care experience. We have professional carers across the whole of England and Wales who are dedicated to providing visiting and live-in care that exceeds people’s expectations again and again. Routine is often important to people who are living with dementia and we’ll offer unrivalled local support that minimises change. We’ll send the same carers to you whenever possible so that you get used to the people coming into your home and understand that they’re there to help. Having care at home means you get to stay in the place that means the most to you, surrounded by precious people, pets and memories that will help reduce anxiety and confusion.
We source, select, assess, and train our carers ourselves as we believe it’s too important to put this process in the hands of anyone outside Helping Hands. We also own and manage all of our 155 local branches as we don’t sell franchises – unlike our competitors. Talk to us today about dementia care at home and see how we could help you to live well at home.