Swallowing Difficulties
WHAT IS DYSPHAGIA?
Dysphagia is a medical term used to describe difficulty swallowing, be it an obstruction in the throat or oesophagus, or a problem with the swallow co-ordination.
While typically more common in babies and the elderly, dysphagia is caused by multiple diseases e.g. Stroke, Alzheimer’s disease and Parkinson’s disease and can affect people of all ages. Dysphagia can cause additional health problems, and should therefore be diagnosed and treated appropriately.
Many rhythmic or repetitive functions are taken for granted until they become problematic, e.g., breathing, chewing and swallowing. However, when there is a problem in one of these functions, it can have a serious impact on people’s quality of life. Dysphagia, defined as difficulty swallowing or the feeling of an obstruction while swallowing, is one such problem.
THE CAUSE?
Causes of dysphagia include disease or damage to the nervous system, spasms of the muscles in the oesophagus or other conditions that physically block the oesophagus or cause it to narrow.1* Impaired saliva production, or dry mouth, can also make dysphagia worse.
THE CONSEQUENCES?
While dysphagia causes eating and drinking to be uncomfortable, it can also cause serious health problems. Because many people with this condition do not seek or receive a proper diagnosis or medical treatment, they eat and drink less which can lead to malnutrition and dehydration, weight loss, respiratory infections and even social problems such as avoiding eating with others.
and also
https://hellocare.com.au/choking-second-common-cause-death-aged-care-falls/
- ----------------------- - - - ----------------------- - - - ------------------------------------ - - - ---------------------------- - - - ---------------------------
Your SPeech pathologist can give specific individual advice about swallowing difficulties and food management.
Speech Language Pathologists can be a great resource for improving your receptive and expressive communication, aid in preventing memory loss, offer caregiver recommendations and help with sound pronunciation, and building swallowing strength.
http://www.parkinsonsresource.org/news/articles/having-difficulty-with-swallowing-food-or-liquids/
According to Speech Pathology Australia, 50 percent of stroke survivors and 84 percent of people with dementia experience dysphagia. Chewing and swallowing problems affect 30-50 percent of residents in aged-care facilities, with choking being the second-highest cause of preventable death.
Starting 1 May 2019, new guidelines were introduced in Australia to standardise the names and descriptions of food and drink used in medical and community settings to reduce choking risk. The new guidelines include easily accessible testing methods that allow consumers, health professionals, nursing homes and hospitals to check that the food or drink they are serving is suitable for older Australians with swallowing difficulties. The guidelines have been developed by The International Dysphagia Diet Standardisation Initiative (IDDSI), which Speech Pathology Australia is actively supporting.
Chewing and swallowing are such a rhythmic and repetitive function for the average person that the act of eating and drinking barely requires any effort or pre-planning, but like everything that we take for granted – only when a problem arises can we begin to grasp just how vital a role it actually plays in our overall well being. The medical term for swallowing difficulties is dysphagia, and these types of issues can occur from an obstruction in the throat or oesophagus or a problem with swallow coordination.
“A lot of people think that sandwiches are soft, but sandwiches require the same number of chewing strokes that a person needs for a piece of meat, and when you look at coronial reports and autopsy reports of elderly people who have died from choking – sandwiches, are all over these reports. They are a high-risk choking item and people don’t necessarily view them in this way,” said Julie. “People will sometimes say that an individual doesn’t have a swallowing problem when this person is missing a few teeth or might have dentures, but if they can’t chew their food down into small enough pieces, then that can potentially block the airways.”
-------------------------------------------
Swallowing refers to the seemingly simple process that gets food and drink from our mouths to our bellies. But the process is anything but simple, and for some, with a condition known as dysphagia or difficulty swallowing, it can seem downright impossible.
“Swallowing happens in three main phases,” explains Stephanie Reyes, a speech language pathologist in the Center for Voice, Airway and Swallowing Disorders at the Medical College of Georgia at Augusta University and AU Health.
“It’s almost like a relay race from the mouth to the throat to the stomach,” Reyes says. “The baton has to be passed on to the next runner at every step and in a smooth way.” Dysphagia occurs when that baton is dropped.
https://jagwire.augusta.edu/6-19-ready-hh-rr-difficulty-swallowing-is-a-symptom-mcg-au-health-team-can-help-find-the-cause/
Dysphagia affects 14% of the population who are over the age of 50, and without any form of medical treatment, it can cause serious health problems like malnutrition and dehydration by affecting a person’s will to consume food and drink. What one person deems as ‘soft’ can be completely different to someone else’s interpretation, and this can have dire consequences for people who are living with dysphagia as they have an extremely increased risk of choking when compared to the rest of the population.
One of the most effective tools in combating these kinds of issues for people living with dysphagia is the usage of texture modified foods and drinks, and the people who prepare these for those with swallowing difficulties have the responsibility of ensuring that the food and drink they serve is safe to consume.
Building swallowing strength - Dysphagia is a term used to diagnose when a patient expresses having difficulty with swallowing foods and liquids.1
What are some signs that you may have difficulty swallowing? Here are some signs identified by the Mayo Clinic.
If you have any of these symptoms, we recommend that you speak with your doctor immediately and tell him/her what foods trigger these responses. Your doctor can then give you a referral to speech-language pathologists and in some cases may suggest that you have a Videofluoroscopic Swallow Study (VFSS), a moving x-ray that gives your doctor real-time information as to how your muscles are moving. During this examination, the speech-language pathologist will give you different foods to eat, all of which are coated with a special substance called barium that allows the food to be visible during the x-ray procedure.
Note. Loss of weight and inability to eat are markers for qualifying for Hospice care.
https://speechpathologyaustralia.org.au/
Why dry mouth in the elderly is hard to identify, but can’t be ignored
By: Jo Purssey in Clinical Focus, Opinion, Top Stories October 31, 2018
https://www.agedcareinsite.com.au/2018/10/why-dry-mouth-in-the-elderly-is-hard-to-identify-but-cant-be-ignored/
In Australia, our population is ageing. In order to support our overall health, this means we need our teeth and mouth to remain healthy for much longer.
There are many oral health issues that can particularly impact the aged and elderly population. Some are obvious – like tooth decay, tooth loss or gum disease – while others can be much more difficult to identify and therefore treat. One example of a condition that is hard to identify is ‘dry mouth’. While the name might give the impression that this condition is merely an inconvenience, it can, in fact, have very serious health consequences.
What is dry mouth?
Xerostomia is the professional term for dry mouth. As a condition, it has been defined as a personal perception of dry mouth. Salivary Gland Hypofunction (SGH) is a physiological condition where there is a reduction in the quality or quantity of salivary flow. Xerostomia may or may not be accompanied by SGH.
Low saliva flow is most commonly caused by inadequate hydration, although other factors can also play a part.
These can include the side-effects of certain medications or damage to the salivary glands by disease, or treatments like radiation therapies.
Complex medical conditions, compromised health and the simultaneous use of multiple medications are common among the elderly. This makes them highly susceptible to the risk factors and consequences related to dry mouth.
= - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = -
It is important not to eat soft food all the time (unless that is all you can safely manage), as the muscles in the jaw need exercise too. While each individual will have different problems and therefore different solutions, the following suggestions may help.
Ø Food that is soft and moist, with a good flavour and smell, tends to be easier to swallow: custards, jelly, pureed fruit, sauces, spices and herbs.
Ø Avoid foods which are hard, dry, crumbly or stringy.
Ø Avoid mixed consistencies (e.g. solid plus liquid).
Ø Be careful with foods which stick to the roof of the mouth or get caught around the mouth: dry mashed potatoes, tomato with skin on, biscuits, bran flakes, hard-boiled eggs.
Ø Thicker fluids (e.g. nectars, milk shakes) may be easier to control and swallow than thin clear liquids, as they move more slowly.
Ø Keep food presentation appetising: flavour, smell and appearance of food.
Ø Relax and enjoy your food. It is good to have a break between mouthfuls and take sips of water during the meal. This will not only help you relax but also allow you to clear your throat and mouth. You may need to swallow twice to clear each mouthful.
Ø Eat smaller portions more frequently, especially if time for meals is limited.
The National meals Guidelines:
http://mealsonwheels.org.au/wp-content/uploads/2016/10/NationalMealsGuidelines2016.pdf
so DO think about having the services of Meals on Wheels.
A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019
Reheating
Food needs to be reheated to a minimum of 75 degrees for two minutes to destroy any bacteria or viruses that might be present. Frozen food needs to be completely thawed before reheating. Extra care must be taken when reheating food in a microwave to ensure that it is heated evenly, as bacteria can survive in portions of poorly heated food.
Possible problem foods:
-mixed textures, like liquid with bits in - minestrone soup or watery mince
-flakey biscuits;
-hard toast or nuts, chocolate, grains, seeds;
-fresh white bread (try wholemeal bread; it is easier to swallow).
-Foods that may be easier to swallow
-boiled milk;
-mousse, custard, yoghurt, icecream;
-souffle, omelette;
-casseroles;
-soup;
-fruit juice, pureed fruit;
-pancakes (with syrup etc.);
-rice;
-well cooked vegetables;
-banana.
If you are using more and more liquid meals, it is important to keep up your energy intake. Your dietician may recommend appropriate supplements and guidelines. You can make liquid foods thicker by using instant pudding, yoghurt, gelatine or instant potato powder.
Looking after oral health in aged care
Last Updated at September 24th 2021
Oral and dental issues don't just impact on a person's smile or how well they are able to consume foods, it’s also important for many other reasons, including the overall health of an older person.
Upkeeping your oral health in your later years is really important to your overall health. Developing oral diseases can drastically impact your quality of life and even result in severe pain if teeth are not taken care of properly. It can result in bacteria from dental plaque entering the body through airways and bloodstreams, which can result in aspiration pneumonia, heart attacks, stroke, a lowered immune system and poor diabetic control.
Bad dental hygiene can also affect continence management; cause delirium, depression, and dementia; and impact skin integrity, mobility and nutrition intake. Having good, maintained oral health is incredibly important and helps protect the body against certain infections -which is incredibly important for an older resident's overall health.
- = - = - = - = - = - = - = - = - = - = - = -
Why Are Older People More Vulnerable To Poor Dental Health?
Dental Health Often “Overlooked” In Australian Nursing Homes
By Caroline Egan. Oct 29, 2018
It can become difficult for older people to take care of their teeth as they age, and so they will often have to rely on others for their dental care.
Conditions such as arthritis and dementia can make it particularly difficult for older people to maintain their oral hygiene.
“Reduced mobility means many residents cannot clean their teeth properly, or visit a dentist for treatment,” said Dr Peppitt. “We need to make it easier for people to get the care they need.”
How Can Poor Dental Health Affect Older People?
Poor dental health can have profound effects on older people’s quality of life. It may mean older people can’t chew properly, and therefore limit the food they can eat. If people are unable to eat the foods they enjoy, they may eat less, and thereby lose weight and becoming malnourished.
Tooth decay, gum disease, and having a dry mouth – a common side effect of many medications used by older people – can make it difficult to swallow.
Having a dry mouth can also make it difficult to speak, taste and chew, and increases the risk of tooth decay, oral infections, and aspiration pneumonia. Aspiration pneumonia is a common cause of hospital admissions among older people, and can lead to death.
Gum diseases, such as gingivitis and periodontitis, have been found to be good indicators of heart disease. One of the best ways to guard against heart disease is to maintain good oral hygiene.
Poor dental health may affect a person’s ability to sleep and relax because of the discomfort they are experiencing.
Older people may feel their teeth contribute to a decline in their appearance, which can affect confidence, and in turn may make people stop talking to others, or prompt people to withdraw from society. Older people’s teeth can darken in colour due to staining and the thinning of the enamel layer.
Teeth problems can make it difficult to communicate with others, whether it be through having trouble speaking, or through loss of confidence.
People with diabetes are more prone to gum disease, which can in turn exacerbate the diabetes and increase the risk of cardiovascular complications.
Dental plaque and bacterial colonisation of the teeth, gums, tongue and dentures can increase the likelihood older people will develop respiratory tract infections.
----------------------------------------
What Causes Choking?
For older people as they age their swallowing function can deteriorate along with their teeth often weak or absent. The mucosal surfaces in the mouth and throat are less moist. There is a loss of muscle strength in the mouth and throat that slows swallowing and makes it difficult to swallow hard or dry solid foods.
Why Is Choking Common In Aged Care?
Two-thirds of aged care residents – 67% – suffer from ‘dysphagia’, which means ‘swallowing problem’.
That’s a significant number – in a dining room of sixty resident, a total of forty will have dysphagia. Dysphagia can affect healthy people, but it can also be the result of a stroke, head and neck cancer, dementia, and Parkinson’s disease.
Not surprisingly, failure to properly manage dysphagia can be fatal. People with dysphagia can choke, become malnourished or dehydrated, or get pneumonia.
How Can You Tell If Someone Has Dysphagia?
Speech pathologists are able to diagnose dysphagia. In rural and remote areas, where a speech pathologist may not be available, nurses can diagnose dysphagia.
They will look for:
5 June, 2018
https://hellocaremail.com.au/choking-second-common-cause-death-aged-care-falls/
------------------------
7 common Alzheimer's eating problems and how to cope with them
by Paula Spencer Scott, Senior Health Writer Last updated: Mar 05, 2018
For when your loved one doesn't eat, or won't eat...
Possible causes:
The person may forget mealtimes altogether because of memory loss.
The person may not eat much during meals because of:
------------------------
If a feeding tube is recommended to deal with difficulty swallowing (as often happens to someone with severe dementia), do think long and hard before giving the green light.
31 October 2018
A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019
WHAT IS DYSPHAGIA?
Dysphagia is a medical term used to describe difficulty swallowing, be it an obstruction in the throat or oesophagus, or a problem with the swallow co-ordination.
While typically more common in babies and the elderly, dysphagia is caused by multiple diseases e.g. Stroke, Alzheimer’s disease and Parkinson’s disease and can affect people of all ages. Dysphagia can cause additional health problems, and should therefore be diagnosed and treated appropriately.
Many rhythmic or repetitive functions are taken for granted until they become problematic, e.g., breathing, chewing and swallowing. However, when there is a problem in one of these functions, it can have a serious impact on people’s quality of life. Dysphagia, defined as difficulty swallowing or the feeling of an obstruction while swallowing, is one such problem.
THE CAUSE?
Causes of dysphagia include disease or damage to the nervous system, spasms of the muscles in the oesophagus or other conditions that physically block the oesophagus or cause it to narrow.1* Impaired saliva production, or dry mouth, can also make dysphagia worse.
THE CONSEQUENCES?
While dysphagia causes eating and drinking to be uncomfortable, it can also cause serious health problems. Because many people with this condition do not seek or receive a proper diagnosis or medical treatment, they eat and drink less which can lead to malnutrition and dehydration, weight loss, respiratory infections and even social problems such as avoiding eating with others.
and also
https://hellocare.com.au/choking-second-common-cause-death-aged-care-falls/
- ----------------------- - - - ----------------------- - - - ------------------------------------ - - - ---------------------------- - - - ---------------------------
Your SPeech pathologist can give specific individual advice about swallowing difficulties and food management.
Speech Language Pathologists can be a great resource for improving your receptive and expressive communication, aid in preventing memory loss, offer caregiver recommendations and help with sound pronunciation, and building swallowing strength.
http://www.parkinsonsresource.org/news/articles/having-difficulty-with-swallowing-food-or-liquids/
According to Speech Pathology Australia, 50 percent of stroke survivors and 84 percent of people with dementia experience dysphagia. Chewing and swallowing problems affect 30-50 percent of residents in aged-care facilities, with choking being the second-highest cause of preventable death.
Starting 1 May 2019, new guidelines were introduced in Australia to standardise the names and descriptions of food and drink used in medical and community settings to reduce choking risk. The new guidelines include easily accessible testing methods that allow consumers, health professionals, nursing homes and hospitals to check that the food or drink they are serving is suitable for older Australians with swallowing difficulties. The guidelines have been developed by The International Dysphagia Diet Standardisation Initiative (IDDSI), which Speech Pathology Australia is actively supporting.
Chewing and swallowing are such a rhythmic and repetitive function for the average person that the act of eating and drinking barely requires any effort or pre-planning, but like everything that we take for granted – only when a problem arises can we begin to grasp just how vital a role it actually plays in our overall well being. The medical term for swallowing difficulties is dysphagia, and these types of issues can occur from an obstruction in the throat or oesophagus or a problem with swallow coordination.
“A lot of people think that sandwiches are soft, but sandwiches require the same number of chewing strokes that a person needs for a piece of meat, and when you look at coronial reports and autopsy reports of elderly people who have died from choking – sandwiches, are all over these reports. They are a high-risk choking item and people don’t necessarily view them in this way,” said Julie. “People will sometimes say that an individual doesn’t have a swallowing problem when this person is missing a few teeth or might have dentures, but if they can’t chew their food down into small enough pieces, then that can potentially block the airways.”
-------------------------------------------
Swallowing refers to the seemingly simple process that gets food and drink from our mouths to our bellies. But the process is anything but simple, and for some, with a condition known as dysphagia or difficulty swallowing, it can seem downright impossible.
“Swallowing happens in three main phases,” explains Stephanie Reyes, a speech language pathologist in the Center for Voice, Airway and Swallowing Disorders at the Medical College of Georgia at Augusta University and AU Health.
- The first phase is the oral phase, when the brain sends messages to the mouth to chew the food, and the muscles there mix it with saliva to form a bolus and move it toward the back of the mouth.
- During the second, known as the pharyngeal phase, the vocal folds close to keep food and liquids from entering the airway and the tongue and throat muscles push the bolus into the esophagus.
- In the third and final phase, the esophageal phase, food and liquids move further into the esophagus, which contracts and moves the food into the stomach.
“It’s almost like a relay race from the mouth to the throat to the stomach,” Reyes says. “The baton has to be passed on to the next runner at every step and in a smooth way.” Dysphagia occurs when that baton is dropped.
https://jagwire.augusta.edu/6-19-ready-hh-rr-difficulty-swallowing-is-a-symptom-mcg-au-health-team-can-help-find-the-cause/
Dysphagia affects 14% of the population who are over the age of 50, and without any form of medical treatment, it can cause serious health problems like malnutrition and dehydration by affecting a person’s will to consume food and drink. What one person deems as ‘soft’ can be completely different to someone else’s interpretation, and this can have dire consequences for people who are living with dysphagia as they have an extremely increased risk of choking when compared to the rest of the population.
One of the most effective tools in combating these kinds of issues for people living with dysphagia is the usage of texture modified foods and drinks, and the people who prepare these for those with swallowing difficulties have the responsibility of ensuring that the food and drink they serve is safe to consume.
Building swallowing strength - Dysphagia is a term used to diagnose when a patient expresses having difficulty with swallowing foods and liquids.1
What are some signs that you may have difficulty swallowing? Here are some signs identified by the Mayo Clinic.
- Having pain while swallowing
- Being unable to swallow
- Having the sensation of food getting stuck in your throat or chest or behind your breastbone
- Drooling
- Being hoarse
- Bringing food back up (regurgitation)
- Having frequent heartburn
- Having food or stomach acid back up into your throat
- Unexpectedly losing weight
- Coughing or gagging when swallowing
- Having to cut food into smaller pieces or avoiding certain foods because of trouble swallowing
If you have any of these symptoms, we recommend that you speak with your doctor immediately and tell him/her what foods trigger these responses. Your doctor can then give you a referral to speech-language pathologists and in some cases may suggest that you have a Videofluoroscopic Swallow Study (VFSS), a moving x-ray that gives your doctor real-time information as to how your muscles are moving. During this examination, the speech-language pathologist will give you different foods to eat, all of which are coated with a special substance called barium that allows the food to be visible during the x-ray procedure.
Note. Loss of weight and inability to eat are markers for qualifying for Hospice care.
https://speechpathologyaustralia.org.au/
Why dry mouth in the elderly is hard to identify, but can’t be ignored
By: Jo Purssey in Clinical Focus, Opinion, Top Stories October 31, 2018
https://www.agedcareinsite.com.au/2018/10/why-dry-mouth-in-the-elderly-is-hard-to-identify-but-cant-be-ignored/
In Australia, our population is ageing. In order to support our overall health, this means we need our teeth and mouth to remain healthy for much longer.
There are many oral health issues that can particularly impact the aged and elderly population. Some are obvious – like tooth decay, tooth loss or gum disease – while others can be much more difficult to identify and therefore treat. One example of a condition that is hard to identify is ‘dry mouth’. While the name might give the impression that this condition is merely an inconvenience, it can, in fact, have very serious health consequences.
What is dry mouth?
Xerostomia is the professional term for dry mouth. As a condition, it has been defined as a personal perception of dry mouth. Salivary Gland Hypofunction (SGH) is a physiological condition where there is a reduction in the quality or quantity of salivary flow. Xerostomia may or may not be accompanied by SGH.
Low saliva flow is most commonly caused by inadequate hydration, although other factors can also play a part.
These can include the side-effects of certain medications or damage to the salivary glands by disease, or treatments like radiation therapies.
Complex medical conditions, compromised health and the simultaneous use of multiple medications are common among the elderly. This makes them highly susceptible to the risk factors and consequences related to dry mouth.
= - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = - = -
It is important not to eat soft food all the time (unless that is all you can safely manage), as the muscles in the jaw need exercise too. While each individual will have different problems and therefore different solutions, the following suggestions may help.
Ø Food that is soft and moist, with a good flavour and smell, tends to be easier to swallow: custards, jelly, pureed fruit, sauces, spices and herbs.
Ø Avoid foods which are hard, dry, crumbly or stringy.
Ø Avoid mixed consistencies (e.g. solid plus liquid).
Ø Be careful with foods which stick to the roof of the mouth or get caught around the mouth: dry mashed potatoes, tomato with skin on, biscuits, bran flakes, hard-boiled eggs.
Ø Thicker fluids (e.g. nectars, milk shakes) may be easier to control and swallow than thin clear liquids, as they move more slowly.
Ø Keep food presentation appetising: flavour, smell and appearance of food.
Ø Relax and enjoy your food. It is good to have a break between mouthfuls and take sips of water during the meal. This will not only help you relax but also allow you to clear your throat and mouth. You may need to swallow twice to clear each mouthful.
Ø Eat smaller portions more frequently, especially if time for meals is limited.
The National meals Guidelines:
http://mealsonwheels.org.au/wp-content/uploads/2016/10/NationalMealsGuidelines2016.pdf
so DO think about having the services of Meals on Wheels.
A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019
Reheating
Food needs to be reheated to a minimum of 75 degrees for two minutes to destroy any bacteria or viruses that might be present. Frozen food needs to be completely thawed before reheating. Extra care must be taken when reheating food in a microwave to ensure that it is heated evenly, as bacteria can survive in portions of poorly heated food.
Possible problem foods:
-mixed textures, like liquid with bits in - minestrone soup or watery mince
-flakey biscuits;
-hard toast or nuts, chocolate, grains, seeds;
-fresh white bread (try wholemeal bread; it is easier to swallow).
-Foods that may be easier to swallow
-boiled milk;
-mousse, custard, yoghurt, icecream;
-souffle, omelette;
-casseroles;
-soup;
-fruit juice, pureed fruit;
-pancakes (with syrup etc.);
-rice;
-well cooked vegetables;
-banana.
If you are using more and more liquid meals, it is important to keep up your energy intake. Your dietician may recommend appropriate supplements and guidelines. You can make liquid foods thicker by using instant pudding, yoghurt, gelatine or instant potato powder.
Looking after oral health in aged care
Last Updated at September 24th 2021
Oral and dental issues don't just impact on a person's smile or how well they are able to consume foods, it’s also important for many other reasons, including the overall health of an older person.
- Sometimes difficult behaviours in people with dementia are actually linked to underlying pain due to dental issues
Upkeeping your oral health in your later years is really important to your overall health. Developing oral diseases can drastically impact your quality of life and even result in severe pain if teeth are not taken care of properly. It can result in bacteria from dental plaque entering the body through airways and bloodstreams, which can result in aspiration pneumonia, heart attacks, stroke, a lowered immune system and poor diabetic control.
Bad dental hygiene can also affect continence management; cause delirium, depression, and dementia; and impact skin integrity, mobility and nutrition intake. Having good, maintained oral health is incredibly important and helps protect the body against certain infections -which is incredibly important for an older resident's overall health.
- = - = - = - = - = - = - = - = - = - = - = -
Why Are Older People More Vulnerable To Poor Dental Health?
Dental Health Often “Overlooked” In Australian Nursing Homes
By Caroline Egan. Oct 29, 2018
It can become difficult for older people to take care of their teeth as they age, and so they will often have to rely on others for their dental care.
Conditions such as arthritis and dementia can make it particularly difficult for older people to maintain their oral hygiene.
“Reduced mobility means many residents cannot clean their teeth properly, or visit a dentist for treatment,” said Dr Peppitt. “We need to make it easier for people to get the care they need.”
How Can Poor Dental Health Affect Older People?
Poor dental health can have profound effects on older people’s quality of life. It may mean older people can’t chew properly, and therefore limit the food they can eat. If people are unable to eat the foods they enjoy, they may eat less, and thereby lose weight and becoming malnourished.
Tooth decay, gum disease, and having a dry mouth – a common side effect of many medications used by older people – can make it difficult to swallow.
Having a dry mouth can also make it difficult to speak, taste and chew, and increases the risk of tooth decay, oral infections, and aspiration pneumonia. Aspiration pneumonia is a common cause of hospital admissions among older people, and can lead to death.
Gum diseases, such as gingivitis and periodontitis, have been found to be good indicators of heart disease. One of the best ways to guard against heart disease is to maintain good oral hygiene.
Poor dental health may affect a person’s ability to sleep and relax because of the discomfort they are experiencing.
Older people may feel their teeth contribute to a decline in their appearance, which can affect confidence, and in turn may make people stop talking to others, or prompt people to withdraw from society. Older people’s teeth can darken in colour due to staining and the thinning of the enamel layer.
Teeth problems can make it difficult to communicate with others, whether it be through having trouble speaking, or through loss of confidence.
People with diabetes are more prone to gum disease, which can in turn exacerbate the diabetes and increase the risk of cardiovascular complications.
Dental plaque and bacterial colonisation of the teeth, gums, tongue and dentures can increase the likelihood older people will develop respiratory tract infections.
----------------------------------------
What Causes Choking?
For older people as they age their swallowing function can deteriorate along with their teeth often weak or absent. The mucosal surfaces in the mouth and throat are less moist. There is a loss of muscle strength in the mouth and throat that slows swallowing and makes it difficult to swallow hard or dry solid foods.
- Eating or drinking too quickly
- Swallowing food before it is properly chewed
- Swallowing small bones or small objects
- Inhaling small objects
Why Is Choking Common In Aged Care?
Two-thirds of aged care residents – 67% – suffer from ‘dysphagia’, which means ‘swallowing problem’.
That’s a significant number – in a dining room of sixty resident, a total of forty will have dysphagia. Dysphagia can affect healthy people, but it can also be the result of a stroke, head and neck cancer, dementia, and Parkinson’s disease.
Not surprisingly, failure to properly manage dysphagia can be fatal. People with dysphagia can choke, become malnourished or dehydrated, or get pneumonia.
How Can You Tell If Someone Has Dysphagia?
Speech pathologists are able to diagnose dysphagia. In rural and remote areas, where a speech pathologist may not be available, nurses can diagnose dysphagia.
They will look for:
- Coughing during or after eating or drinking
- Taking a long time to eat their meals
- Leaving meals incomplete
- Spitting out food
- Drooling
- Saying they feel full quickly
- There is a ‘wetness’ in their vocal tones
- They have recurrent chest infections and temperature spikes
- They keep food in their mouths
- Refuse food and fluids
- Weight loss
5 June, 2018
https://hellocaremail.com.au/choking-second-common-cause-death-aged-care-falls/
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7 common Alzheimer's eating problems and how to cope with them
by Paula Spencer Scott, Senior Health Writer Last updated: Mar 05, 2018
For when your loved one doesn't eat, or won't eat...
Possible causes:
The person may forget mealtimes altogether because of memory loss.
The person may not eat much during meals because of:
- A short attention span.
- Distraction.
- Confusion about how to use utensils.
- Confusion about how to eat the particular food served.
- Something problematic about the food (temperature, flavor, lack of familiarity).
- A physical impairment (sore mouth, upset stomach, reaction to a new medication, problem with denture fit).
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If a feeding tube is recommended to deal with difficulty swallowing (as often happens to someone with severe dementia), do think long and hard before giving the green light.
31 October 2018
A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019