Dysphagia, otherwise known as disordered swallowing, can impact people who have had a stroke, a traumatic brain injury, or other neurological or neuromuscular disorders like Parkinson’s or Multiple Sclerosis. When we swallow, there are three major phases that speech-language pathologists (SLPs) and occupational therapists (OTs) usually think about — the oral phase, when we put liquid or food in our mouths and prepare it to go down our throat; the pharyngeal phase, when the muscles in our throat work together to move food safely down through our throat and into our esophagus; and finally the esophageal phase, when our esophagus pushes foods and liquids into our stomach.
These three phases require coordination and strength, and if the nerves or muscles that take part in any of those stages of swallowing are impacted, a person can be at risk of aspiration (when material like saliva, liquid, or foods goes down the trachea and into the lungs instead of down the esophagus and into the stomach), which can cause pneumonia. Check out this cool video to see how cleverly our bodies protect our airways and get food safely into our stomachs!
Looking for a few holiday tips to maximize your swallow safety? Read on!
“Diet recommendations,” doesn’t mean cutting back on sugar. This refers to the textures and consistencies of the foods and drinks that are recommended for you or your loved one’s specific dysphagia difficulties.
If you’ve had a swallow study done or worked on dysphagia with an SLP or OT, you may have had some specific compensatory strategies recommended based on you or your loved one’s needs. Make sure you follow those, whether they’re using a chin tuck or taking a clearing swallow of water following each bite of solid food. Keep reading to learn some general compensatory strategies that are helpful for just about anyone.
The first part of the oral phase of our swallow is getting our bite or sip ready, and when we do that, we need to think about size! Make sure that you or your loved one are taking reasonably sized bites and sips so that you’re able to safely get all the food or liquid past your trachea and into your esophagus. For many people with dysphagia, it is important not to take overly large bites, as that makes it harder to safely swallow. There are some situations where slightly larger bites may be helpful – it’s important to check with your therapist to make sure you’re taking the right-sized bite for you or your loved one.
When we slow down and think carefully about each step of swallowing, we are much more likely to fully clear all the food from our mouth and get it safely down our throat and into our esophagus. We also want to make sure we get all the food from the previous bite safely down before taking on any more food or drink.
If you or your loved one is having a hard time eating or drinking safely, they may need to take a step back and focus on one thing at a time. Eating and drinking are often social events, but for someone with dysphagia, it may be so effortful for them to swallow safely that they need to focus ONLY on swallowing, and might need to take a break from the conversation while they are eating or drinking. This might mean tuning conversation out for a moment, or even eating or drinking in a separate, quiet room.
Do you have a loved one who has a hard time remembering their compensatory strategies? Make them a quick, picture-reminder card that they can have at their place at the table! Something as simple as a little snail picture to remember to slow down, or even pictures of your loved one demonstrating their compensatory strategies can be SO powerful! It also can save you having to verbally remind your loved one to use their strategies in front of company – you can just quietly point to the picture as a reminder, rather than having to say anything aloud.