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Tips & advice

Nutrition management of dysphagia can feel overwhelming, so we’ll try and make it easier for you. In this section, we’ll share tips and advice for patients seeking healthcare resources, and how caregivers can help.



Preparing for your visit with a doctor



Your family doctor is your gateway to various healthcare resources. From screening and assessment, to recommendation on what products to use, they are often your first point of contact for medical care for swallowing difficulties. When you’ve decided that you would like to speak with your doctor about your swallowing problems, you have already taken the first step in understanding dysphagia and what it means for you.

To help you get the most out of your meeting with your doctor, here are some questions you may like to ask about your possible swallowing difficulties:

  • How will my swallowing problems be tested?
  • What could be causing my swallow difficulties?
  • What kind of management options are available, and what can I expect from them?
  • Will I be referred to any other healthcare specialists, and what can I expect from them?
  • What can I do to help manage my swallowing problems at home?
  • Where can I go to learn more about dysphagia and ways to manage this condition at home?

You can expect your doctor to ask you a number of questions, such as:

  • How long have you had swallowing difficulties?
  • Can you describe what your swallowing difficulties feel like?
  • Have you taken any self-assessments? (It may help to discuss your EAT-10 results with your doctor)
  • Can you think of any specific events that caused them to start?
  • Are your swallowing difficulties ongoing or intermittent? Specifically, when do you have swallowing difficulties?
  • Are you doing anything right now to manage your swallowing difficulties at home?
  • How have your swallowing difficulties impacted your life? Have they affected how much you eat or drink? Have they caused any other problems?

Who is involved in dysphagia care?

Caring for an individual with dysphagia may require many different healthcare professionals, in addition to your family and friends. In many cases, healthcare professionals take a multi-disciplinary team approach to caring for your swallowing problems. In all cases, your care ultimately revolves around ensuring you can swallow safely. While you may not require help from everyone on the list below, keep them in mind as you manage your swallowing difficulties.

General practitioners

General practitioners, also known as family physicians or family doctors, are the first point of care for many Canadians. They are also often the first point of contact for individuals who are looking for an assessment and care for swallowing problems. General practitioners have knowledge of a wide range of common and less common problems that patients may face and can refer dysphagia patients to appropriate specialists.

Registered dietitians

Registered dietitians are regulated healthcare professionals who are experts in nutrition. As nutrition care is a key part of living with dysphagia, dietitians are the go-to healthcare professionals for advice on how to ensure a healthy and adequate diet, especially if you require any texture changes to your food and drinks. In many cases, dietitians conduct swallowing assessments and will recommend the right texture changes for you.

Speech-language pathologists

Speech-language pathologists (SLP) are healthcare professionals who specialize in identifying and treating communication and swallowing disorders. SLPs are experts in swallowing assessments and the physiology of swallowing. SLPs are often the go-to healthcare professionals for clinical swallowing assessment to diagnose dysphagia and can recommend any food texture changes, postural modifications and/or rehabilitation exercises.

Occupational therapist

Occupational therapists are healthcare professionals who specialize in helping patients achieve a sense of normalcy in their life. Occupational therapists’ role in dysphagia management is diverse, including assisting dysphagia patients with feeding strategies, environmental and behavioural modifications, and conducting swallowing assessments.

Specialist physicians

Radiologists, neurologists, gastroenterologists, and otolaryngologists (ear, nose, and throat doctors) may also be involved in dysphagia care as these specialist physicians have advanced knowledge of the medical issues that are related to swallowing problems.

Dentists and registered dental hygienists

Oral care is a key component in living a healthy life with dysphagia. Aspiration pneumonia is a potential serious risk of dysphagia, and poor oral hygiene can increase this risk. (Koichiro 2011) Given the importance of oral care in dysphagia management, dental healthcare professionals play an important role in dysphagia care.

Healthy habits and mealtime tips

Posture and mealtime tips

Below are a few tips that may help you reduce your risk of choking while eating. It is important to ask your healthcare professionals which of these tips may be right for you, and if there are any others that may help you to swallow better.

  • Eating while sitting upright and avoiding lying down while eating
  • Eat when you are fully awake and alert
  • Avoid distractions while you eat, such as talking or watching television, to help you concentrate on your swallowing
  • If you find it difficult to keep upright while eating, put cushions around yourself to stop you from leaning over to one side
  • If you find it difficult to hold your head up, try using neck cushions for help
  • Avoid stretching your neck backwards while you are swallowing
  • If you need help with eating, the person who is helping you should be in front of you but lower down than the seat of your chair
  • Take small bites and sips, and don’t put more food in your mouth until you have swallowed the previous mouthful
  • Remain upright for at least 30 minutes after eating to avoid reflux
  • Try not to talk while you eat; talking opens up the airway, making it easier for you to choke
Oral care

People with dysphagia may be at increased risk of aspiration pneumonia. (Baijens L, et al. European Society for Swallowing Disorders – European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Int Aging. 2016:11:1403-1428) This may occur when harmful mouth bacteria is carried into the lungs along with food, drink or saliva. For this reason, oral care is very important for people with dysphagia. Keeping a clean and healthy mouth, including your tongue and palate, can be an important part of managing the risk of aspiration pneumonia. (Koichiro 2011) Ask your dental or healthcare professional about the right oral health plan for you.

Dry mouth can be a concern for people with dysphagia. Dry mouth may make swallowing problems worse by making it difficult to manipulate food and drink in the mouth, and to form a bolus. It may lead to a number of oral health problems such as gum disease, tooth decay, and infections. (Ouanounou A. Compend Contin Educ Dent. 2016 May;37(5):306-311) This is because saliva has a role in keeping your mouth clean and healthy. Ask your healthcare professional about using mouth-lubricating products, such as artificial saliva.

Advice for caregivers and friends

When your friend or a loved one has dysphagia, it’s normal to want to do everything you can to help. There are many things you can do to help, such as:

  • Keeping track of medications and medical appointments
  • Writing a list of questions and taking notes during your visits with healthcare professionals
  • Watching for signs of changes in mood or health, and raising any concerns with the person’s healthcare professionals
  • Learn about dysphagia, so you can help your friend or loved one identify any signs of swallowing problems or changes in condition

Taking care of someone with dysphagia can be physically and emotionally demanding for the caregiver. This is why it’s so important for the caregivers and friends of those living with dysphagia to also take care of themselves, and to reach out for help if the demands and stress are too much.

It may be a good idea to share your feelings with someone you trust or another caregiver who may understand and share in your challenges. Take care of your physical health. Eat healthy and nutritious foods, and try to be physically active most days of the week.

Try to have daily conversations about a topic that is not related to dysphagia or the condition that caused it. Keep up with current events and local news to broaden your outlook and keep the conversations going.

Online resources

There is a variety of online resources from reputable organizations to help you recognize signs of caregiver stress. The below is just a short list of links that you may find useful.

SELF-ASSESSMENT
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Nestlé Health Science has made every effort to include on this website only information that it believes to be accurate and reliable. Information provided on this site is for education purposes. It is not intended to replace the advice or instruction of your healthcare professionals, or to substitute medical care. Contact a qualified healthcare professional if you have questions or issues about what is best for you as you manage your swallowing difficulties at home.




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