Swallowing problems in dementia.

• Swallowing problems in dementia and age related swallowing difficulties are very common in moderate to advanced dementia.

• Swallowing co-ordination diminishes with dementia.

• Risk of silent aspiration and chest infections increases in dementia with swallowing problems.

• The first sign of swallowing problem is coughing after swallowing solids and liquids.

• The person should be sitting upright and forward to reduce the risk of “silent aspiration” (food or fluid going down the wrong way into the lungs)

• Supervised meals where they swallow small amounts and if food is too difficult to swallow then it should be cut up finely with gravy to assist with swallowing.

• Sometimes the Speech Pathologist may recommend thickened fluids which may be easier for the patient with dementia and impaired swallowing to cope with and reduce the risk of it going down the wrong way.

• Unfortunately many patients hate thickened fluids, as there is nothing worse than having thickened tea or coffee. 

• When pills get stuck in the throat, you can try taking pills with custard or yoghurt.

• Avoid pills that dry the mouth (anti-cholinergic drugs) and sedatives which impair swallowing muscle co-ordination.

• GAMA syndrome (published by Dr Lipski) occurs in frail older people with-

  ·       G-poor walking balance (gait ataxia).

  ·       A-Alzheimer’s Dementia.

  ·       M-Malnutrition. 

  ·       A-Silent aspiration of food and fluids.

• The GAMA syndrome is a reflection of severe neuro-degenerative brain disorder.

• Never let people with dementia eat or drink in bed or slouched back on the lounge chair which will increase their risk of aspiration.

For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.