Choking in the Elderly

Choking in elderly

Choking in The Elderly – Signs of Choking To Watch For

Choking in the elderly is a serious issue and is one of the leading causes of death for adults over the age of 76. There has been a lot of research on choking in the elderly or why exactly it happens or what medical conditions or eating habits aggravate it.

What Causes Choking in the Elderly:

Following are the common causes of choking in the elderly while eating that should closely be observed in order to prevent it.

  • Eating too fast
  • Trying to swallow large portions of food
  • Eating foods that are the wrong texture when on a special diet

Signs of Choking:

  • Coughing
  • Gagging
  • Turning blue in face and lips
  • Suddenly not able to speak
  • Passing out

News Update on Elder Abuse Case:

A Nursing Home Resident Chokes on Chicken and Dies. Chef at fault! Orange County Elder Abuse Jury Verdict! $1.25 Million. ‘Choking-Chicken’ Case

Other Contributing Reasons for Choking in Elderly 

In addition, other contributing reasons to choking in the elderly are

Parkinson’s Disease

Parkinson’s disease is a progressive neurological disorder that develops when brain cells that control movement & coordination expire and/or become impaired.

Elderly adults who suffer from Parkinson’s disease often experience difficulty in swallowing.

What is Dysphagia

Difficulty swallowing is known as Dysphagia. Dysphagia affects the muscles and nerves in the mouth and neck that are used for swallowing.  This can cause trouble in being able to safely swallow foods and/or liquids.

Aspiration from Dysphagia

Some complications from dysphagia can arise when liquid or food enters your airway while swallowing.  This is known as aspiration.  When this happens, you can develop respiratory infections, such as aspiration pneumonia.

Swallowing Problems in the Elderly Dysphagia

In people with stroke, a common complication is a poor nutrition due to limited intake of food, which can affect as many as 63% of stroke survivors. Poor nutrition is often caused by the inability to swallow food, which is a common residual for people post-status stroke.

The term “dysphagia” is used to describe the elderly with swallowing difficulties. It is important to pay special attention if that term is used in regards to your loved one because it triggers a number of different measures that must be implemented to protect your loved one from the risks of aspiration and choking.

Signs of Dysphagia in Elderly 

  • Food or drink leaving from the mouth
  • Gurgling voice after eating or drinking
  • Coughing during or right after eating
  • Extra effort or time needed to chew and swallow
  • Frequent pneumonia or chest congestion after eating, and
  • Weight loss and dehydration
  • Swallowing Problems in the Elderly

Health Consequences of Dysphagia

There are also a number of different avoidable health consequences, caused by nursing home abuse/neglect, associated with dysphagia, including:

  • Malnutrition in elderly
  • Dehydration in elderly
  • Nursing home choking
  • Lung infections
  • Urinary tract infection in elderly
  • Nursing home pressure sores
  • The decline in functioning
  • Death

What To Do When Diagnosed with Dysphagia

If your loved one has been diagnosed with any of these conditions contact us for an elder abuse attorney in Los Angeles or an elder abuse attorney in Orange County

Dysphagia Home Treatment

If your loved one is diagnosed with dysphagia, then it is important to make sure that he or she receives the appropriate diet. A dysphagia diet will consist of foods that are easy to chew and swallow. Foods that are in large chunks or pieces or that are very hard and cannot be chewed easily are to be avoided. Mechanically altered diets are defined by the National Dysphagia Diet Guidelines and are on a level system.

The National Dysphagia Diet guidelines apply to foods as well as liquids which may need to be altered as well depending on the person’s ability to swallow.

Feeding Tip for the Elderly

Here are some helpful tips to assist your loved one with safe feeding:

  • Have the person sitting upright for meals and for 30 minutes after to avoid aspiration.
  • Make eating easier by putting a towel behind your loved ones’ back and remembering chin to the chest when swallowing.
  • Coaching may be needed by family members, with small reminders like chew your food and swallow multiple times.
  • Making sure your family member is taking small bites and drinking small sips.
  • Checking the cheeks for food left behind (or pocketed), after eating.
  • Performing good oral hygiene after meals to decrease the risk of lung infections.

Aspiration pneumonia

Aspiration pneumonia is a serious illness and the elderly are more susceptible to it if they suffer from Parkinson’s disease and swallowing disorders like dysphagia.  The leading cause of death in people who suffer from Parkinson’s disease is aspiration pneumonia.  Moreover, patients who have Parkinson’s are also susceptible to choking to death when flood blocks the airway & they stop breathing.

How To Prevent Choking in the Elderly

DYSPHAGIA/SWALLOWING DIFFICULTIES 

Caused by conditions that weaken or damage the muscles and nerves used for swallowing.

MEDICAL CONDITIONS THAT AFFECT SWALLOWING:

  1. Stroke
  2. Brain or spinal cord injuries
  3. Parkinson’s disease
  4. Dementia
  5. Muscular dystrophy
  6. Multiple sclerosis
  7.  

TESTING FOR DYSPHAGIA

  1. Evaluation by Speech Pathologist
  2. Modified Barium Swallow Test
    • GOLD STANDARD
    • A videofluoroscopic swallowing exam
    • The patient is observed swallowing various consistencies and textures in order to evaluate his or her ability to swallow safely and effectively.

DIFFERENT DIETS FOR DIFFERENT LEVELS OF DYSPHAGIA

Level 1 – Pureed Nutrition Therapy

For moderate to severe dysphagia.

    1. Pureed
    2. “Pudding-like” consistency

PUREED NUTRITION THERAPY

Beverages

Any smooth, homogenous beverages without chunks or pulp.  Beverages can be thickened to the appropriate consistency.

Desserts

Smooth puddings, custards, yogurt

Fruits

Apple sauce, pureed fruit, fruit juices without seed or pulp

Meats

Pureed meats

Vegetables

Pureed vegetables without chunks

Level 2 – Mechanically Altered Nutrition Therapy

For mild to moderate dysphagia.

  1. Food that is moist
  2.  Soft-textured
  3. Chopped to no larger than 1/4 inch cubed or the size of a dime
  4. All foods that can be given for Level 1 can be given to individuals who are appropriate for Level 2.
  5.  

MECHANICALLY ALTERED NUTRITION THERAPY

Beverages

Milk, juices, coffee, tea, sodas.

Beverages can be thickened to the appropriate consistency.

Desserts

Pudding, custard, canned fruit, soft fruit pies with a bottom crust only, soft, moist cakes with icing.

Fruits

Soft drained canned or cooked fruits without seeds or skin, soft/ripe banana.

Meats

Moistened ground meat, tender cut meat/fish chopped to no larger than 1/4 inch or the size of a dime.

Vegetables

Any vegetable as long as it is prepared soft and well-cooked, and chopped to no larger than 1/4 inch.  Should be easily mashed with a fork.

Level 3 – Advanced Nutrition Therapy

For mild dysphagia.

    1. Food that is moist
    2. Bite-sized, but with a more regular texture.

ADVANCED NUTRITION THERAPY

Beverages

Milk, juices, coffee, tea, sodas.

Beverages can be thickened to the appropriate consistency.

Desserts

Any desserts except dry cakes, or cookies that are chewy or dry.

Fruits

All canned and cooked fruits. Soft peeled fruits like peaches, nectarines, mangoes, cantaloupe, honeydew, seedless watermelon, and soft berries.

Meats

Thin-sliced, tender, or ground meats and poultry.

Vegetables

All cooked, tender vegetables.

Choking Treatment and Prevention:

Some choking treatment and prevention options include exercises and swallowing techniques to help coordinate swallowing muscles and nerves. Another treatment involves learning ways to put food in your mouth and to position your head and body to allow you to swallow effectively.  A modified liquid diet that consists of specific food and liquid textures can help you swallow more successfully.   In more severe instances, a feeding tube may need to be implemented in order to circumvent the problems associated with swallowing and choking.

A speech therapist and a registered dietician can help plan out what appropriate treatment steps need to be taken.

If you or a loved one has experienced nursing home choking in the elderly, please contact one of our elder abuse attorneys in California.

Sources of Information:

  1. https://www.parkinson.org/Understanding-Parkinsons/Symptoms/Non-Movement-Symptoms/Speech-and-Swallowing-Problems
  2. https://www.nsc.org/community-safety/safety-topics/choking
  3. https://www.michaeljfox.org/news/swallowing-and-parkinsons-disease

Share the article