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How To Prevent Choking in Elderly

Between 2007-2010, there were 2214 deaths reported in the United States related to choking in the elderly.  Most occurrences of choking in the elderly are due to dysphagia, or swallowing difficulties. Dysphagia is caused by conditions that weaken or damage the muscles and nerves used for swallowing. Some examples of medical conditions that affect swallowing are strokes, brain or spinal cord injuries, Parkinson’s disease, muscular dystrophy, multiple sclerosis, and Gastroesophageal reflux disease (GERD). To learn how to prevent choking in elderly, it is important that you have the person seen by a speech pathologist to assess their swallowing abilities so you know the right diet to provide.

Dysphagia Diet

Understanding the dysphagia diet is a pivotal step in learning how to prevent choking in elderly. As the elderly are more susceptible to swallowing difficulties, tailoring their diet based on the severity of dysphagia ensures that they consume nourishing food with minimized risk. When a senior faces challenges in swallowing, even seemingly harmless food textures can become potential hazards. By adhering to the guidelines set by the different levels of the dysphagia diet, we ensure that the food provided aligns with the individual’s ability to swallow safely. Regular consultations with a speech pathologist and understanding which level of the diet is suitable can dramatically reduce the risks associated with choking. This dietary approach, combined with vigilance during meal times, plays a crucial role in ensuring both the nutrition and safety of the elderly.

Level 1 – Pureed Nutrition Therapy

Recommended for individuals who have moderate to severe dysphagia. Diets within this category consist of pureed, homogenous, and cohesive foods, with a “pudding-like” consistency. Any food that requires controlled manipulation or chewing would not be considered pureed.

Example of foods within the Pureed Nutrition Therapy is:

BeveragesAny smooth, homogenous beverages without chunks or pulp.  Beverages can be thickened to appropriate consistency.
DessertsSmooth puddings, custards, yogurt
FruitsApple sauce, pureed fruit, fruit juices without seed or pulp
MeatsPureed meats
VegetablesPureed vegetables without chunks

Level 2 – Mechanically Altered Nutrition Therapy

Recommended for individuals with mild to moderate dysphagia. Diets within this level consist of foods that are moist, soft-textured, and chopped to no larger than 1/4 inch cubed or the size of a dime. All foods that can be given for Level 1 can be given to individuals who are appropriate for Level 2.

Example of foods within the Mechanically Altered Nutrition Therapy is:

BeveragesMilk, juices, coffee, tea, sodas. Beverages can be thickened to the appropriate consistency.
DessertsPudding, custard, canned fruit, soft fruit pies with bottom crust only, soft, moist cakes with icing.
FruitsSoft drained canned or cooked fruits without seeds or skin, soft/ripe banana.
MeatsMoistened ground meat, tender cut meat/fish chopped to no larger than 1/4 inch or the size of a dime.
VegetablesAny 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

Recommended for individuals with mild dysphagia. Diets within this level consist of foods that are still moist and bite-sized but with a more regular texture.

BeveragesMilk, juices, coffee, tea, sodas. Beverages can be thickened to appropriate consistency.
DessertsAny desserts except dry cakes, or cookies that are chewy or dry.
FruitsAll canned and cooked fruits. Soft peeled fruits like peaches, nectarines, mangoes, cantaloupe, honeydew, seedless watermelon, and soft berries.
MeatsThin-sliced, tender, or ground meats and poultry.
VegetablesAll cooked, tender vegetables.

Additional Precautions to Prevent Choking in Elderly

When considering how to prevent choking in the elderly, it’s beneficial to adopt a multi-faceted approach that encompasses not just dietary modifications but also involves caregiver training, environmental adjustments, and regular medical assessments. This holistic strategy ensures that all aspects contributing to the risk are addressed, ultimately fostering a safer environment for the elderly.

Regular Health Check-ups

Periodic health assessments are crucial, especially after any medical incident. These check-ups can identify early signs of swallowing difficulties and ensure timely interventions.

Medication Assessments

Some medications can cause a dry mouth, making swallowing harder. It’s always a good idea to review medications with healthcare professionals to ensure they aren’t contributing to swallowing problems.

Educate Caregivers

Training for caregivers, including first aid specific to seniors, is invaluable. Proper training can ensure that caregivers are prepared to handle and prevent potential choking incidents.

Use of Specialized Eating Tools

There are utensils and plates designed specifically for those with swallowing difficulties. These tools can help seniors consume food in safe and manageable portions.

Stimulate Saliva Production

Simple sensory enhancements, like increasing the flavor or aroma of food, can naturally stimulate saliva, making swallowing easier.

Innovative Technologies

Modern devices can monitor swallowing patterns and alert caregivers to any abnormalities. Embracing such technologies can be a proactive step in preventing choking incidents.

By integrating these strategies, we can enhance safety measures and effectively address the concern of how to prevent choking in the elderly.