How To Prevent Choking in the 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 damages 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 prevent choking in the 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:
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:
| Beverages | Any smooth, homogenous beverages without chunks or pulp. Beverages can be thickened to 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:
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:
| Beverages | Milk, juices, coffee, tea, sodas. Beverages can be thickened to the appropriate consistency. |
| Desserts | Pudding, custard, canned fruit, soft fruit pies with 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:
Recommended for individuals with mild dysphagia. Diets within this level consist of foods that are still moist, and bite-sized, but with more regular texture.
| Beverages | Milk, juices, coffee, tea, sodas. Beverages can be thickened to 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. |