Why dementia can make swallowing more difficult

If you care for someone with dementia, you may notice that mealtimes can become stressful or even dangerous. The gradual decline in cognitive and physical abilities can affect the muscles and nerves that control swallowing, making it a struggle to consume food and liquids. 

These difficulties can have a profound impact on a person’s health and overall quality of life. Understanding why swallowing becomes harder and how to support your loved one through it can make a real difference in their wellbeing.

How dementia affects swallowing

As the brain’s ability to function declines, the signals responsible for coordinating the muscles in the throat and mouth weaken. This disrupts the sequence of actions required for swallowing, which relies on both voluntary and involuntary reflexes. 

For example, people may forget how to chew properly or may not recognise when food is in their mouth. This confusion can lead to choking, aspiration (when food or liquid enters the lungs), and discomfort.

Damage to the muscles responsible for swallowing may make it physically harder to move food from the mouth to the throat, or the person may have trouble swallowing liquids and solids at the same time. 

The brain’s decreasing ability to assess risks also means the person may not realise when they’re struggling to swallow, which can result in dangerous situations.

Supporting safe and comfortable mealtimes

You can make mealtimes safer and more comfortable by adjusting the way food is presented and eaten. One practical step is to consider offering puréed meals. 

These meals are softer and easier to swallow, which can reduce the risk of choking and aspiration. Puréeing food also allows you to preserve nutrients, ensuring that the person gets the nutrition they need. 

In addition, offering frequent, smaller meals throughout the day rather than larger ones can help prevent overwhelming the person. Avoiding distractions during meals, such as loud music or television, will also help them focus on the task of eating and drinking. 

You may also find that modifying the texture of liquids helps. Thicker fluids can be easier to manage than thin liquids. Be patient and gentle, and always offer encouragement.

Getting professional support

If swallowing problems become more frequent or severe, seeking professional advice is essential. Speech and language therapists (SLTs) are particularly trained to assess swallowing difficulties and can offer tailored strategies to manage the condition. 

They can recommend specific techniques, such as altering eating positions or using special utensils, and help with the progression of the impairment.

Doctors and dietitians can also provide important insights into maintaining nutrition. They may suggest supplements or alternative feeding methods if swallowing becomes too risky. 

Don’t hesitate to reach out to a healthcare professional for guidance and support, as they can ensure your loved one receives the best possible care during this difficult time.