Typically, around 85% of people will experience swallowing problems, medically known as dysphasia, at the end-of-life. What this means is that your loved one, or someone you care for, has trouble swallowing food, liquids, or both.

This is a 4-part series on Alzheimer’s Care and Swallowing Problems, and this episode is focused on The Basics.

  • In Part 2, I will talk about how to Modify Textures + Flavor  Building;
  • In Part 3, I will review what Adaptive Equipment is and how to use it; and
  • In Part 4, I will talk about Maximizing Independence in Eating.

If you missed an episode, you can check them out where you found this one – or on my YouTube Channel, MelissaBPhD.


What is Dysphagia?

  • Some people will have trouble swallowing certain foods or liquids; others can’t swallow at all.

Signs of dysphagia

  • Coughing or choking when eating or drinking
  • Bringing food back up, sometimes through the nose
  • A sensation that food is stuck in your throat or chest
  • Persistent drooling of saliva

Complications of Dysphagia:

  • Malnutrition
  • Dehydration
  • Aspiration Pneumonia

Treating Dysphagia:

  • Speech-Language Therapy to learn new swallowing techniques
  • Change consistency of food and fluids to make them safer to swallow
  • Alternative forms of feeding – Tube Feeding or Handfeeding



  • Estimated that 9 million Americans experience difficulty swallowing
  • 1 in 5 older adults; 40% of those living in nursing homes or assisted living facilities
  • Alzheimer’s Disease: 80%
  • Parkinson’s Disease: 60%

Underlying Health or Chronic Conditions

  • Nervous System (Stroke, Head Injury, Parkinson’s Disease or Dementia)
  • Cancer (Mouth or Throat Cancer)
  • Gastroesophageal Reflux Disorder (GERD)
  • Other Conditions:
    • Trouble with swallowing or chewing
    • Have trouble moving or have lost feeling in parts of your mouth, such as lips or tongue
    • Tooth pain; Missing teeth

Psychosocial Considerations

  • Impaired social and psychological well-being
  • Increased worry about choking in front of others
  • Caregiver fear / anxiety
  • Caregiver burnout in managing the needs of unfamiliar disease
  • Lack of comprehensive guidelines for the management of dysphagia in older adults.


Diet Consistencies:

  • Regular Diet
  • Mechanical Soft Diet
    • These foods require less chewing than foods on a regular diet.
    • Foods may require different textures and thicknesses, such as chopped, ground, or pureed foods
  • Pureed Diet
    • Minced, pureed, or liquidized
    • Foods don’t require chewing, such as mashed potatoes or pudding
    • Can also blend or stain other foods to make them smoother
    • Liquids, such as broth, milk, juice or water, may be added to foods to make them easier to swallow.

Liquid Consistencies:

  • Pudding Thick (Extremely thick)
  • Honey Thick (Moderately thick)
  • Nectar Thick (Mildly Thick)
  • Thin (Slightly thin)




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About Melissa:

Melissa Batchelor, PhD, RN, FNP, FGSA, FAAN. I am a nurse, nurse practitioner, nurse educator and nurse researcher with over 25 years of experience in the aging and long-term care healthcare space. You can visit my website at MelissaBPhD.com to learn more about me, how you can work with me directly,
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