What I Learned About Swallowing Problems (Dysphagia) in the Elderly

After my mom's first stroke, she not only had problems with her right arm and right leg, but also with swallowing. Apparently, the swallowing muscles on the right side of her throat also were affected by the stroke. Along with the Physical Therapy and Occupational Therapy that she began shortly after the stroke, she also had Speech Therapy, which quickly restored her speech to normal and addressed any potential swallowing problem. The speech therapist explained that she had to be careful when she swallowed, especially thin liquids like water, which was mostly what she drank. She was told that, after a stroke, she was at higher risk for aspiration (having liquid go down her airway when she swallowed instead of down her esophagus).

She was gagging more often when swallowing, but had significant improvement with that problem after purchasing an Alpha-Stim Cranial Electrotherapy Stimulation (CES) device from her doctor to use daily. But within another couple years, it was gradually getting worse and she started a habit of holding liquids in her mouth without swallowing. So we took her for more Speech Therapy to see if they could help her any more with the swallowing problem. The therapist she worked with this time conducted a Modified Barium Swallow test, which showed on a moving video x-ray that foods and liquids were getting caught in her throat. At each therapy session, the therapist attached a Vital Stim device that worked to strengthen her swallowing muscles. This speech therapist told her one very important detail about swallowing safely: Put your chin down as you swallow and you're less likely to gag or aspirate. This made a huge difference as she got into the habit of doing it and was something that I've even begun doing and sharing with others because we were never told this simple solution. In fact, we may even tilt our head back when we swallow, which makes it worse because that angle opens up our airway.

Even though my mom's memory was getting worse, she got pretty good at remembering to put her chin down and swallow. But when she forgot, she would usually gag on the food or liquid, causing choking, coughing, and sometimes even vomiting from it. Over the next couple years, when she started forgetting more regularly, I made a sign on my computer and printed it for her. I posted it as a reminder for her where she could easily see it as she sat to eat:

As she got weaker in her later years, we had to start adding a thickener to her water to help prevent aspiration. We heard of one that wouldn't add a nasty taste to her water that was called Simply Thick, so I bought that for her and we started giving that to her regularly.

For quite a few years, my mom had preferred drinking room temperature water over cold water, mainly because of sensitivity of her teeth. On the last few days before she passed, she was thought to have either a respiratory infection or fluid/congestion in her lungs. So, two days before she passed (which was the last day that I was able to spend chatting and visiting with her), I brought her some Winter Respiratory Tea from Mama Jo's Sunshine Herbals. I had found that this tea works wonderfully at breaking up (and bringing up) congestion in the bronchial tubes and lungs. After two or three cups of this tea, it started working and she began coughing up stuff. She started breathing better and feeling better overall. But the biggest surprise on that day was that she swallowed this hot liquid with no hesitation of holding it in her mouth! I immediately started trying to think of ways to have her drink warm or hot liquids more regularly in the future...but the future for her wasn't meant to be. It was sad to think that I learned one more way to help her, but wouldn't be able to put it into use.