My role as a Speech and Language Therapist within the Community Learning Disability Team involves me seeing people with swallowing and or communication difficulties. Swallowing difficulties are also known as dysphagia. Typically someone will be referred for a dysphagia assessment if they have been coughing or choking when eating or drinking; have had recent chest infections; have experienced unexplained weight loss or shown a reduced appetite. Sometimes people will choose to refuse food and fluid intake if they are finding swallowing difficult or painful.
When I go to assess someone, I will often see them eating their lunch and having a drink. This can feel a bit strange, however it is the best way for us to see what might help to reduce the difficulties that they are experiencing and to advise on how best to prepare their food and or fluids to make their swallowing more comfortable, and ultimately to increase their safety when eating and/or drinking. I will also ask the person and their carer a few questions about what difficulties they have been experiencing to try to help identify what may be going wrong and how best to manage it.
Sometimes it is a case of slowing down when eating and making sure that the person is having regular sips of fluid to help their food go down. In other cases, we may suggest that food is cut up in to smaller pieces and given with additional moisture, for example with extra gravy or sauce. It may even be that having food mashed or pureed may help to increase swallow safety and reduce the difficulties experienced. In terms of fluid intake, we may recommend using thickener in fluids which will slow down the swallow process and reduce or stop any coughing or choking.