Expert Blog Contributor:
Barbara Braithwaite
Principal Speech Pathologist
Safe Swallowing Education
Like breathing, swallowing is a reflex and is essential to everyday life. Humans swallow between 500 to 900 times a day: around three times an hour during sleep, once per minute while awake and even more often during meals. We swallow food, liquids, medicine and saliva.
With each swallow we hold our breath for around one second, to make sure the food or drink travels down the correct tube to the stomach rather than the lungs. Swallowing uses 26 muscles and many nerves to coordinate the split-second timing needed to safely swallow. Mistimed movements can lead to food or drink ‘going down the wrong way’.
Prevalence
Swallowing difficulties affect up to 1 in 25 adults. As we age or if we have disability, the swallowing reflex can deteriorate due to a number of conditions such as illness, damage to the brain or structures of the head and neck. According to Speech Pathology Australia, 50 percent of stroke survivors and 84 percent of people with dementia experience Dysphagia. Sixty-nine per cent of people with Parkinson’s disease will have swallowing difficulties, as will 25 per cent of those with Multiple Sclerosis. Chewing and swallowing problems affect 30-50 percent of residents in aged-care facilities and those with a disability, with choking being one of the highest causes of preventable death.
Impact
The impact of having a swallowing problem is far reaching, not only for the person themselves but for their family and friends. Eating and drinking is an important part of everyday life; it’s not only essential for life, but should be an enjoyable pastime with many social activities happening around mealtimes. Yet, for an average of around eight percent of the population, this simple act of eating and drinking can be uncomfortable, stressful, isolating and frustrating.
Swallowing problems can result in life threatening medical problems such as pneumonia, choking, poor nutrition and dehydration if left unmanaged. Sometimes this problem is so severe that regular food and drink can become a life-threatening choking risk. While Australians are alert to the choking risks for small children, few know the danger of choking on food is 7 times greater for people aged over 65 years and those with specific disabilities than those aged 1-4 years.
Dysphagia Care Plan
If the person suffering from a swallowing problem has been advised that they can’t have some types or consistencies of food and drink, this can make eating and drinking in front of friends and family difficult and embarrassing. These problems can lead to anxiety, depression, social isolation as well as the health concerns mentioned above.
A Dysphagia care plan supports both the carer and sufferer to enable safe eating and drinking. The good news is that education about Dysphagia and its management empowers staff, carers and family members to understand ways of eating and drinking that can reduce or remove these problems.
IDDSI
The wonderful work of the International Dysphagia Diet Standardisation Initiative (IDDSI) outlines the various levels of food and liquid modifications recommended for those with Dysphagia. The online course explains these dietary guidelines and how to best manage a swallowing difficulty.
