Swallowing is something we rarely, consciously think about. It’s essentially an automatic, unconscious process. The majority of us don’t need to even think about swallowing.

For the elderly though, this can be a very serious issue, that requires considerable care from those around them. Your responsibility, as a carer or disability and aged carer staff member is huge. A third of disability and aged care facility residents are at risk of choking without the correct staff education and care.

Causes of Dysphagia

Adults may also develop swallowing problems as a result of damage to the brain or structures of the head and neck. Almost half of everyone who has had a stroke will have a swallowing problem. People who have had a head injury, those with Parkinson’s disease, motor neuron disease, dementia, cancer of the head and neck may also have swallowing problems.

The impact of swallowing problems may be short or long term and can have a big impact on a person’s life. If you think you or a loved one might have a swallowing problem, make sure you get help. Eating and drinking is an important part of everyday life. Not only do we need to eat and drink to live but eating and drinking should be an enjoyable pastime and many social activities happen around eating and drinking. 

Swallowing problems can result in life threatening medical problems such as pneumonia, choking, poor nutrition and dehydration, if not managed properly. In babies and children, poor nutrition may impact on growth and brain development. Eating and drinking can be uncomfortable, stressful and frustrating for a person with swallowing problems. They can’t have some types of food and drink and symptoms of swallowing problems can make eating and drinking in front of friends and family difficult and embarrassing. These problems can lead to anxiety, depression and social isolation. 

How is Dysphagia Diagnosed?

The good news is that people who seek professional help can work on ways of eating and drinking that can reduce or remove these problems. What can be done about swallowing difficulties? Early identification is very important. If you notice any of the signs or symptoms below see your doctor and/or refer yourself directly to a speech pathologist. 

• Your baby has difficulty sucking during breast or bottle feeding
• A feeling that food or drink gets stuck in the throat
• A feeling that food or drink is going the wrong way
• Long meal times or eating slowly (it takes more than 30 minutes to finish a meal)
• Coughing, choking or frequent throat clearing during or after eating and drinking
• Becoming short of breath or your breathing changes when eating and drinking
• Avoiding certain foods because they are difficult to swallow
• Unplanned weight loss for adults or for children, or failing to put on weight because of avoiding foods or finding it hard to eat
• Frequent chest infections with no known cause 

Speech Pathologists may recommend changes to the textures of foods or drinks and provide rehabilitation techniques and exercises to help people swallow safely. If the swallowing problem is very severe, a speech pathologist may recommend the person take food and drink via a tube that goes directly to the stomach. Speech pathologists work with other health professionals such as doctors, nurses, dietitians, occupational therapists, physiotherapists and others to help people with swallowing problems.

Acknowledgement - Speech Pathology Australia Dysphagia Fact sheet www.speechpathologyaustralia.org.au



There are 16 tell tale signs of a swallowing difficulty, such as difficulty or discomfort when eating or drinking, drooling or dribbling, mouth constantly open, spitting food out of mouth, taking longer to eat than most residents, excessive tongue movement or saliva in mouth.

Recognising what these behaviours mean may well save a resident or loved one’s life.

Symptoms of Dysphagia

Some symptoms of dysphagia include: 

• Cannot swallow at all
• Painful swallowing
• Bouts of coughing or choking on food during or after swallowing
• Experiencing a feeling or sensation that food is stuck somewhere in the throat or chest
• Drooling
• Unexplained weight loss
• Hoarse voice
• Food regurgitation 
• Heartburn 

What to Look For

Signs of a Swallowing Problem include:

• Resident reports difficulty or discomfort when eating or drinking
• Drooling or dribbling
• Mouth constantly open
• Spitting food out of mouth
• Taking longer to eat than most residents
• Excessive tongue movement or saliva in the mouth
• Food collecting in the mouth after swallowing
• Voice sounding gurgly after eating or drinking
• Diminished or absent gag reflex
• Weight loss or dehydration
• Chest infection
• Slurred speech (Dysarthria)
• Reduced or fluctuating levels of alertness 
• Mouthfuls requiring multiple swallows
• No voluntary cough
• Coughing or choking before, during or after a swallow

Types of Dysphagia

There are two main types of dysphagia, based on the location of the swallowing problem:

1. Oropharyngeal Dysphagia – This issue begins with chewing the food or appropriately moving it to the throat from the mouth.
2. Oesophageal Dysphagia – The food enters the airway rather than passing into the stomach; the resident may or may not feel the sensation of food getting stuck after it passes the pharynx or back of the throat.