Sharon Ron , speech language pathologist and director of MAYTAV clinic, gave an in-service training session to MELABEV staff titled ”Better treatment for Alzheimer's patients with swallowing problems” to enable Melabev staff to be better equipped to help their clients with swallowing difficulties. For our readers, we asked Ms. Ron about swallowing issues that could affect dementia patients, at home.
Sharon Ron, M.Ed. CCC-SLP
Food is an integral part of everyone's life. Holiday celebrations in most Jewish homes center around the family meals shared together. For example the holiday of Pesach is one that has many specific foods associated with it: matzah, marror, charoset and the 4 cups of wine to name a few. And Shavuot has cheese cake. But what if the matzah makes you choke? Or the four cups cause you to cough terribly? Aside from the discomfort of a swallowing problem, having difficulty swallowing can cause serious medical consequences. Even the Gemara (Pesachim 108 a ) refers to swallowing health issues in its discussion of reclining at the seder on Pesach when it cautions us not to eat with the wrong posture “lest they inhale their food into the breathing pipe instead of swallowing it.
Swallowing problems or dysphagia, are very common in many neurological disorders including all types of dementia. Common symptoms of a swallowing problem may include any of the following: coughing or choking during eating or drinking or afterward, swallowing over and over on each bite or sip, shortness of breath while eating, history of aspiration pneumonia, wet or strangled voice quality when eating or drinking, sneezing or runny nose while eating or drinking, congestion or poor oxygen saturation. Symptoms of dysphagia that are specifically associated with Alzheimer's dementia include: refusing to open the mouth for food or drink, leaving the mouth open after taking a spoonful rather than closing the lips and starting to swallow, spitting out food, holding food in the mouth without chewing or swallowing, taking a very long time to eat a meal, eating very small amounts and talking or moaning while eating.
This difficulty can lead to many medical complications such as aspiration pneumonia, dehydration, malnutrition and choking. Dysphagia can also reduce one's quality of life and lead to depression, the need to change diet consistency and in extreme cases the need for an alternate means of nutrition rather than eating by mouth.
These issues are quite serious but there is help: evaluation and treatment by a qualified speech language pathologist in conjunction with your doctor can help locate the cause of the problem and find ways to alleviate the difficulty. Whether through diet changes or swallowing maneuvers, a speech language pathologist can help alleviate these symptoms and lower the risk of respiratory complications, malnutrition and dehydration. If your loved one is suffering from some of these symptoms and you suspect a swallowing problem, ask your doctor for a referral to a qualified speech language pathologist for a full evaluation. To reach the Maytav Clinic, please call: 02-673 1397 or e-mail: sharon@maytav.co.il
* A more extensive article on the topic is included in Working with Alzheimer's Patients, in press, by MELABEV and ESHEL. To preorder, contact melabev1@gmail.com
