Dysphagia commonly occurs in the elderly. It is more prevalent in those who have suffered from a stroke or have a neurodegenerative form of dementia or disease (e.g., Parkinson’s, Alzheimer’s). There is a grave danger of the sufferer becoming malnourished, contracting pneumonia from food particles getting into the lungs, or being dehydrated from battling to swallow liquids. We briefly look at the statistics then place our focus on the treatment of dysphagia in the elderly.
Between ten percent and one third of the elderly are afflicted by dysphagia. One study of the elderly population in nursing homes found that they had a higher risk of mortality (nearly 25%, or a quarter) within six months of diagnosis than residents without dysphagia (under 12%). The risk of dying is more than double when dysphagia is present.
Dysphagia made hospital stays more expensive for patients. While those patients without dysphagia paid $13,001 for an average stay, those who had the condition could expect to spend $19,244 for each hospital admission. This was also associated with longer hospital stays. The length of stay (LOS) for non-dysphagia patients was five days while dysphagia patients were hospitalized for an average of eight to ten days.
Another study found that dysphagia affected the quality of life of seniors with the condition. Because it can affect eating ability, such as choking, 30% of patients were not willing to eat in front of other people. Less than half of the study participants found eating to be an enjoyable activity.
Oropharyngeal dysphagia refers to swallowing difficulties that affect the throat or mouth. In addition to oropharyngeal dysphagia caused by neurodegenerative conditions, other causes are mouth or throat cancer or noncancerous growths, decreased muscle function, and radiation or surgery to the area.
- Referral to a swallowing or speech therapist.
- Being taught exercises that improve coordination of the muscles used for swallowing.
- Learning exercises to stimulate the swallowing reflex.
- Tips on positions of the body and head that make swallowing easier.
Esophageal dysphagia has several causes. The elderly suffering from this type of dysphagia will experience the feeling that food gets stuck in the chest or at the base of the throat. Possible treatments include:
- Esophageal dilation, which is done using an endoscope to which a medical balloon has been attached or stretching the esophagus with tubes.
- Prescribed medicines to decrease stomach acid for GERD, muscle relaxants for spasms, or corticosteroids for esophagitis.
- A special diet – a health care practitioner will almost certainly put the patient on a soft diet.
- Food and drinks might be thickened with a substance to make swallowing easier – you can learn more about this here.
In severe cases, or where other measures have not been successful, life-saving intervention is needed. Patients are fitted with a feeding tube. This bypasses the need to swallow and delivers nutrition directly to the stomach.
Dysphagia can be life-threatening and any difficulty in swallowing must be handled with a visit to a medical practitioner.