1. Dysphagia

2. Dysphagia = difficult swallowing
During a meal, have you ever noticed someone
Coughing?
Choking?
Gurgling?
Clearing their throat?
Chewing slower than normal?
Reporting chest pain?
Regurgitating their food?
These are all signs and symptoms of dysphagia!

3. Why does it happen?
Unfortunately the esophagus (food pipe connects mouth to stomach) is directly behind the trachea (wind pipe connects mouth to lungs) and the coordination of muscles to ensure that air goes to the lungs and food to the stomach is difficult for some people
Esophagus (food only please!)
Trachea (oxygen only please!)

4. Who does it happen to?
People that have difficulty with muscle coordination, concentration, or level of alertness. These are a few examples of conditions in which swallowing may be affected:
Stroke
GERD (reflux disease)
Cerebral Palsy
Multiple Sclerosis
Muscular Dystrophy
Sedation (such as the postictal state following a seizure)
Manic episodes

5. What’s the big deal?
Food entering the lungs can lead to a condition called aspiration pneumonia which has the potential to be life threatening.
Aspiration pneumonia can cause shortness of breath and difficulty breathing and can result in permanent lung damage.
Leads to hospitalizations.
Negative effects of being removed from a comfortable and familiar environment.
Difficult and complicated recovery (especially for individuals who are unable to move independently!)

6. What’s my role?
Report your observations to your supervisor. Even if it seems like an insignificant detail, share it anyway!
If necessary, provide emergency assistance within your ability and call 911.
Be aware of the following guidelines that can help someone with dysphagia avoid aspiration (the process of taking anything other than air in to the lungs).
Avoid foods that are difficult to swallow or have high potential for occluding the airway.

7. Eating and Feeding Guidelines
Be within an arm’s length of the individual when they are eating
Ensure they are sitting upright at 90°
They must be awake in order to eat. If they are drowsy or unable to keep their eyes open, they should not put anything in their mouth.
Never force food in to the mouth or feed an individual faster than they can chew and swallow.
Provide small bites and wait until one bite is swallowed before offering another.
Do not give solid food and liquid drink together; they should be alternated.
Cut food in to small pieces so they do not block the airway.
Give only small bites of peanut butter or similar food to avoid blocking the airway.
Encourage individual to “swallow hard” and clear their throat between bites.
Test Question!!!

8. Foods to Avoid Test Question!!! Hard candy Peanuts Seeds Grapes
Carrots
Apples
Popcorn
Hot dogs
Large chunks of peanut butter
Marshmallows
Chewing gum
Sausages 
“Reducing Choking Risks: Tips for Early Education and Child Care Settings.” American Academy of Otolaryngotology.
Test Question!!!

9. Remember…
Always follow the doctor’s orders when preparing and delivering food.
Act quickly and report any signs or symptoms of dysphagia immediately to your supervisor!
Be aware of foods that could potentially block the airway.
Make meal time a priority and be proactive in identifying individuals who may be at risk for choking.
Your quick intervention could make the difference between a safe, healthy meal and a potentially serious incident.