Image May is Better Hearing and Speech month, a time set aside to honor our speech-language pathologists (SLPs) and focus on their specialties and achievements. Evaluation and treatment of swallowing problems are a large part of an SLP’s job. But in a recent article published in Advance for Long-Term CareManagement, Mary Barker, senior clinical supervisor for Speech Therapy Group of Beverly, Mass., and an SLP at Kindred Nursing and Rehabilitation – DenMar, warns SLPs are not the only staff members who should be on the lookout for swallowing issues in residents.

Barker stressed that all employees must be watchful for swallowing problems. Nurses, CNAs, dining room staff, and volunteers also play a critical role in making sure that residents are safely getting the nutrition they need. Unidentified swallowing problems can lead to choking, weight loss, malnutrition, or even aspiration pneumonia - a potentially life-threatening condition. This month, we’d like to remind all staff members to be vigilant about safety issues related to swallowing.

Signs of swallowing problems include:

  • Chewing for a long time
  • Drooling
  • Food pockets in the cheeks or around the gums
  • Spitting out food (or food falling out of the mouth)
  • Food or liquid getting stuck in the mouth
  • Choking
  • Refusing to eat
  • Vomiting
  • Coughing (or excessive throat clearing) during or right after meals
  • Reports of food sticking in the throat or chest
  • Swallowing multiple times to get food to go down
  • Weight loss
  • Dehydration
  • Recurring pneumonia or chest congestion after eating

In addition to watching for swallowing problems, it is important for staff to recognize personal preferences or reactions to food and accommodate them. When evaluating swallowing, the visual and olfactory senses should not be overlooked, said Barker. “Some people will not eat foods that touch other foods,” she said. “Some people are nauseated by seeing foods mixed together on their plate.” Too much food on the plate or foods with strong smells (i.e., broccoli or liver) may also be unappetizing for residents.

Be alert to these potential swallowing issues, and report signs of swallowing problems. We can best ensure our patients’ safety by remembering to be attentive to issues that might fall outside our own area of expertise.

By Kindred Hospital Rehabilitation Services