Monthly Archives: August 2025

Food Access and Dysphagia

Swallowing difficulties, also known as dysphagia, are common among older adults. To keep eating safe, healthcare providers often recommend diet changes, such as softer foods or thickened liquids. While these modifications reduce choking risk, they can also make eating less enjoyable and decrease how much a person eats and drinks. Over time, this can lead to dehydration, malnutrition, and faster health decline, especially for older adults. 

Many older adults also face food insecurity, meaning they don’t always have enough nutritious food due to financial limitations, mobility challenges, or living in areas with limited grocery options (“food deserts”). When swallowing problems and food insecurity overlap, it creates significant risks for both health and quality of life. 

One major concern is dehydration. Thickened drinks are often recommended to prevent aspiration (liquid entering the lungs), but many people dislike them and drink less. Inadequate hydration can trigger urinary tract infections, confusion, kidney issues, and general weakness. Lack of fluids and poor nutrition can also worsen swallowing difficulties, creating a cycle that’s hard to break. 

For caregivers, these challenges can be overwhelming. Preparing safe meals often involves extra steps—blending, chopping, or thickening liquids—which takes time and energy. This can add stress, reduce opportunities for social meals, and contribute to caregiver burnout. Caregivers often find themselves juggling food preparation, healthcare appointments, and navigating assistance programs, all while supporting their loved one’s day-to-day needs. 

Social and financial barriers can make things harder. Older adults from marginalized communities are more likely to face food insecurity and severe swallowing problems. Programs like the Supplemental Nutrition Assistance Program (SNAP) can help, but their complex application processes may be difficult for older adults or their caregivers to manage. Many also feel stigma around using food assistance, which can prevent them from seeking help. 

What can caregivers do?

  • Prioritize hydration. Offer sips of preferred drinks throughout the day, use high-water foods (like melon or soups), or try commercial thickened beverages if recommended.
  • Simplify meals. Prepare soft, easy-to-swallow foods in advance and freeze them into single portions to save time.
  • Seek professional guidance. Speech-language pathologists (SLPs) can teach safe swallowing strategies and recommend appropriate food textures. Dietitians can help plan meals that are both nutritious and safe.
  • Ask about support programs. Local senior centers, Meals on Wheels, and social workers can help with meal delivery, shopping assistance, or SNAP enrollment.
  • Include yourself. Caregiving is demanding. Reach out to support groups or respite services to maintain your own health and wellbeing.

Reference 

Beltrán, J., & Shune, S. (2025). Environmental Considerations in Dysphagia Care: Exploring the Relationship Between Dysphagia and Food Security. Perspectives of the ASHA Special Interest Groups. https://doi.org/10.1044/2025_PERSP-24-00276 

New Research on Swallowing Difficulties in Older Adults

Swallowing difficulties, or dysphagia, are more common in older adults than many realize. While occasional coughing or trouble swallowing pills might seem minor, these can signal underlying changes in swallowing function that require attention. A recent study by Namasivayam-MacDonald, Werbeloff, and Shune used data from over 11 years of interviews with thousands of older adults to better understand the prevalence and risk factors of swallowing problems in the U.S. 

The study found that 8.7–10.2% of older adults reported swallowing difficulties at any given time. Interestingly, these problems were often transient, meaning they came and went rather than staying constant. This suggests that dysphagia in older adults can be linked to episodic health changes—such as illness, injury, or medication side effects—rather than always being permanent. 

Several important risk factors emerged, including: 

  • Poor overall health and multiple medical conditions
  • Lower physical activity and reduced muscle strength
  • Difficulty eating independently (needing help at meals)
  • Low income and less education, highlighting the role of social determinants of health
  • Hispanic ethnicity, which the authors linked to disparities in healthcare access and support

These findings underscore that swallowing is not just a medical issue—it’s deeply connected to overall health, nutrition, mobility, and social support. 

For caregivers, understanding these risks is crucial. Swallowing problems can lead to serious complications, including pneumonia, malnutrition, dehydration, and reduced quality of life. Because dysphagia is often under diagnosed, caregivers are often the first to notice red flags such as frequent coughing during meals, needing to swallow multiple times per bite, or avoiding certain foods. 

What can caregivers do? 

  1. Watch for early signs. Keep track of changes like coughing or throat clearing during meals, unexplained weight loss, or prolonged meal times.
  2. Encourage regular check-ups. Ask healthcare providers about swallowing screenings, especially if your loved one has dementia, lung disease, or recent hospitalizations.
  3. Promote safe eating environments. Reduce distractions at meals, ensure good posture (upright position), and allow plenty of time for eating.
  4. Seek professional help early. Speech-language pathologists (SLPs) can assess swallowing and recommend safe strategies or food textures.
  5. Support overall health. Physical activity, adequate hydration, and good nutrition can help maintain muscle strength—including swallowing muscles.
  6. Address barriers. If cost, transportation, or language are obstacles, reach out to social workers or local aging agencies for support. 

The research also suggests that periodic re-screening is essential, as swallowing problems can develop or resolve over time. By staying vigilant and advocating for care, caregivers can help prevent complications and maintain their loved one’s safety and dignity. 

Understanding dysphagia and its risk factors empowers caregivers to act early and effectively. With proper support, many older adults with swallowing problems can continue to enjoy meals safely and comfortably. 

Reference

Namasivayam-MacDonald, A., Werbeloff, M., & Shune, S. (2025). Prevalence and predictors of self-reported swallowing difficulties in community-dwelling older adults: A population-based study from the National Health and Aging Trends Study (NHATS). Dysphagia. Advance online publication. https://doi.org/10.1007/s00455-025-10860-0