The Effect of Confusion on Swallowing
Some people with confusion may develop swallowing difficulties. Often this occurs because the muscles are weak or un-coordinated. Sometimes a person loses insight into the need to eat, when to swallow, how to chew etc. People with swallowing difficulties often cough during or after eating or drinking. Appetite can diminish and people might lose weight.
How can you help?
1. Posture
It is much easier for people to swallow when sitting upright. The back should be straight and well supported and the head should be facing straight ahead with the chin level.
2. Food types and textures
Crispy, crumbly and lumpy foods are often difficult to eat e.g. biscuits, meat and bread. People with swallowing difficulties find soft, thick smooth consistencies easier to swallow e.g. yoghurt (without “bits”), mousse, egg custard etc.
3. Fluids
Sometimes normal, thin liquids are difficult to control in the mouth and may trickle into the person’s airway leading to coughing or dribbling from the mouth. Fluids that are thickened to a syrup or custard consistency may be easier to swallow. Encourage the person to take “small sips” of fluid.
4. Alertness and attention
Offer food and drink when the person is most awake and alert. Noises and distractions such as television and radio, or other people talking can make swallowing more difficult. Keep such distractions to a minimum when offering food and drink. If the person is being fed, try to make sure that they can see the fork/spoon coming towards them and allow plenty of time for each mouthful to be finished before offering another mouthful.
5. Verbal prompting
The person may tend to keep food and drink in the mouth for a long time. Sometimes this happens because the person has forgotten that food and drink need to be swallowed. It may help if you remind them to swallow.
6. Oral care and hygiene
Food may become pocketed in the cheeks or around the teeth. This is unpleasant and unsightly. It can also cause coughing after a meal. Check the person’s mouth, clean if necessary and ensure they remain sitting upright for approximately 30 minutes after eating.