Disease: dysphagia
Question: for dysphagia, home treatment?
Answer: You will likely coordinate your home treatment for dysphagia with your doctor, who may refer you to a speech therapist or occupational therapist. According to the NIDCD
, your home treatment for dysphagia may include:
Muscle exercises. You may be shown exercises to do at home to strengthen weak facial muscles or to improve coordination.
Eating in a specific position. Sometimes the position of your head makes it easier to swallow. For example, when you eat, you may need to turn your head to one side or look straight ahead.
Preparing food differently. You may need to prepare food in particular ways to make them safe for you to swallow. For example, if you can�t swallow thin liquids, you may need to add thickeners to your drinks.
Avoiding certain foods. You may need to avoid hot or cold foods or drinks.
For examples of exercises that doctors or speech therapists might prescribe to strengthen swallowing, see this selection of five exercises from the Napa Center.
Diet
There are many texture-modified foods for people with dysphagia. Because the consistencies of these foods vary so much, the International Dysphagia Diet Standardization Initiative (IDDSI) has created standardized worldwide terminology and definitions for texture-modified liquids and thickened foods.
The IDDSI standards have five levels or grades of thickening that range from grade 0, which is thin liquid, to grade 4, which is a pudding-like consistency.
The Nutrition Care Manual, the standard dietary resource for professionals established by the Academy of Nutrition and Dietetics (AND), adopted the IDDSI standards effective October 2021.
Elaine Achilles, author of �The Dysphagia Cookbook,� gives helpful tips and recipes in her book on how to cook and present food for someone with swallowing difficulty.
She learned how to cook this way firsthand when her partner of 17 years was diagnosed with amyotrophic lateral sclerosis (ALS), which makes swallowing progressively difficult. Achilles gives tips like these in her book:
Downsize dish, cup, and utensil size. This will necessitate smaller bites, which is important for people with swallowing difficulty.
Always think about texture. Make it appealing. For example, put meringue on custard.
Emphasize taste and aroma. This will overpower unappealing soft textures and help make food appetizing.
Make the environment nice. A pretty table setting, flowers, and a simple attractive environment can do wonders for the appetite.
It�s important to note that dysphagia with a neurologic cause may present differently than dysphagia with other causes.
The Montana Department of Public Health and Human Services summarizes which foods to eat and which to avoid if you have swallowing difficulty. Here are some of its recommendations for foods to avoid or use only when carefully prepared:
Peas and corn. These can roll to the back of the throat and create a choking hazard unless carefully prepared into a puree or porridge.
Meat. Meats can be tiring to chew and can get stuck in the throat or esophagus. Again, proper preparation is necessary.
Rice. It can get stuck in the throat and fall into the airway. It is usable if properly prepared.
Ice cream. Its consistency changes when it melts, and it may become too thin for some people with swallowing difficulty.
Bread. People tend to swallow it too soon, and balls of it become lodged in airways. Gelled bread can be used instead.
Peanut butter. It can be hard for people with swallowing difficulty to process peanut butter, and it may block the airways if aspirated (inhaled into the airway). It cannot be removed by a Heimlich maneuver.
Fibrous cooked vegetables. Some examples include cabbage, Brussels sprouts, and asparagus.
Fresh fruits. Fruits like apples and pears can be hard to chew. Stringy, high pulp fruits like pineapple or oranges are also best avoided unless properly prepared.