Understanding Dysphagia in Older Adults

By Ben Cornu

As we age, our bodies undergo a series of changes that can significantly impact our daily lives. One such challenge that many older adults face is dysphagia. This condition affects the ability to swallow and can become quite dangerous for aging adults. Learn more about dysphagia, including dysphagia symptoms, diagnosis, treatments, and more.

By shedding light on this often overlooked condition, we hope to empower caregivers and families to better navigate dysphagia's complexities with knowledge and empathy.

Understanding Dysphagia

Dysphagia is a medical term that refers to difficulty swallowing. Swallowing is a complex process that involves many nerves and muscle groups. However, most of the time, we take this activity for granted.

Dysphagia occurs when signals from the brain can't quite coordinate the swallowing motion. For example, a stroke can impact neurons throughout the body, making it hard for someone to swallow. Dysphagia can also happen if muscles or structures used to swallow are damaged for any reason. For example, weak muscles may not be able to move food around properly in the mouth.

While anyone can experience difficulty swallowing, it is more prevalent among older adults due to the natural aging process. Our bodies naturally experience a change in anatomy, and seniors are at higher risk for neurological conditions that impact swallowing.

Types of Dysphagia

Difficulties swallowing are generally categorized into 2 types of dysphagia: oropharyngeal and esophageal.

  1. Oropharyngeal Dysphagia: Involves difficulties in the initial stages of swallowing, such as moving food or liquids from the mouth to the throat. It often results from issues with the muscles and nerves that control the mouth and throat.
  2. Esophageal Dysphagia: Characterized by difficulties in the later stages of swallowing, like food passing through the esophagus and into the stomach. It may stem from structural abnormalities or muscle dysfunction within the esophagus. These swallowing problems could also be the result of acid reflux. A senior may feel like food is stuck in the base of the throat or in the chest after swallowing.

Risks of Dysphagia

We might all experience difficulty chewing and swallowing on occasion, and this shouldn't cause concern. However, if an older adult, constantly has problems chewing, then it's definitely something that a medical professional should take a look at.

If left untreated, dysphagia can lead to:

Call 9-1-1 immediately if your loved one's dysphagia interferes with their breathing.

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Recognizing the Symptoms

Dysphagia can manifest in a variety of ways, and its symptoms may vary from person to person. Common signs of dysphagia in older adults include the following:

  1. Coughing or choking while eating or drinking
  2. Feeling as though food or liquids are getting stuck in the throat or chest
  3. Pain or discomfort while swallowing
  4. Vomiting when eating or drinking
  5. Unintended weight loss due to avoidance of eating
  6. Recurrent respiratory infections, as food or liquids may enter the airway
  7. Inability to swallow
  8. Hoarseness
  9. Drooling
  10. Frequent heartburn
  11. Weight loss

If you notice that a loved one constantly has one or more of these symptoms, encourage them to seek medical treatment.


If dysphagia is suspected, a doctor will conduct a physical exam to determine underlying causes and severity. This diagnostic process may include:

  1. Clinical Evaluation: A speech-language pathologist or a gastroenterologist may conduct a thorough examination of the swallowing function.
  2. Imaging Studies: Tests, like an X-ray with contrast, may help visualize the swallowing process in real-time. You may also need to swallow barium-coated foods so doctors can track how they travel down the throat.
  3. Endoscopy: Healthcare providers may examine the esophagus through an endoscopy. This involves a thin, flexible tool that goes down your throat, providing visibility into the esophagus.
  4. Esophageal Manometry: This test measures the pressure and muscle contractions in the esophagus, helping to diagnose esophageal dysphagia.


If your doctor does diagnose you or a loved one with dysphagia, there are treatment options available. However, these treatments depend on the type of dysphagia and the underlying cause.

Treatment for Oropharyngeal Dysphagia

A healthcare provider may refer you to a speech or swallowing therapist to address these types of swallowing challenges. Treatment will often included exercises to stimulate nerves or coordinate muscle groups. You might also learn different ways to to position your head or tongue to be more effective at swallowing.

Treatment for Esophageal Dysphagia

Treatment for these types of swallowing challenges may include a change in diet, medications, or even surgery. In some cases, you may be a good candidate for expansion of your esophagus.

If you have a severe case of dysphagia and are not responding to treatments, a doctor may recommend a feeding tube.

Managing Swallowing Challenges at Home

While dysphagia can be challenging, there are various strategies that can improve swallowing function and enhance overall quality of life. Here are some lifestyle tips for you or a loved one with dysphagia.

  1. Diet: Choose foods with a soft texture and consistency to make swallowing safer and more comfortable. This might involve transitioning to soft or pureed foods and thickened liquids. Limit caffeine and alcohol intake because they can actually dry out your mouth and throat.
  2. Eating Habits: Instead of eating 3 large meals a day, try eating smaller meals more frequently throughout the day. Cut your food into smaller bites, and chew your food longer. Don't rush to eat quickly.
  3. Thicken Drinks: If water and other liquids are hard to get down, try thicker alternatives. Smoothies and shakes can be a great way to get down liquids. You can also try gels or powders to thicken drinks.
  4. Swallowing Exercises: If you have been prescribed exercises to help with swallowing, do them! These exercises can strengthen the muscles involved in swallowing and improve coordination.
  5. Positioning: Adjust your body posture during meals to help promote better swallowing. Sit up straight if possible.
  6. Medications: If you are prescribed medications to help aid your symptoms, take them as recommended by your doctor. You may also need to try swallowing pills with pudding or applesauce instead of with water.
  7. Avoid Straws: If possible, avoid using straws. While they might seem very helpful, they increase the flow of liquid in the mouth. This can make it harder for someone with dysphasia to swallow down the right pipe.

Dysphagia is a complex condition that can significantly impact the lives of older adults. By understanding it better, families and caregivers can take proactive steps to manage and alleviate its effects in their loved ones. With the right knowledge and resources, older adults with dysphagia can still enjoy a healthy relationship with food.

To learn how we can help support adults with dysphagia, reach out to your local Caring team.

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Tags: Senior Health