Caring for a loved one with dementia comes with many challenges, and one that often catches families and caregivers off guard is swallowing difficulties (also known as dysphagia). While it may seem like a minor issue at first, swallowing problems can lead to serious complications, including malnutrition, dehydration, and an increased risk of choking or aspiration pneumonia.

Understanding why swallowing becomes difficult in dementia, how to recognise the signs, and what you can do to help can make a significant difference in your loved one’s safety and quality of life.

Why Does Dementia Affect Swallowing?

Dementia is a progressive condition that affects the brain’s ability to control and coordinate muscle movements, including those involved in chewing and swallowing. As dementia progresses, the brain’s ability to send signals to the muscles involved in swallowing may become slower or less effective.

Certain types of dementia, such as Alzheimer’s, vascular dementia, and Lewy body dementia, are more commonly linked to swallowing difficulties. In later stages, even basic actions like chewing or remembering to swallow can become challenging.

Signs That Someone with Dementia is Struggling to Swallow

It’s important to watch for early signs of swallowing difficulties to reduce the risk of choking or food entering the lungs. Some key signs include

·         Coughing or choking while eating or drinking

·         A gurgling or wet-sounding voice after swallowing

·         Taking longer to chew and swallow food

·         Drooling or food spilling from the mouth

·         Frequent throat clearing during meals

·         Avoiding certain foods or refusing to eat

·         Unexplained weight loss or dehydration

·         Frequent chest infections or pneumonia (which could be caused by food or liquid entering the lungs instead of the stomach)

If you notice any of these signs, it’s essential to seek medical advice. A speech and language therapist (SLT) can assess swallowing function and recommend safe eating strategies.

How to Help Someone with Dementia Who Has Swallowing Problems

If your loved one is struggling to swallow, there are several ways you can help make mealtimes safer and more enjoyable:

1. Choose the Right Foods & Textures

·         Serve soft, moist foods that are easier to chew and swallow, such as mashed potatoes, soups, scrambled eggs, or pureed fruits.

·         Cut food into smaller, manageable pieces.

·         Avoid dry, crumbly, or sticky foods like crackers, nuts, and peanut butter, which can increase the risk of choking.

2. Encourage a Safe Mealtime Environment

·         Reduce distractions – A quiet, calm setting can help the person focus on eating.

·         Sit upright – Encourage your loved one to sit in an upright position during and after meals to aid digestion.

·         Take it slow – Allow extra time for meals and encourage small bites and sips.

3. Adapt Drinks for Easier Swallowing

·         If thin liquids cause choking, thickened drinks (available through a doctor or dietitian) can help slow the flow and make swallowing safer.

·         Offer small sips of fluid between bites to help clear the throat.

4. Use Adaptive Tools

·         Specialised cutlery or cups with spouts can help improve independence during meals.

·         Straws can sometimes make swallowing easier, but they should be used with caution and only if recommended by a speech therapist.

5. Watch for Signs of Aspiration

If food or drink goes "down the wrong way" too often, it could lead to aspiration pneumonia. Signs include:

·         Coughing or choking during meals

·         Shortness of breath after eating

·         Fever or repeated chest infections

If you notice these symptoms, consult a healthcare professional immediately.

The Emotional Side of Swallowing Difficulties

Watching a loved one struggle with swallowing can be distressing for both caregivers and the person with dementia. Mealtimes are often social and comforting, so changes in eating habits can feel upsetting or isolating.

Try to remain patient and positive—encouragement and reassurance can make a big difference.

If your loved one can no longer enjoy their favourite foods, find new ways to make meals pleasurable—play soft music, use familiar plates, or share meal times with them.

You Are Not Alone – Join the We Talk Care Community

Caring for someone with dementia can be challenging, but you don’t have to navigate it alone. At We Talk Care, we provide a supportive, understanding space where caregivers, family members, and friends can share experiences, ask questions, and find encouragement from others who truly understand.

Join We Talk Care today and connect with people who can help you navigate the challenges of dementia care with support, compassion, and shared experience.