Dysphagia
Manual of Clinical Nutrition Management III- 36 Copyright © 2013 Compass Group, Inc.
by the speech-language pathologist (SLP). Concentrated sweets may cause increased salivation.
Certain foods (eg, Popsicles) may be used to practice sucking, as prescribed by the SLP.
Offer a variety of food items to reduce boredom and possible reliance on certain foods.
Foods should be served either warm (not tepid, but not hot enough to risk burning the mouth,
secondary to loss of sensations), or cold (for increased stimulation).
Offer foods in small amounts so the sight of large quantities of food does not overwhelm the patient.
Select nutrient-dense foods.
Do not use liquids to clear the mouth of food; the patient should drink liquids only after food has
been cleared.
The SLP should determine proper positioning: Some patients with neurologic impairments should sit
in an upright position with hips flexed to a 90o angle, back straight, feet flat on the floor, and head
bent slightly forward. This allows the tongue to facilitate laryngeal elevation and subsequently
protect the airway. An upright position also helps to close the glottis, decreasing risk of aspiration.
Patient should be sitting up for 15 to 30 minutes before and after meals to prevent aspiration of any
residue potentially remaining in the glottis area.
Ensure a quiet atmosphere, free of distractions while the patient eats.
Ensure patient comfort. Some patients may require medication to alleviate painful swallowing.
It is important that the patient be encouraged to communicate problems and successes with the staff.
It may be beneficial to stir medications into pudding if the patient has fluid restrictions.
Allow the patient to set his or her own pace while eating.
Have the patient or caregiver cleanse the patient’s mouth before eating.Bibliography
Dysphagia. In: Nutrition Care Manual. Academy of Nutrition and Dietetics: Updated annually. Available at: nutritioncaremanual.org. Accessed
September 20, 2010.
Mahan K, Escott-Stump S. Medical nutrition therapy for neurologic disorders (Chapter 41). Krause's Food & Nutrition therapy, 12th
Edition. St. Louis, MO: Saunders; 2008:1074-1077.