Dementia support: understanding and helping with swallowing issues

Dementia is a progressive condition. Over time, issues with swallowing can become more common. If you are a carer, it can be worrying to watch someone with dementia choke on their food or have difficulties swallowing. You can find information below on how to help with eating and drinking.

About swallowing issues 

As dementia progresses, swallowing issues can become more common.

This can lead to:

Over time, the person you are caring for may have difficulties letting you know they are hungry or thirsty. Food and drink intake will need to be monitored every day to make sure they are eating and drinking enough.

How to adapt to changes in swallowing 

A person with a dementia may have difficulty with some types of food and fluids. This can lead to them spitting out lumps or holding food in the mouth.

Things that can help include:

  • giving a soft, moist diet - avoid hard, dry or fibrous foods that need a lot of chewing like steak, bacon and wheaten bread
  • using gravy or sauces to moisten food
  • encouraging small sips of fluids

How to help if a person is spitting out lumps 

A person with a dementia may begin to spit out food. Things that can help include:

  • avoiding foods with lumps/bits/mixed textures like crumbly biscuits, soup with bits, food with skins or pips
  • ensuring food is soft or smooth in consistency throughout

How to help if a person forgets to swallow 

A person with a dementia may forget to swallow. Things that can help include:

  • alternating temperature and taste within a meal, for example, sweet and savoury food or hot and very cold foods or fluids
  • offering sips of ice cold drink prior to a meal or in between mouthfuls
  • giving verbal prompts to swallow
  • trying placing an empty spoon in the mouth between mouthfuls to help stimulate a swallow

What to do if food remains in the mouth at the end of a meal 

A person with a dementia may begin to keep food in their mouth. Things that can help include:

  • checking their mouth after each meal and encouraging or providing regular teeth brushing or denture cleaning, as food left in the mouth can cause mouth infections and bad breath
  • the person should remain upright for a short time
  • if food remains in the mouth despite these attempts to encourage a swallow, you should safely attempt to remove it

If the person you are caring for is persistently coughing or choking when eating and/or drinking, please contact their GP for advice as a speech and language therapy assessment may be needed.

If they are having difficulty with swallowing tablets, talk to their GP or local pharmacist who will be able to advise you.

Where to find help and support 

Living with a dementia can bring different changes to a person’s life that are individual to them. As a carer, there are many ways you can help support them in their everyday life and activities.

If you have any concerns about the person you are caring for, you can speak to the person’s GP for advice.

They can refer you to a relevant health professional including:

  • dietitian
  • physiotherapist
  • occupational therapist
  • speech and language therapist

For more help and advice about supporting a person living with a dementia, read about:

You can find more information and support services from the following organisations, see also ‘more useful links section’:

The Public Health Agency has also produced a range of information to help support people with a dementia, their families and friends.

This information includes the following publications:

Dementia apps library

The ‘Apps4Dementia’ library is a digital service which groups together safe, trusted apps to provide information and guidance on the condition.

There a number of apps that offer support, self-care of symptoms and enable users to carry on with their day-to-day activities for as long as possible.

More useful links 

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