Speech and Language Therapy - Eating, drinking and swallowing

If you are experiencing regular physical difficulties with your eating / drinking e.g. choking, coughing, food sticking in your mouth or throat, frequent unexplained chest infections etc you may have Dysphagia. (Dysphagia is the medical term for swallowing difficulties).

Please contact your GP or Speech and Language Therapy (SLT) department for a referral.

SLT can assess your swallow and provide advice / treatment or signpost you to the appropriate resources.

General tips for effective swallowing

Choking episodes or feeling like food has gone down the wrong way can happen to us all. The following tips will help to reduce any risks of choking.:

  • Sit upright and in a well supported position during all episodes of eating and drinking
    Sitting at the dining/kitchen table is ideal to help good posture.
  • Reduce distractions so that you can concentrate on eating. This includes turning the TV off and putting down your mobile phone.
  • Ensure that the food / drink is in front of you so that you do not need to twist and turn while you are eating.
  • If you wear dentures, ensure they are well fitted and clean.
  • Look after your oral hygiene – ensure your teeth and gums are clean. Even if you have no teeth, ensure your gums and mouth are cleaned daily. See your dentist for advice if you have concerns.
  • Ideally we should remain upright for at least 20 minutes following a meal. Bending or lying down will increase the risk of heart burn or reflux.
  • Tablets can be difficult to swallow. Try taking them with a spoon of custard or mousse because water can often leave them behind in your mouth.
  • Don’t eat and drink if you are excessively tired, or chose food which is easier to swallow at these times
  • Some specific conditions can exacerbate swallowing difficulties. Look on their websites for more specific advice – these websites are referenced on the SLT section of the trust website.

Particular difficulties

Some foods are more likely to cause difficulties than others. These more difficult foods combined with poor posture, distractions and rushing mealtimes are highly likely to increase the risks of coughing and choking.

Difficult foods tend to be:

  • Dry and crumbly / separates off e.g. biscuits, rice
  • Need excessive chewing e.g. some meat
  • Mixed different consistencies e.g. cereal + milk, meat sandwich with salad
  • Stringy, fibrous textures e.g. pineapple, celery and bacon
  • Skins on some vegetables and fruit’

Easier foods tend to be:

• Soft, moist foods e.g. macaroni cheese, shepherd’s pie, stews / casseroles
• Foods which had additional sauces e.g. fish in sauce, sponge and custard

Communication is very important to an individual’s wellbeing

If you have any difficulty getting your message across or understanding what people are saying to you, you may have a communication difficulty and you should be referred to the Department of Speech and Language Therapy (SLT). Referral details can be found on the trust website.

SLT can assess your communication skills and provide advice / treatment or signpost you and your family / carers to the appropriate services.

The SLT section of the trust website includes useful links to specific websites including communication following stroke, fluency / stammering, changes in voice, laryngectomy, Long Term Conditions, learning disabilities and mental health / wellbeing.

Top tips:

  • If you or the person you are communicating with have hearing aids wear them
  • Remember that communication is not just about speech – you can use gesture, pointing, writing, drawing or a combination to get your message across
  • Some apps may be helpful such as ‘text to speech’ apps. See the SLT section of the Trust website for information or contact the SLT team
  • Reduce distractions when communicating – stop what you are doing so you can concentrate, turn the TV down or off, don’t look at your phone while talking, reduce or avoid background noise such as the radio, hoover or washing machine
  • Ensure that the person you are communicating with knows you are wanting to communicate by getting their attention before you begin
  • Face the person you are communicating with – you will need to be in the same room
  • Repeat back what you think the person with communication difficulties has said / communicated to you. Do not pretend you have understood, it is better to say that you do not understand
  • Texting and using social media is another effective way of communicating and does not require face to face contact or being in the same room. Be aware that people who have difficulty thinking of or saying words may also have difficulties spelling / texting. Ensure that you have got the right message by checking back with them
  • Busy places like shops and bars can be difficult communicative environments
  • The car is a difficult place for communication due to the noise and being unable to be face to face. It is particularly difficult if the person with communication difficulties is the driver and needs due to shared concentration. Leave the conversation until you have arrived at your destination.
  • Sometimes communication episodes will have to wait until a more appropriate time
  • Don’t underestimate the effects of fatigue / tiredness on communication. It is often more difficult to concentrate and get your words out / understand what is said when you are tired.