Identifying dysphagia in residents in care homes

This list is not exhaustive but is designed to help care home staff identify those symptoms which may be due to swallowing problems

What to look for Why
Routine chewing of medicines before swallowing Resident potentially concerned about bolus size and choking or aspiration and coughing
Gurgly or wet voice after swallow Liquid in lungs can cause this and therefore can be a sign of aspiration
Resident taking longer than usual to swallow food, liquid or medicines May be due to problems with preparing the bolus before swallowing, concerns about choking or coughing or food sticking on swallowing
Regular chest infections May be due to unidentified aspiration where food or liquids are regularly passing into the lungs and causing infection
Coughing or choking after swallow May be due to aspiration or inability to prepare the bolus safely for swallow
Unexplained weight loss May be due to residents routinely not completing meals due to swallowing problems

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