You may have seen a speech-language pathologist if you were a “late talker” or needed some extra help pronouncing letters as a child. If not, you likely know someone who got to leave class for speech therapy once a week (and came back with cool stickers and candy). But SLPs can support you and your loved ones at every age and stage.
“A running joke in the field is when SLPs walk into a patient’s room and are met with an annoyed “My speech is just fine!'” Michelle Retsky, M.S. CCC-SLP, a speech-language pathologist & clinic director at Words in Motion Therapy, tells Parade. “My very short explanation of my job is ‘anything lungs up.'”
That includes how you breathe and even how you swallow. Retsky says many factors can negatively affect your airway safety (and, for that matter, communication clarity). Progressive dementias, strokes, brain injuries and neuromuscular disorders (like ALS) are some of the better-known reasons why someone might have trouble talking, breathing or swallowing. However, Retsky points out that even UTIs can cause confusion, and SLPs can help with therapy for the aging person (and even strategies for the caregiver).
“Cognitive decline, language breakdowns and swallowing dysfunction directly impact an older adult’s health, safety, independence and overall quality of life,” Retsky says.
Unfortunately, one flag that an older adult is having problems swallowing is often overlooked. Retsky identified an early sign of swallowing trouble that many families miss in aging parents, along with what to do if you notice it.
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‘The Early Sign of Swallowing Trouble I Wish Families Didn’t Miss in Aging Parents’
Retsky says coughing during meals is an early sign of swallowing issues that many people miss in aging family members. Coughing during meals is common, but it’s not necessarily normal. It’s an involuntary reflex—we cough to keep foreign objects out of our lungs.
“Foreign material—even if it is your own saliva—introduces bacteria into the lungs, which can lead to pneumonia,” Retsky says.
She adds that healthy individuals have some safeguards to keep their airways safe, such as:
The epiglottis folds down (a small elastic cartilage above the voice box and behind the tongue) The vocal folds close (the more contemporary term for vocal cords) The larynx elevates (you may know it as a “voice box”)“If something is preventing this system from working to protect the lungs, coughing is the reflex that steps in as a last resort,” Retsky explains. “Our bodies are complex systems, so it is normal for something to go wrong for a variety of reasons and let out a cough occasionally, but when it is a common occurrence during meals, it is a concern.”
She adds that coughing isn’t always a swallowing problem, and sometimes it’s just chance.
“It is important to keep perspective: We can swallow 1,000 times in a day,” Retsky reports. “An occasional cough or throat clear can be completely normal.”
Whoa! Besides chance and swallowing issues, a person may cough during eating because of:
GERD COPD Asthma Medications, like ACE inhibitors“A cough due to a swallowing issue has a direct link to the act of swallowing. It can occur during a bite or within a few seconds of swallowing,” Retsky says. “Clinical markers include a gurgly vocal quality after drinking, needing to swallow multiple times, throat clearing during meals or food or water on the lips.”
Related: That Cough Has Been Hanging Around for Weeks—Here’s the Point When Doctors Want To Hear About It
What To Do if You Notice Swallowing Issues in Aging Family Members
Retsky says it’s important not to ignore regular coughing during eating in aging parents.
“If someone is coughing during meals often, the family should notify the primary care physician to secure a referral for a Speech-Language Pathology swallowing evaluation,” she says. “Unsupervised diet modifications can worsen residue or increase choking hazards.”
Other signs of swallowing trouble to flag include:
A “wet” or “gurgly” post-swallow voice Keeping food in the mouth Longer meal times Unexplained low-grade fevers Recurrent respiratory infectionsRetsky says these can signal objects being “pooled” in the vocal folds, weak swallowing muscles and other swallowing-related issues an SLP may be able to help with.
Related: The Habit to Stop by 50 to Lower Your Risk of Osteoporosis, According to Endocrinologists
How SLPs Help People With Swallowing Issues
Retsky says that speech-language therapy typically begins with a clinical bedside evaluation and may order more detailed assessments as needed. Here’s what the process might look like for your aging parent with swallowing issues:
Evaluation: During this assessment, SLPs look at factors such as vocal quality (e.g., wetness or gurgling), reflexive cough timing (coughing keeps food out of the lungs) and oral bolus clearance (it’s easier to inhale food if it gets stuck in the mouth) in various food textures and how thick/thin/sticky something is. Videofluoroscopic Swallow Study (often also called the Modified Barium Swallow): This study uses imagery to help clinicians see where the food/water goes in the body. “If all is well, everything will go down the esophagus into the stomach,” Retsky says. “The epiglottis is what blocks food from going into the lungs, and you can physically see it working and moving with this method.” Fiberoptic Endoscopic Evaluation of Swallowing (FEES): SLPs use a camera to visualize your pharynx (the tube that connects the nasal cavity and mouth to the esophagus and larynx). “A camera goes from your nose to your pharynx to allow clinicians to see how the structures of the throat are moving and if there is any pooling of food and saliva by the vocal folds,” she explains.Help is available. Retsky says SLPs can work with your aging parent on personalized treatment plans to rebuild swallowing muscle strength and compensate for weaknesses, making swallowing safer. They may also adjust the diet at first, including food texture and liquid thickness, for safety purposes.
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Sources:
Michelle Retsky, M.S. CCC-SLP, a speech-language pathologist & clinic director at Words in Motion Therapy Urinary Tract Infection Induced Delirium in Elderly Patients: A Systematic Review. Cureus. A framework for understanding shared substrates of airway protection. JAOS. Evaluation of Spontaneous Swallow Frequency in Healthy People and Those With, or at Risk of Developing, Dysphagia: A Review. Gerontology and Geriatric Medicine. Drug-Induced Cough. Physiology Research.Hence then, the article about i m a speech language pathologist this is the early sign of swallowing trouble families miss in aging parents was published today ( ) and is available on Parade ( Saudi Arabia ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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