Swallowing difficulties: Signs, risks and support available

Swallowing difficulties: Signs, risks and support available
Published Summary

Early awareness and the right support can make a lasting difference. Let’s break down what swallowing difficulties look like and how NDIS participants and their support teams can take the next steps with confidence.

Swallowing difficulties, also known as dysphagia, can affect people of all ages, but they’re more common among people with disability, older adults or those with neurological conditions.

Swallowing is mostly an automatic (involuntary or reflexive) process, but it also involves voluntary control especially at the start. The first stage, when you chew and move food to the back of your mouth, is something you control. When the food or liquid then moves down the throat and into the oesophagus, it happens automatically and is controlled by your brain and nervous system.

While you can start a swallow consciously, much of the action happens unconsciously, like breathing. Most people swallow between 500 to 700 times a day: around three times an hour during sleep, about once every minute when awake and even more often while eating or drinking. We swallow food, fluids, medication and saliva.

When swallowing becomes difficult, it can lead to serious health issues. Adults may experience dehydration or poor nutrition, while babies and children may struggle to get the nutrients they need to grow and develop.

In residential aged care, studies suggest up to 50% of residents may be living with some form of swallowing difficulty, many of whom have never been formally diagnosed.

When any part of this system doesn’t work well, which can be due to a neurological condition, injury or other health issue, eating and drinking can become uncomfortable, unsafe or even life-threatening.

What are swallowing difficulties?

Swallowing is actually a very complex process involving more than 30 muscles and multiple nerves working in sync.

It is common among people with conditions like:

Children can also experience dysphagia, particularly those with neurological differences or developmental delays.

Recognising the signs of swallowing difficulties

swallowing difficulties 1
Swallowing issues are more common than many realise, particularly for people with complex disabilities or cognitive conditions.

Some signs of swallowing difficulties may be easy to miss or mistaken for something else. But the earlier they’re noticed, the sooner support can be put in place.

Look out for:

  • Coughing or choking during meals
  • A gurgly or “wet” voice after eating or drinking
  • Mouth constantly open
  • Spitting food out of mouth
  • Struggling to swallow pills or tablets
  • Food or drink coming back through the nose
  • Pain, effort or hesitation when swallowing
  • Repeated chest infections or pneumonia
  • A feeling of food being stuck in the throat
  • Avoiding meals or taking longer to eat
  • Slurred speech (Dysarthria)
  • Reduced or fluctuating levels of alertness
  • Diminished or absent gag reflex

If any of these signs show up regularly, it’s important to take them seriously and seek professional advice.

Even when these more urgent risks aren’t present, swallowing difficulties can lead to malnutrition and dehydration over time. Many people start to eat and drink less either because it’s uncomfortable or because they’re afraid of choking. Mealtimes can become stressful or isolating for some especially when they need help or feel self-conscious about their symptoms.

That’s why recognising the signs and taking them seriously is so important. With the right support, people can feel safer, more confident and better supported every day.

Getting help for dysphagia

If you or someone you care for is showing signs of swallowing difficulties, the first step is to speak with your GP. From there, a referral to a speech pathologist is often recommended. They can assess swallowing function safely and create a personalised plan based on the person’s needs, preferences and goals.

Depending on the situation, other allied health professionals like occupational therapists or dietitians may also play a role in supporting nutrition, safety and independence.

If you’re an NDIS participant, these supports can often be funded through your plan under Capacity Building or Core Supports, depending on your needs.

Simple strategies for safer swallowing

Speech pathologists may recommend different strategies depending on the person’s abilities and risks. Some common ones include:

  • Sitting upright while eating or drinking
  • Taking smaller bites or sips, one at a time
  • Avoiding distractions during meals
  • Using texture-modified foods or thickened fluids
  • Taking medication with puree rather than water
  • Avoiding hard-to-chew items like dry bread unless cleared as safe

Every person is different and that is why strategies should always be based on an individual swallowing assessment.

Can swallowing difficulties be managed long-term?

The answer is yes. With proper support and regular reviews, many people can manage swallowing difficulties effectively. In some cases, like after a stroke, function may improve over time. But in other cases, like with progressive neurological conditions, long-term strategies are key.

swallowing difficulties - person with disability
Swallowing difficulties can affect so much more than mealtimes, that is why having the right support makes all the difference.

Speech pathologists play an ongoing role in assessing and adjusting care to ensure support remains safe and person centred.

Why this matters for NDIS participants

For people living with disability, swallowing difficulties can impact independence, mental health and daily functioning. Under the NDIS, mealtime management and dysphagia-related support can be included in your plan notably when risks are high or needs are complex.

Support workers, families and carers need clear guidance. Having a formal mealtime management plan can help outline:

  • What food textures are safe
  • What positioning or equipment is needed
  • Who provides supervision during meals
  • How medication should be given

When followed correctly, these plans promote both safety and dignity at every meal.

Working with support teams

NDIS participants often have a network of people involved in their care. For swallowing difficulties, that team might include:

  • Support coordinators
  • Speech pathologists
  • Nurses
  • Support workers
  • Occupational therapists
  • Family and informal carers

Leora works closely with participants and their allied health teams to make sure everyone is on the same page. Our care teams are trained to follow mealtime plans and recognise when something changes or needs to be reassessed.

Our nurses are trained in managing complex swallowing needs, making sure the right care is in place, safely and without delay. Learn more about our high care supports.

Do you or someone you know need support for swallowing difficulties or dysphagia? Contact our team today to get started.

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