What Food to Eat When Risk of Aspiration? Accidental inhalation of food or liquid into the lungs and can cause life threatening illnesses such as aspiration pneumonia, chronic cough and lung infections. Patient with increased risk of aspiration is those with certain diseases like neurological disorders, esophagus diseases or those who have experienced a recent stroke. It is not easy to manage the risk of aspiration, but taking right kind of food is fundamental and may go a long way in managing aspiration of patients. This article discusses the feeding guidelines for aspiration prone and this entails nutritional, swallow and chew foods that can assist people whose aspiration condition in improving.
One of the biggest risks in hospice and palliative care is someone getting aspiration pneumonia. Here are some things you can do to decrease that risk. First, what is aspiration pneumonia?
What is Aspiration Pneumonia?
This happens to a lot of people who have dysphasia, which is when you have difficulty swallowing or you can’t swallow at all. Almost everyone on hospice and sometimes palliative care will eventually get to a place where they have difficulty swallowing because it takes a lot of muscles – your neck, your mouth, your tongue. All of these muscles start weakening, so it gets harder and harder to swallow.
How Does Aspiration Pneumonia Occur?
Aspiration ammonia happens when some of those food particles or liquid particles, instead of going down your esophagus into your stomach, go down your trachea into your lungs. Sometimes people can silently aspirate, meaning you don’t even hear them choking or coughing because they aspirated. Sometimes you can tell; it’s a little easier to tell. They start coughing; they feel like they’re choking, but it can be pretty subtle sometimes.
Definition of Aspiration Pneumonia
So aspiration pneumonia is basically when food or water goes into the lungs and it settles there and eventually turns into an infection.
Typical Signs of Aspiration Pneumonia
Typical signs you’ll see from aspiration pneumonia are going to be fever, a lot of coughing, and some shortness of breath. If someone shows any of these signs and they’re on hospice, for sure call your hospice team. An antibiotic may need to be started. If you’re not on hospice or palliative care, of course, talk to your doctor.
Who is Most at Risk?
So some things that increase that risk, or people who are most at risk, are anyone that has any kind of disease where their muscles are going to be weakening. Dementia, Alzheimer’s, Parkinson’s, MS, ALS – anyone that will slowly have deteriorating muscles will be at risk for this. Stroke – a lot of times people become dysphagic because of stroke. It just depends. And a lot of times, people on hospice with any disease, once they’re getting very towards the end, like near the transitioning time where they’re not actively dying yet but they’re having a hard time taking in food and water, you’ll notice them kind of coughing a lot with every sip of water or spoonful of food.
Identifying the Risk
If you notice them coughing, coughing, coughing, that is a sign that they are getting weakened muscles right there, and they are at risk for aspiration, which can then turn into aspiration pneumonia.
How Can You Help?
How can you help? That’s the biggest thing here, right? People want to know how can they prevent this or at least make someone less at risk. The main thing will be noticing that someone’s getting weak.
Signs of Weakness
So if you have a loved one that you’re caring for, and you’re feeding them food or feeding them drink, and you notice with every sip or every other sip, you notice them coughing, coughing, coughing, coughing, coughing, that doesn’t necessarily mean they’re aspirating. That actually means they’re probably still protecting their airway well. That’s a good sign, but it’s a sign to you that their muscles are weakening. That’s something you want to talk to your doctor about or your hospice team about.
Using Thickeners
We can usually start something called a thickener, which will help thicken your liquids, because that’s the first thing your loved one will be coughing on. Liquids are actually hardest to swallow. So they’ll put a thickener in the liquid, make the liquid a little thicker, and it’s a little easier to swallow.
Altering Food Texture
And last but not least, you can always alter solid food versus liquids. So they take something solid and then follow it with liquid, take something solid, follow it with liquid. And again, small portions and slowly.
Avoiding Forced Feeding
Second, I don’t want you to force anything. Remember how I always say, “Don’t force someone to drink or eat or take medication.” That is because if you do, they are at risk to aspirate, and then the aspiration again can turn into aspiration pneumonia. So do not force. Always offer food and water if they want it – great. If they don’t, don’t force it.
Aspiration Precautions
All of these things I’m describing to you are something we call aspiration precautions. Your hospice team will likely have a lot of these things in place, so you can always ask them as well.
Elevating the Head of Bed
Head of bed at 90 degrees will help with decreasing the risk for aspiration. Having them take small, small bites, so instead of like big meals three times a day, small little meals throughout the day. And in those meals, slowly feeding them in small bites.
Encouraging Multiple Swallows
Also, another thing you can do is when they are sipping water or taking a drink or having some soup, after they swallow, have them swallow a bunch of times after that. So small little swallows, multiple times.
Managing Medications
If you are giving medications and swallowing pills is difficult, you can always ask your hospice team if you can crush certain pills. Do not crush pills unless you ask them first, because some pills will be time-released that you can’t crush. So ask if you can crush them. If you can, you can crush them and mix them with applesauce or something, which makes it easier to swallow.
Alternating Between Solid Food and Liquids
If you can’t crush, you can always just take one pill at a time, and again, always talk to your hospice company or your doctor about risk versus benefit. You know, if it’s too much risk to try to swallow the pill, maybe don’t swallow the pill or be on that medication anymore. It just depends, especially if you’re on hospice. You always want to outweigh risk versus benefit.
Diets modified for texture and other measures Aspiration:
Changes to Diet to Reduce Aspiration Risk:
- Blending and pureeing: Describing a food as thick is useful when patients have difficulty swallowing and are at risk of aspiration if given a puree. Adding of different protein sources, fats and fiber rich foods in the form of smoothie or soup can support a balanced diet with reduced risk of the disease.
- Texture adapters: This is cutlery designed for the feeding of those with swallowing problems: These come in a range of textures so that they can be used to scoop food with different levels of thickness. There are large and small ones depending on how one wants to change the texture of food to allow people with tendencies of asperation to take their meals.
- Swallowing therapy: It’s possible some people might benefit from professional swallowing therapy or seeing a speech language pathologist about proper swallowing techniques and reducing your chance of aspiration.
- Small, frequent meals: Another way to prevent the ability of the swallowing mechanism to overload as well as the chance of asperation is to take many, but small portions, instead of large meals. This approach also gives a chance to test different food consistencies and find out what type of a consistency is suitable for each of its consumer. You can contact us here.
Conclusion:
As a result, strong desire is a horrible thing to have, but an intractable thing too. This is because, if patients at high risk of aspiration take in the correct nutrients and soft diets, their chance of nightmare complications will be reduced greatly and they can live a full life. The best approach when choosing the right diet to adapt should consult the health care practitioner or speech and language pathologist. Aspiration risk patients are able to have beneficial results while agreeing to change their nutrition plans when engaged in choosing foods and preparing them.
Final Reminder
The most common reason for aspiration is from force-feeding, so again, please do not force-feed or take a syringe full of fluid and try to make someone drink. That’s the biggest risk you can give your loved one. So again, at the end of the day, just let them be your guide. Let their body be the guide. Offer everything, everything you can, and if they want it and can take it, good. If they can’t, hold off. Always talk to your hospice company or your medical provider for advice.
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