Day: June 25, 2025

Swallowing is a function we often take for granted. Yet, for individuals living with Alzheimer’s disease, this seemingly simple task can become increasingly difficult as the condition progresses. Difficulty swallowing, known as dysphagia, is a common and serious complication in the later stages of dementia. Left unaddressed, it can lead to malnutrition, dehydration, aspiration pneumonia, and a decline in overall health.
As a caregiver, recognizing the early warning signs of a swallowing problem is essential to ensure safety, comfort, and appropriate medical intervention for your loved one or those under your care.

Why Swallowing Becomes Difficult in Alzheimer’s Disease

Alzheimer’s affects more than just memory—it impairs coordination, muscle function, and the brain’s ability to control the complex process of swallowing. As the disease advances, individuals may forget how to chew or swallow or become unable to recognize the food in front of them.

Key Warning Signs of Swallowing Difficulties

If you’re caring for someone with Alzheimer’s, be alert to these common signs of a swallowing problem.

• Complaints of pain or difficulty when swallowing
The person may verbally express discomfort or seem distressed when trying to eat or drink.

• Leaking food or saliva from the mouth
This may indicate a loss of muscle control in the lips or jaw.

• Coughing before, during, or after meals
This could mean food or liquid is entering the airway instead of the esophagus.

• Choking while eating or drinking
A serious sign that requires immediate attention to prevent aspiration.

• Increased congestion or runny nose after meals
This could be a subtle sign of aspiration or food entering the nasal passages.

• Change in voice quality
A wet, gurgling, or hoarse voice after eating or drinking may indicate that food or liquid has entered the airway.

• Food retention in the mouth or throat
Watch for food lingering in the cheeks or not being swallowed properly.

• Resistance to being fed or eating
This may stem from fear of choking or discomfort while swallowing.

• Refusal to open the mouth
A sign of discomfort, confusion, or loss of interest in eating.

• Unexplained weight loss
Often a late sign, weight loss may result from inadequate nutrition due to swallowing issues.

Notify a supervisor or physician if any of the above symptoms are observed.

Maintaining Dignity During Mealtimes

Beyond recognizing the physical signs, it’s just as important to maintain a person’s dignity while eating. For those who struggle to keep food in their mouths, be mindful of how you assist them.
Avoid scraping the spoon across their lips or the area around their mouth. This can be both painful and embarrassing. Instead, gently use a napkin to wipe their mouth. Even better, if the person is able, ask them to wipe their own mouth when needed. This simple act respects their autonomy and self-esteem.

Helping someone with dementia starts with understanding and support. To make that journey easier, get 10% OFF any training and certification program with promo code SunnyJuly at checkout. Offer valid through July 31, 2025.

Eating is a deeply personal and social activity, often tied to comfort, identity, and daily routine. For individuals living with Alzheimer’s disease, the ability to eat independently changes with each stage of the condition. Understanding how eating behaviors and needs evolve is crucial for caregivers and loved ones to provide appropriate support and maintain quality of life.

1. Normal Thinking (No Dementia)

In this stage, the individual does not have Alzheimer’s disease or any other form of dementia. Their cognitive functions are intact, and eating habits remain typical. No special intervention is needed, unless there are other health-related dietary needs.

Note: The term “normal thinking” refers only to the absence of dementia and not to a person’s value or capabilities. Those living with dementia are still very much whole individuals deserving of dignity and respect.

2. Early Stage of Alzheimer’s Disease

In the early stages, there is minimal impact on a person’s ability to eat or prepare food. Individuals can often:

• Feed themselves without difficulty.
• Prepare simple meals independently.
• Continue enjoying meals with minimal, if any, assistance.

Caregivers can support by:

• Offering occasional reminders or assistance only when needed.
• Respecting the individual’s autonomy and abilities.

3. Middle Stage of Alzheimer’s Disease

This stage brings more noticeable cognitive and functional challenges that begin to affect eating behaviors.

Common difficulties include:

• Inability to focus on meal preparation, often leaving meals unfinished.
• Skipping meals due to forgetfulness or lack of hunger awareness.
• Disrupted meal patterns because of time confusion or lack of routine.

Tips for caregivers:

• Set consistent mealtimes and provide gentle reminders.
• Offer meals in a quiet, distraction-free setting.
• Prepare simple, easy-to-eat meals that require little effort to serve and eat.

4. Late Stage of Alzheimer’s Disease

In the final stage, eating abilities decline significantly. The person may require full assistance and close monitoring during meals.

Common challenges:

• Loss of appetite and inconsistent willingness to eat.
• Difficulty using utensils—may need hand-over-hand guidance.
• Struggles with portion control, often trying to eat too much or too little at once.
• Strong preference for sweet foods.
• Frequent need for verbal and visual prompts to continue eating.
• Physical difficulties, such as trouble sitting up or maintaining posture during meals.
• Forgetfulness of basic actions, such as chewing or swallowing.

End-of-Life Considerations:

• Difficulty holding the head up may affect feeding.
• Straws or special cups may make drinking easier if the person can still sip.
• The primary goal becomes comfort care—offering small amounts of food or fluids only if they bring comfort or pleasure.
• Maintain oral hygiene by keeping the mouth clean and lips moist.

Care Tip: Keep the Tabletop Uncluttered

Especially during the late stage, it’s essential to reduce visual and sensory distractions at mealtime. Remove:

• Flowers
• Decorative items
• Sugar packets
• Any non-edible clutter
An uncluttered table helps the person focus on eating and minimizes confusion or distress.

Helping someone with dementia starts with understanding and support. To make that journey easier, get 10% OFF any training and certification program with promo code SunnyJuly at checkout. Offer valid through July 31, 2025.