What adjustments should be made during meals for someone with a swallowing disorder?

An optimal environment should be created for mealtime. The following adjustments and measures are recommended:

Sufficient time should be set aside for meals, as swallowing difficulties can lead to longer meal times. To help the person focus on the act of swallowing itself, it may be helpful to avoid distractions (e.g., television, radio, and conversations). Proper posture is a crucial factor for efficient swallowing. Meals should therefore be eaten in a straight, upright position at the table. If the core muscles are weak, it is helpful to use back support or to lean the torso against a backrest. The arms should be slightly bent, and the shoulders pulled forward. Eating and drinking while lying down should be avoided. The head should be tilted slightly forward to facilitate the necessary movements of the larynx during swallowing. For individuals with paralysis of the hands, special drinking cups, straws, and handle thickeners should be provided and customized individually. Only small portions should be served on the plate. Food portions should be appropriate. If necessary, a teaspoon should be used instead of a tablespoon. Solid and soft foods should be chewed and mixed with saliva for a sufficient amount of time.

The swallowing process should not be initiated until you subjectively feel that the food in your mouth has been sufficiently broken down and is easy to swallow (do not swallow “too soon”). After swallowing, you should swallow again at least once. Before the next swallow, a voice test should be performed (“a-a-h” or “o-o-h”). Do not speak while chewing or swallowing. Do not lean back while swallowing.