What is dysphagia?
Dysphagia means difficulty swallowing. It is common in people with dementia and can make
eating and drinking unsafe.
This leaflet explains:
- Signs to look out for
- When to seek help from a Speech and Language Therapist (SLT)
- Tips to try before referring to a SLT
Common eating and swallowing problems in dementia
People with dementia may experience:
- Difficulty recognising food
- Refusing to eat or drink
- Holding food in the mouth or forgetting to swallow
- Spitting out food
- Getting distracted while eating
- Cramming food in their mouth
- Difficulty using utensils
- Delayed swallow
- Coughing or choking while eating
These problems can lead to:
- Dehydration (not drinking enough)
- Malnutrition (weight loss)
- Lung infections (aspiration pneumonia – food or drink entering the lungs)
| Problem | Possible causes | What you can do |
| Drooling of food or saliva | -Not swallowing frequently enough -Poor posture -Weak muscles | -Encourage upright sitting -Remind them to swallow -Try different food textures -Speak to GP if saliva problems continue |
| Holding food in mouth or spitting it out | -Reduced awareness or taste -Drowsiness | -Use verbal prompts -Try stronger flavours (sweet, sour) -Talk about the food -Use cold drinks to increase sensation -Try textured foods if swallowing is safe |
| Difficulty swallowing safely | -Coughing -Choking Wet voice after eating -Recurrent chest infections | Refer to SLT for assessment |
Improving mealtime safety
- Supervision: Offer help and monitor signs of swallowing problems
- Good positioning: Sit upright while eating
- Encourage independence: Let them feed themselves as much as possible
- If helping to feed: Watch for swallowing before giving more food
| Behaviour | How to help |
| Agitation | -Reduce noise and distractions -Consider personal preferences (alone or with others?) |
| Drowsiness | -Check for medical issues or infections -Feed when most alert -Avoid feeding if too drowsy (risk of choking) |
| Wandering | -Offer finger foods -Give reminders that it is mealtime -Reduce distractions -Use clear cups/plates -Help with hand-over-hand feeding |
| Easily distracted | -Reduce distractions -Use clear cups/plates -Help with hand-over-hand feeding |
| Refusing food/drink | -Check for pain, changes in taste, or need for help -Offer small amounts frequently -Use verbal cues (“This smells nice!”) |
| Eating too fast | -Cut food into small pieces -Give verbal prompts to slow down -Refer to SLT if coughing/choking |
| Eating too slowly | -Keep food warm -Offer small meals more often -Refer to SLT if coughing/choking |
| Eating non-food items | -Increase supervision -Remove unsafe objects |
When to refer to Speech and Language Therapy
Contact SLT if the person:
- Has frequent chest infections
- Coughs or chokes while eating or drinking
- Loses weight unexpectedly
- Continues to struggle despite trying the strategies above
Information needed for referral:
- Which foods/drinks cause problems?
- How often do symptoms occur?
- History of chest infections
- Weight changes
- Current diet and eating environment
Speech and Language Therapy contact details:
Phone: 0151 604 7271
Email: [email protected]
Download the PDF version:
Page last reviewed: 05/06/2025