By Meghan Ahern, MS CCC-SLP
As the holiday season approaches, a common unspoken theme runs through many of our activities. We lovingly spend hours preparing a roast turkey. We honor our family traditions by breaking out a battered recipe card with a Great Aunt’s secret ingredients. We fill stockings with treats, and fry crispy latkes in hot oil. We toast milestones and a new year by clinking champagne glasses.
What is the common thread? Eating and drinking together.
Thinking about the ways in which we gather and connect with loved ones, you will be hard pressed to find a tradition that doesn’t involve food or drink. We so often express love and connection by providing and sharing sustenance together.
But for hundreds of thousands of New Yorkers, these commonplace interactions are fraught with stress and frustration. Approximately 1 in 25 adults experience some trouble eating or swallowing, and some estimate that for older adults, that number may be as high as 1 in 3. That means that upwards of 250,000 people are struggling with this issue in New York City alone.
Eating and swallowing problems can vary from trouble chewing, to an uncomfortable lump in the throat, to food or drink going “down the wrong pipe” and causing coughing or choking, to a complete inability to swallow and reliance on a feeding tube for nutrition/hydration.
Difficulty swallowing is referred to as Dysphagia, and a Speech-Language Pathologist (SLP) who specializes in swallowing disorders is the appropriate professional to diagnose and treat Dysphagia.
As SLPs, there are several ways we can help with swallowing during the holidays. You should talk to your SLP about your goals for eating and drinking during special occasions. Maybe you want to make it through the whole meal without coughing, or maybe it’s most important to be able to take one taste of a special traditional food. Here are some ways that an SLP might be able to help:
1. Adjust your meal plan
Your SLP can help you identify how your holiday meal can be modified to accommodate your particular swallowing issues. Sometimes small tweaks in texture or thickness can result in an easier time swallowing–for some it might be adding more gravy to their turkey, but for others the mixed consistency might make things worse. There is no one-size-fits-all solution, so it’s important to get checked out if you have concerns.
If it is an issue with chewing or manipulating foods in the mouth, the SLP might be able to make these recommendations right away. If there are concerns about which textures are sticking in the throat or going down the wrong way, some further tests might be needed to determine which holiday foods are more or less safe. Outreach is able to perform some swallowing testing in your home, such as using an endoscope to look in your throat.
2. Adapt your environment
Some might have decided that, come hell or high water, they are going to have a bite of Mom’s pumpkin pie this year, even if they are supposed to avoid it!
If you are set on having a particular food/drink this season, and the food itself can’t be adapted, an SLP can help develop strategies to make that food as safe as possible. This might involve eating/drinking while in a certain position or angle, or washing food down with liquid between bites (or the opposite, and avoiding drinking until the end of the meal). Again, there is no one-size-fits-all approach, but your SLP might be able to help create a tailor-made plan to lessen the risk.
3. Think outside the tube
For individuals receiving bolus tube feeding, it might be possible to receive homemade or special foods blended and via tube in order to take part in family traditions. For some, it might even be possible to take a small amount of food or drink by mouth.
Again, it is important to discuss your particular situation with an SLP and evaluate risk, and pros and cons. If there are concerns about food/drink going down the wrong way, it might be important to first receive a swallowing test using either an endoscopic camera or an x-ray procedure.
As SLPs, we are here to support you in your journey of eating and drinking, and respect that it is always your choice as to what you want to consume. We are not the “food police”, but rather work collaboratively with you and your family to help you reach your swallowing goals.
If you are looking for in-home or in-office support for your eating or swallowing difficulty this season, and have any questions, please contact Outreach at email@example.com or 212-842-0080.