Keeping Aspiration Pneumonia at Bay
This topic was reviewed by Meghan A., Speech and Language Pathologist with Outreach
Meghan A, MS CCC-SLP is a Speech-Language Pathologist specializing in swallowing and speech disorders. In addition to being the Speech Supervisor at Outreach, she is a Clinical Supervisor at Long Island University, Brooklyn. She can be reached at firstname.lastname@example.org.
Pneumonia is a risk that increases with age, and it can significantly complicate your overall health, even leading to hospitalization or death. Pneumonia refers to any infection in the lungs where the air sacs fill with pus, and can be caused by a number of different viruses or bacteria. Your pneumonia shot protects you against one specific type of viral pneumonia, but offers you no protection against pneumonia caused by other bacteria or viruses.
Aspiration pneumonia is a particularly dangerous type of pneumonia, resulting in frequent hospitalizations and almost a 25% mortality rate. It is caused by food, liquid, or saliva going down “the wrong pipe” to the lungs; this food/liquid/saliva carries bacteria along with it that takes root and grows in the vulnerable air sacs of the lungs. Anyone can be at risk for aspiration pneumonia if food/drink/saliva is going down “the wrong pipe” too often, but individuals who have experienced a Stroke, Parkinson’s or Multiple Systems Atrophy, Head/Neck Cancer, a Spinal Cord Injury, or Motor Neuron Disease (like ALS) are especially vulnerable. Your (or your loved one’s) risk is increased even more if you/they:
- Have a feeding tube (a PEG tube through the wall of the stomach, or an NG tube through the nose)
- Have someone else feeding you
- Are in bed for most of the day
- Have someone else taking care of brushing your teeth/cleaning your mouth, or you don’t clean your mouth at least twice per day
- Have any decayed teeth or infection in the mouth
While aspiration pneumonia is scary, there are some easy things to do to lessen the risk. Firstly, consult a Speech-Language Pathologist (SLP) who specializes in dysphagia (chewing and swallowing problems). Your SLP will be able to create a customized plan for you that can dramatically help reduce the risk of developing pneumonia. However, a good step that anyone can take is paying close attention to the health of your mouth. If there are a lot of bacteria in your mouth, from a decayed tooth, for example, this increases the risk that those bacteria will travel with your food or saliva down to your lungs and cause big problems. Consult a dentist to have any problematic teeth treated or removed, and make sure that you are cleaning your mouth out with a soft toothbrush at least twice per day, even if you don’t have teeth. Additionally, if you are being fed by a caregiver, make sure that the caregiver is going very slowly, allowing ample time for you to swallow and take a few breaths before providing you with another bite or sip. As we get older, sometimes we require a little bit more time to swallow and clear away any reside in the mouth. Going too fast can lead to small amounts of the food/liquid going down the wrong way, even if you/your loved one doesn’t feel it.
Together with your SLP, you can reduce your chances of developing aspiration pneumonia, and can help keep your lungs clear and healthy for many years to come!
Sue Eisenstadt, E. (2010). Dysphagia and aspiration pneumonia in older adults. Journal of the American Association of Nurse Practitioners, 22(1), 17-22.
Langmore, S. et al. (1998) Predictors of aspiration pneumonia: How important is dysphagia? Dysphagia, 13(2), 69-81.