Eating and Swallowing Clinic

Healthy eating is always important, but even more so as we grow older. Proper nutrition raises energy levels, boosts the immune system and protects the body against illness. Maintaining good nutrition, however, is very complex - eating a healthy meal involves shopping for and preparing food; having an appetite and a desire to eat; and having adequate chewing and swallowing abilities. Troubles with any of these can cause poor eating, which in turn can cause undernourishment. Unfortunately, problems with these areas are common in the elderly, placing them at risk for malnutrition.

MMC's Geriatric Center is now offering an Eating and Swallowing Clinic designed specifically to help elders who are experiencing difficulty with any or all aspects of preparing and eating meals. The goal of the clinic is to help seniors maintain their nutritional status, prevent complications such as aspiration, encourage independence with eating and ensure that meals are an enjoyable experience. To accomplish this, the team will look at specific aspects of eating and swallowing including: the environment; use of feeding utensils; vision impairments; presence of swallowing deficits and resulting need for swallowing strategies and change in diet consistency; and the impact of medication on swallowing and appetite.

What causes eating and swallowing difficulties?

A number of things occur during the normal aging process that impact eating and swallowing that can make it challenging to keep up with nutritional requirements: There is a decline in the sense of smell that directly affects the ability to taste and saliva production decreases, causing dry mouth. Metabolism and body composition also change, resulting in loss of bone and muscle and reduced appetite. Poor dentition or ill fitting dentures can make chewing meats and raw vegetables difficult, and failing eyesight can make meals appear less appetizing.

Beyond physical changes, getting older also brings about shifts in social and financial status that can be harmful to nutritional health. Eating is a social activity and many older individuals dislike eating alone, or consider it a chore to cook for one. Similarly, the loss of a spouse or close friend can result in loneliness and isolation, which can lead to depression and loss of appetite.  Money worries may also play a role, as many retirees on fixed budgets may be forced to make cut-backs in their food allowance.

Finally, there are a number of disease processes common in the elderly that impair eating and swallowing function, making it difficult to eat. Strokes, Parkinson's disease, multiple sclerosis, gastroesophageal reflux, and Alzheimer's disease are examples of these. Weakness and mobility issues can make it difficult to get to a grocery store, shop and put away groceries. And, there are a number of medications commonly taken by the elderly that reduce appetite, or change swallow function.

What can be done to help with eating and swallowing problems?

Despite these hurdles, there are things that can be done to assist with eating and swallowing and encourage older individuals to attend to nutrition:

• Stay physically active
• Make meals enjoyable - prepare foods appealing in color, smell and texture
• Make mealtime enjoyable - join a dining group, family or neighbors for meals
• Get help with shopping - ask someone to shop for you or use delivery services
• Report any problems with swallowing to your doctor: you may benefit from an evaluation by a Speech/Language Pathologist
• Report any unintentional weight loss to your doctor
• Ask your doctor if medications could be playing a role in reduced appetite and/or swallowing problems

The Eating and Swallowing Clinic is staffed by a Geriatrician, an Occupational Therapist and a Speech-Language Pathologist and is held on Fridays at the Geriatric Center located at 66 Bramhall Street in Portland. For an appointment or for more information, please contact us at 662-2847.

View pictures of our Eating and Swallowing Clinic team.