What could cause trouble swallowing?
Trouble swallowing can appear gradually or start suddenly, and it’s often more common than people realise. If you are supporting an older adult or experiencing changes yourself, understanding what causes swallowing issues can help you seek help early. A professional swallowing assessment can identify the underlying cause and guide safe mealtime strategies that reduce risk and improve comfort. We also do mealtime management plan.
Swallowing is a complex process involving the lips, tongue, jaw, throat, airway protection, and timing. When even one part isn’t working as expected, eating and drinking can become unsafe.
What Trouble Swallowing Means
Trouble swallowing is known as dysphagia. It affects a person’s ability to move food or drink from the mouth to the stomach safely. This may look like:
- coughing during meals
- foods getting “stuck”
- taking longer to chew
- difficulty coordinating chewing and breathing
- needing multiple swallows for one mouthful
- avoiding certain textures
Dysphagia can occur at any age but is especially common among older adults, residents in aged-care facilities, stroke survivors, people with neurological conditions, and individuals living with disability.
We provide swallowing assessment in Sydney, a swallowing assessment helps determine which part of the swallowing process is affected and what level of support is needed.
Common Signs & Red Flags to Watch For
- Coughing or choking during meals
- Food pocketing inside the cheeks
- Wet or gurgly voice after swallowing
- Taking significantly longer to finish meals
- Unintentional weight loss
- Avoiding hard or dry foods
- Recurrent chest infections
- Feeling short of breath while eating
- Needing to drink to “wash food down”
- Complaints of pain when swallowing
For aged-care staff, noticing small changes early can prevent complications such as aspiration pneumonia, dehydration, and malnutrition.
Why Trouble Swallowing Happens
Swallowing issues can have many causes. Some are temporary, while others are linked to long-term health conditions.
Swallowing difficulties or trouble swallowing can develop for many reasons. For some people, age-related changes in muscle strength make chewing and coordinating the swallow more challenging. For others, neurological conditions such as stroke, Parkinson’s disease, dementia or brain injury can affect timing, sensation, or control of the muscles used for eating and drinking. Difficulties may also arise from poor oral health, including missing teeth or ill-fitting dentures, which can make chewing less effective. Certain medications can reduce alertness or cause dry mouth, affecting how safely someone manages different textures. Ongoing respiratory illness or reduced energy levels can also make it harder to coordinate breathing with swallowing. Because the causes vary widely, a thorough swallowing assessment by a speech pathologist is important to identify what is contributing to the issue and to guide safe, personalised mealtime recommendations.
Practical Things Families & Carers Can Do | Safe Swallowing Strategies
✔ Offer smaller, slower mouthfuls
This supports coordination and reduces choking risk.
✔ Encourage upright positioning
A 90-degree seated position is essential during meals.
✔ Allow extra time for meals
Rushing increases aspiration risk.
✔ Check alertness before offering food
Meals should be provided when the person is awake, alert, and able to follow instructions.
✔ Encourage sips between bites
This can help clear residue — but avoid very large drinks.
✔ Monitor for changes in breathing or voice
If coughing, wheezing, or “wet” voice occurs, pause the meal.
✔ Follow any prescribed texture-modified diets or thickened fluids
These are essential for safety, not a preference. Please see IDDSI for more information for different IDDSI Levels
These strategies help, but they do not replace a professional assessment.
You should arrange a swallowing assessment when:
- signs of trouble swallowing have appeared recently
- there is coughing or choking during meals
- there is ongoing weight loss
- chest infections are recurring
- the person refuses food or takes too long to eat
- the person has a diagnosis known to affect swallowing
- support staff or family feel unsure about safety
At swallowing and dysphagia support, we provide swallowing assessment Sydney, provides clear, personalised guidance so the person can eat and drink as safely as possible.
At Swallowing & Dysphagia Support, we specialise in assessment and mealtime recommendations for:
- aged-care residents
- NDIS participants
- adults with neurological conditions
- people experiencing swallowing changes for the first time
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