What Is a Common Cause of Choking in the Elderly?
Choking is a serious concern in aged care and community settings. Understanding the common causes of choking in the elderly can help carers and healthcare staff provide safer support during meals.
Changes in muscle strength, coordination, and medical conditions can affect how safely they swallow food and drinks.
Dysphagia (swallowing difficulties) can lead to:
difficulty chewing or swallowing
reduced control of food in the mouth
food or drink going down the wrong way
In the older population, there are several factors that can affect the functions involved in eating and drinking.
These changes may impact chewing, swallowing, attention, and overall safety during meals.
Neurological Conditions
Conditions such as dementia, Parkinson’s disease, and stroke can affect the coordination and control required for safe swallowing.
These conditions may impact muscle function, timing, and awareness during eating and drinking.
Dry Mouth (Xerostomia)
Many medications can cause dry mouth (xerostomia), which reduces saliva.
Saliva plays an important role in:
moistening food
forming a bolus
supporting safe swallowing
Reduced saliva can make food harder to chew and swallow.
Reduced Cognitive Function
Some older individuals may experience changes in memory and attention.
This may lead to:
forgetting that they are eating
holding food in the mouth without swallowing
reduced awareness of safe eating strategies
These changes can affect how safely food and drinks are managed during meals.
There are many factors that can increase the risk of choking in the elderly.
1. Inappropriate Food Texture
Food that is too hard, dry, sticky, or difficult to chew can be harder to manage safely.
2. Eating Too Quickly
Rushing meals or taking large bites can make swallowing more difficult.
3. Poor Positioning During Meals
Eating while lying down or slouching can affect swallowing safety.
4. Reduced Supervision
Some individuals may require reminders, pacing support, or assistance during meals.
5. Distractions During Eating
Talking, watching TV, or being in a busy environment can reduce focus on swallowing.
Common High-Risk Foods
Some foods are more commonly associated with choking in the elderly, including:
tough meats
raw vegetables
nuts and seeds
sticky foods (e.g. peanut butter)
round foods such as grapes
These foods may be harder to chew, control, or swallow safely. Read this article for 15 foods that can be difficult to manage in dysphagia.
How to Support Mealtime Safety
To reduce the risk of choking:
ensure food textures are appropriate
encourage small bites and sips
allow time between mouthfuls
support proper positioning
reduce distractions during meals
The Role of Dysphagia Training
Dysphagia training helps carers and staff:
recognise risk factors
understand safe swallowing strategies
improve understanding on how to support individuals appropriately during meals
This plays an important role in improving mealtime safety in aged care.
Final Note
If there are concerns about swallowing or choking risk, it is important to seek assessment and guidance from a speech pathologist.
About the Author
Vanessa Chan is a speech pathologist and chair of the Australian IDDSI Reference Group. She provides dysphagia education and IDDSI training to aged care and disability providers through Swallowing & Dysphagia Support.
