The older adult with one of these conditions is at even greater risk for aspiration because the dysphagia is superimposed on the slowed swallowing rate associated with normal aging. Conditions that suppress the cough reflex (such as sedation) further increase the risk for aspiration.
Elderly patients with cerebrovascular disease often have dysphagia that leads to an increased incidence of aspiration. It was previously reported that patients with silent cerebral infarction affecting the basal ganglia were more likely to experience subclinical aspiration and an increased incidence of pneumonia.
Dysphagia and aspiration are associated with the development of aspiration pneumonia. While some changes in swallowing may be a natural result of aging, dysphagia is especially prevalent among older adults with neurologic impairment or dementia, leading to an increased risk of aspiration and aspiration pneumonia.
Several factors create a high choking risk among the elderly. As people age, they naturally produce less saliva, so chewing and swallowing food becomes more difficult. Seniors may lack sufficient teeth to break down food easily or have ill-fitting dentures causing difficulties.
The risk factors for aspiration pneumonia were sputum suctioning, deterioration of swallowing function, dehydration, and dementia. These results could help improve clinical management for preventing repetitive aspiration pneumonia.
The most commonly cited factors were decreased level of consciousness, supine position, presence of a nasogastric tube, tracheal intubation and mechanical ventilation, bolus or intermittent feeding delivery methods, high-risk disease and injury conditions, and advanced age.
Aspiration pneumonia is caused by saliva, food or stomach acid leaking into the lungs. Germs (bacteria) introduced by this route set up an infection of the lung tissue, resulting in pneumonia.
In fact, people over 65 years of age have seven times higher risk for choking on food than children aged 1–4 years of age. Texture modified foods are provided clinically to reduce choking risk and manage dysphagia. Although certain food textures offer greater swallowing safety, they significantly restrict food choice.
PREVENTION OF ASPIRATION DURING HAND FEEDING:
Swallowing is a complex process that changes over time, and swallowing difficulty (dysphagia) can be associated with aging. Changes in the tongue, upper throat (pharynx), vocal cords and voice box (larynx), and lower throat (esophagus) occur with aging.
Older adults’ teeth are often weak or absent. The mucosal surfaces in the mouth and throat are less moist. There is a loss of muscle strength in the mouth and throat that slows swallowing and makes it difficult to swallow hard or dry solid foods.
Aging. Due to natural aging and normal wear and tear on the esophagus as well as a greater risk of certain conditions, such as stroke or Parkinson’s disease, older adults are at higher risk of swallowing difficulties.
Severe choking: back blows and abdominal thrusts
Risk factors for aspiration pneumonia include people with:
Causes and risk factors Aspiration pneumonia often occurs if a person has a compromised immune system and inhales an object containing a lot of germs. In many cases, the person will cough automatically, which will expel these unwanted particles and prevent aspiration pneumonia from developing.
Risk factors for developing aspiration pneumonia Dependence for oral care. Poor oral hygiene or poor oral health. Limited or infrequent ambulation. Compromised respiratory system.