Choking and older people
In the run up to publication of my new book Carers and Caring; the One Stop Guide; how to care for older relatives and friends I am sharing an A to Z of some of the practical solutions learned from research and experience. If you think any problems have been missed you can email me and tell me, and I’ll make sure they are covered in the next edition and online on my website at www.juneandrews.net.
Choking
If you’ve ever done a first aid course you already know what to do if someone is choking. Older people have a higher choking risk than other people. They naturally produce less saliva, so chewing and swallowing food becomes more difficult. If their teeth are not very good or they have ill-fitting dentures this adds to the problem. If they have Parkinson’s disease or have had a stroke or have dementia, that will affect their chewing and swallowing ability.
Heimlich Manoeuvre
You will have heard of the Heimlich Manoeuvre. In the event of an incident stand behind the person with your arms around their waist. Bend them forward and put your fist above the bellybutton and pull sharply inwards and upwards. Repeat this a few times. If that doesn’t clear the blockage you need to dial 999. You can purchase a device that uses suction to pull fluid or food out of the person’s mouth, clearing their airway. This is advertised as a piece of kit that someone can use on themselves.
To avoid the need for this adventure, encourage the person to take time eating and avoid talking or drinking while chewing. Certain foods are known to trigger coughing or choking. They include dry meat and chicken, raw vegetables, nuts, seeds and dried fruits. Large medicine tablets can also be hard to swallow.
I am proud to say that I have twice helped someone who was choking using the Heimlich Manoeuvre. It worked both times. I shook like a leaf afterwards and wondered if they minded me manhandling them, but both were grateful that their life had probably been saved. I’d only ever seen it in a diagram. And they were strangers in a public restaurant both times. So you will definitely be able to do it if you need to.
Seek medical advice early to treat symptoms
If someone has difficulty swallowing, they should seek medical advice early because there may be treatment to help with the symptoms. Early investigation rules out other more serious conditions like oesophageal cancer. If tiny bits of food or fluid go down the wrong way, it can lead to chest infections such as pneumonia. Pneumonia is a medical emergency and you should call NHS111 immediately.
Ask the GP for a consultation with a speech and language therapist (SALT).
It’s a misleading name because assessing swallowing is one brilliant area of their expertise. And a dietician to see what diet changes could help. Liquids might be easier to swallow if they are thickened, and soups if they are blended. Sitting up properly at the table to eat and keeping distractions to a minimum while eating can make a difference. Sometimes the person, having had a fright, avoids some vital foods and exists on things like ice cream and custard. If they become weaker as a result, they will be even less able to control their swallowing.
There is much more about first aid and swallowing in Carers and Caring: The One-Stop Guide: How to care for older relatives and friends - with tips for managing finances and accessing the right support available from all good bookshops in May 2022
Three hints:
Get help with early signs of swallowing problems
Use the SALT (speech and language therapist)
Doing a Heimlich Manoeuvre is easier than you think.
