[Dysphagia] Gagging

[Marie.Isbell at state.tn.us (Marie Isbell)]

Consider looking at the consistency of the food.  The minced food may be
too dry, scatter in her mouth and make it difficult for her to form the
bolus, leaving little pieces that trigger a gag.  The foods that she
likes have a creamy or smooth consistency.  Adding a gravy or sauce to
the minced foods might make a difference for her.  For instance, add
butter to the sweet potatoes and mash it in, add a gravy or BBQ sauce to
meats, spinach could have a cheese sauce added.  All of these could be
purchased in a grocery and kept in her home area to add to the foods
when they come up from the kitchen.

Marie M. Isbell, MA, CCC-SLP
West TN Regional PNM Team
West TN Regional Office
8383 Wolf Lake Drive
Bartlett, TN 38133
(901) 213-1847
Fax: (901) 372-3460
Marie.Isbell@state.tn.us

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>>> "TURNBULL Harmony" <Harmony.Turnbull@dadhc.nsw.gov.au> 7/6/2004
12:26:57 AM >>>
Does anyone have any suggestions here?
I saw a client today who is 52, has Down Syndrome and diabetes. She has
some communication skills and usually answers y/n appropriately to most
q's. She is a very fussy eater and prefers to eat dessert (dont we
all?). She feeds herself and needs pretty consistent encouragement to
eat her main meal (minced consistency). She has little difficulty at the
beginning of the meal, but when she gets about 1/2 way through she
starts to gag. Initially we thought she was putting her spoon too far
into her mouth triggering the gag, but today it looked more like a
response to the food she was eating (minced spinach, sweet potato and
meat). She looked like she didnt like the food and only ate with lots of
encouragement but I was afraid she would make herself vomit if she
continued. She then went on to eat icecream and puree fruit for dessert
with no probs. We have given her a shorter spoon so she cant put it as
far back in her mouth, so it really seemed that it was an objection to
the food.
I work in a large residential facility with a limited menu to offer
clients. Does anyone have any other suggestions since this lady would
only eat dessert all day long if we let her??
Thanks,
Harmony


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