
Swallowing seemed simple until one mother’s experience with her newborn revealed just how fragile this process could be.
Her daughter struggled to feed, coughing and sputtering despite every precaution. A chilling diagnosis changed their lives forever.
The baby had caught RSV and stopped gaining weight, prompting the mother to observe troubling feeding signs.
She noticed coughing, sputtering, and occasional back-arching during feeds.
A live X-ray confirmed dysphagia, and the speech-language pathologist delivered a stark warning: 'You're lucky we caught this early. Even a tiny amount of food or liquid entering the lungs can cause pneumonia.'
This early encounter inspired her to become a speech-language pathologist, specialising in swallowing disorders—a field increasingly relevant for older Australians.
Mild swallowing difficulties are common in seniors over 80, according to Victoria’s Department of Health.
The statistics are stark: while 6–9 per cent of the general population are affected, over 60 per cent of residents in aged care facilities experience dysphagia, and roughly 60,000 people die each year from complications, primarily aspiration pneumonia.
'Dysphagia is more prevalent than many realise and can significantly impact quality of life'
Swallowing is a complex process involving numerous muscles and nerves in the mouth, throat, and oesophagus.
Dr Laura Dominguez, a Dallas-based specialist, explained that although the 'right' way to swallow varies slightly, the principles remain: 'Take appropriately sized bites, chew well, and have water or some liquid available during meals.'
Better swallowing technique
Tilt your head only slightly when drinking, or use a straw
Take appropriately sized bites
Chew thoroughly before swallowing
Keep water nearby during meals
Avoid 'chugging' large amounts of liquid
Slow down, especially with dry foods
Speech-language pathologists recommended slowing down with dry foods like sandwiches, sushi, and meat, and resisting the urge to 'knock back' liquids. Leaning the head back and consuming large amounts quickly makes throat structures work harder, raising aspiration risk.
Dysphagia is often under-recognised and under-diagnosed, with seniors frequently dismissing early symptoms as part of ageing.
Almost 60 per cent of people aged 60 and over reported difficulty swallowing medication, with many crushing tablets or opening capsules, and 72 per cent had not told their GP.
Watch for these red flags
Swallowing problems can trigger pain, dehydration, malnutrition, and serious complications like aspiration pneumonia or choking.
Amy Zembriski, a speech-language pathologist, noted that one in 25 adults experience swallowing issues annually, while around one in three dozen children under five may have a paediatric feeding disorder.
Did you know?
Did you know? Swallowing uses over 30 muscles, many cranial nerves, and requires rapid coordination to move food safely from mouth to stomach.
Causes vary from temporary throat inflammation to longer-term neurological conditions such as stroke, Parkinson’s disease, and dementia.
Dysphagia is not a normal part of ageing, though the risk increases with physiological changes in people over 80. Stephanie Jeret added that elderly patients are predisposed due to weakening swallowing muscles and other comorbidities. Rising cases of gastroesophageal reflux disease and medications like Ozempic are also contributing factors.
Living with dysphagia often requires lifestyle adjustments. John Paul Andersen, who developed dysphagia at 30, said: 'Nothing could get around it—not even saliva. I now have to eat all my meals mindfully, which is a huge nuisance, but I learned to live with it.'
Some adults rely on feeding tubes, avoid certain textures, or require pureed foods and thickened liquids, while social impacts can lead to isolation and stress.
Early detection can save lives. Simple bedside swallowing tests such as the Toronto bedside screening, volume-viscosity swallowing test, 3-ounce water swallow test, and cough test have high sensitivity and specificity. Practice nurses follow protocols to refer patients presenting with new or worsening swallowing difficulties.
Treatment is highly effective when started early. Speech-language pathologists offer strategies ranging from thickening liquids to comprehensive rehabilitation programs, including swallowing exercises, compensatory strategies, modified food textures, and patient education.
Victoria’s health department highlights interventions that optimise intake and prevent cascading risks. For some, mild difficulties offer unexpected mindfulness: 'I savour food differently now—it's almost meditative.'
Prevention strategies include staying hydrated, practising good posture during meals, maintaining oral hygiene, performing swallowing exercises, managing acid reflux, and sharing social meals to prevent isolation.
What This Means For You
Dysphagia affects a significant number of older adults, particularly those living in aged care, and can become life-threatening if left untreated.
The good news is that early detection through simple screenings and honest conversations with your GP can prevent serious complications like aspiration pneumonia. For those living with swallowing difficulties, lifestyle adjustments, treatment, and mindful eating strategies can make a real difference in improving quality of life. Maintaining hydration, practising good oral hygiene, sitting with proper posture, and enjoying meals in social settings are key preventive measures to keep swallowing safe and comfortable. For seniors, these steps aren’t just medical advice—they are practical ways to protect independence, preserve enjoyable mealtimes, and stay engaged with family and friends.
The Prevalence of Dysphagia in Individuals Living in Residential Aged Care Facilities: A Systematic Review and Meta-Analysis — Meta-analysis reporting 56% prevalence of dysphagia in aged care residents.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10970675/
Prevalence of and risk factors for dysphagia in the community dwelling elderly: A systematic review — Review showing 15% of community-dwelling seniors over 50 have dysphagia.
https://www.sciencedirect.com/science/article/pii/S1279770723009120
Swallowing | health.vic.gov.au — Overview of swallowing difficulties in older people, noting mild issues are common over age 80.
https://www.health.vic.gov.au/older...ion-and-swallowing-in-older-people/swallowing
Dysphagia in the Elderly — Review of prevalence in general population (6–9%) and risk factors.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3999993/
Adult Dysphagia — Notes prevalence rises to over 60% in skilled nursing facilities and estimates ~60,000 deaths annually from complications.
https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/
Practice Nursing—Dysphagia in the older person: an update — Highlights under-recognition of oropharyngeal dysphagia and common medication swallowing difficulties.
https://www.practicenursing.com/content/clinical/dysphagia-in-the-older-person-an-update/
Have you noticed any changes in your swallowing? What steps have you taken to stay safe and comfortable during meals?