Journal scan

People with dementia can follow written instructions to swallow safely

Study looked at using written instructions to improve safety of eating and drinking in patients with dementia.
dementia swallowing

Memory deficits in dementia can make it difficult to have self-feeding strategies for people with swallowing disorders. External memory aids such as lists and signs have been successfully used to make cognitive processes less difficult and help people maintain independence.

This study of 5 people with dementia, who also had swallowing difficulties, aimed to see if specifically written instructions could be used to improve safety of eating and drinking.

After individual assessment therapists decided which strategies were needed to maintain safe swallowing. This might include taking small sips or bite sizes; using a chin-down posture to redirect the bolus of food or drink; using fluid to clear food between bites; or cleaning the mouth with a sweep of the finger after swallowing food.

Written instruction cards

...

Memory deficits in dementia can make it difficult to have self-feeding strategies for people with swallowing disorders. External memory aids such as lists and signs have been successfully used to make cognitive processes less difficult and help people maintain independence.

dementia swallowing
Taking small sips of fluid can maintain safe swallowing in people with dementia. Picture: Alamy

This study of 5 people with dementia, who also had swallowing difficulties, aimed to see if specifically written instructions could be used to improve safety of eating and drinking.

After individual assessment therapists decided which strategies were needed to maintain safe swallowing. This might include taking small sips or bite sizes; using a chin-down posture to redirect the bolus of food or drink; using fluid to clear food between bites; or cleaning the mouth with a sweep of the finger after swallowing food.

Written instruction cards

The ability to read is relatively preserved as dementia progresses so the intention was to make best use of this ability. Participants were given a clearly written card with the heading ‘I eat and drink safely’.

Instructions written below this were tailored to their specific needs. One person’s card, for instance, read: ‘I inhale and hold my breath; I swallow then cough; I swallow again then breathe’.

Results showed that more than half of participants were able to follow the written instructions to swallow safely. In some cases participants had reduced need for altered thickness of food and fluid so enhancing their enjoyment of food.


Benigas J, Bourgeois M (2016) Using spaced retrieval with external aids to improve use of compensatory strategies during eating for persons with dementia. American Journal of Speech-Language Pathology. 25, 3, 321-334.

Want to read more?

Subscribe for unlimited access

Enjoy 1 month's access for £1 and get:

  • Full access to nursingolderpeople.com
  • Bi-monthly digital edition
  • RCNi Portfolio and interactive CPD quizzes
  • RCNi Learning with 200+ evidence-based modules
  • 10 articles a month from any other RCNi journal

This article is not available as part of an institutional subscription. Why is this?

Jobs