Elderly Choking & Dysphagia
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Many residents of nursing homes suffer from respiratory systems conditions, which makes it difficult for them to breathe on their own. For these types of patients, mealtimes are especially dangerous—a time when nursing home staff should be constantly monitoring or physically assisting the patient.
Suffocation is entirely preventable. If a patient has a known respiratory problem, preventative steps should be taken to protect them; for example, their food should be cut up into small bites or they should only be given soft foods. Staff should also be vigilant in watching them during meal times to protect them from choking.
Unfortunately, many facilities suffer from understaffing issues and meals become a process of just handing out the food instead of giving the attentive care that residents deserve. This can not only lead to issues related to malnutrition and dehydration, but it can also lead to patients who suffer from severe choking incidents. Choking can lead to injuries to the brain, as well as other serious medical complications.
Clogged Breathing Tubes
Similar to choking, nursing home patients can also suffer from clogged breathing tubes. Many residents rely entirely on respiratory devices to breathe properly. Such residents are vulnerable to severe injuries and require constant monitoring and device cleaning to ensure their safety. Unfortunately, that does not always occur, causing clogging or damage to tubing devices. If a breathing tube becomes clogged oxygen is cut off from the brain, leading to severe, permanent brain damage or even death.
Signs of Choking
Seniors in nursing homes can suffer from medical conditions that may leave them susceptible to dangerous and potentially fatal choking incidents. Suffering from difficulties with swallowing and breathing, for example, can lead to choking during mealtimes. Choking presents a serious issue, and when caregivers fail to address it promptly, it can lead to brain injuries and sometimes death. Signs of choking which should be acted on immediately include:
- Gagging and coughing
- Clutching the throat
- Hand signals and panic
- Turning blue
Staff in the nursing home needs to have the training and qualification necessary to quickly identify and deal with any choking incidents. If the choking incident remains mild, with the airway only partially blocked, simply encouraging a resident to cough and delivering some light blows to the back can help to clear the blockage.
The Heimlich Maneuver
If the choking incident gets severe, back blows together with abdominal thrusts—also known as the Heimlich maneuver— can help to clear a blockage. If the person has lost consciousness and is no longer breathing, you should seek medical help immediately.
The Heimlich maneuver itself can cause injuries to an elderly person. A thorough medical examination should take place after every serious choking incident to make sure that the nursing home resident does not suffer any other injuries.
Difficulty Swallowing in Seniors
Difficulty swallowing is another term for dysphagia, and dysphagia in the elderly frequently occurs. Stroke and dementia, as well as many other age-related diseases, contribute to dysphagia in seniors.
Some other conditions that can contribute to difficulty swallowing in the elderly can include:
- Parkinson’s disease
- Cerebral palsy
- Respiratory problems
- Age-related changes
- Radiation therapy
- Intubation and tracheostomy
Other conditions can contribute to, or worsen, dysphagia. As dysphagia affects nursing home residents in the United States, nursing home staff should know how to identify the condition. Dysphagia itself can cause other health problems for nursing home residents, such as malnutrition and pneumonia.
Does your loved one suffer from dysphagia or signs of choking? Some of the symptoms of dysphagia include coughing when swallowing, a hoarse voice, having pain when swallowing, and regurgitating food, among others. If your relative in the nursing home suffers from difficulty swallowing, they may require extra assistance and closer supervision by staff when eating and drinking.
Managing Dysphagia in Seniors
The goal of managing any difficulty with swallowing in the elderly includes avoiding further deterioration in health and ensuring that the resident receives adequate nutrition and hydration amounts as needed.
Nursing home staff can help by cutting foods into smaller pieces and encouraging a resident to eat slowly and deliberately. These simple adjustments can go a long way to helping a senior who has any problems with swallowing. Rather than eating three big meals a day, staff can experiment with offering several smaller meals to the affected senior at various times throughout the day.
Treatment and management of dysphagia in the nursing home can also include swallowing exercises and learning how to position the body correctly to make eating and drinking easier for a resident. If swallowing proves difficult and adequate nourishment and hydration suffer as a result, nursing home staff must act quickly and may have to resort to either a liquid diet or a feeding tube.
Negligence on Behalf of the Nursing Home
Most of the efforts to control dysphagia and signs of choking in nursing homes have one thing in common: they require the staff to acknowledge the issues and accommodate the residents accordingly. If your loved one struggles to swallow and is not getting the nutrition they require, or if they had choking incidents or medical problems from dysphagia, this may signal negligence on the part of the staff in the nursing home.
You have the right to consult a nursing home lawyer for advice in this situation. If your loved one has suffered unnecessarily, you may wish to act and hold the nursing home responsible.
Choking Deaths in Nursing Homes
Nursing homes bear responsibility for identifying residents in need of extra help while eating and residents who suffer from swallowing difficulties or signs of choking. Not having enough staff to help residents or failing to assess a choking risk in a resident can qualify as negligence.
Causes of Choking
Choking happens when an object gets stuck in a person’s airway and makes it difficult or impossible to breathe. Choking is potentially life-threatening and classifies as a medical emergency. Several conditions and incidents can cause choking, especially for seniors and young children. Prevention provides the best method of stopping choking incidents.
Incidents Leading to Choking
Choking can result from a wide variety of problems. While medical causes are possible, causes of choking usually involve food or eating. Some causes of choking include the following.
Food that gets stuck in the windpipe can cause a blockage that makes it impossible to breathe. Some choking accidents happen because of blockages caused by large pieces of food.
Small objects can also cause blockages in the windpipe and cause choking. This is usually a concern for small children, but it can happen to seniors as well.
Dehydration (Lack of Saliva)
Experiencing dehydration can reduce the amount of saliva in a person’s mouth. Saliva helps break down food, making it soft enough to swallow. If there is not enough saliva, pieces of food may get stuck on the way down.
Asthma refers to a condition in which the lining of the windpipe becomes inflamed and restricts airflow. Asthma can turn into a fatal medical condition if a victim fails to treat it.
Chronic Obstructive Pulmonary Disease (COPD)
COPD involves a series of conditions that can make it difficult to exhale. Because of this, victims may struggle to breathe in general. COPD develops over time and has a variety of treatment options based on the symptoms.
Other causes of choking with different risk factors for each age group exist as well. If you think someone is choking, apply emergency medical techniques or seek emergency care right away.
Choking Risk Factors
Choking may present a problem for anyone at any age. It can happen to anyone, but specific groups may live with a higher risk of choking. Seniors, especially those who wear false teeth or have respiratory system conditions, are at risk of unintentional death from choking, according to the U.S. Centers for Disease Control and Prevention (CDC). These groups are more likely to ingest something that is too big for their windpipe or experience a medical emergency related to breathing. People with dysphagia (swallowing problems) may choke at some point as well. Because they have difficulty swallowing, food may get stuck in their throats as they swallow.
Choking hazards fall into several categories. Choking often results from something that is too large to swallow safely. Several other things may cause someone to choke. Choking hazards are listed below.
Hard foods, like apples, may cause choking hazards. Elderly residents at a nursing home, for example, have caregivers who cut their food, and they may fail to cut their food into small enough pieces.
Drinking a high volume of liquids at one time can cause choking. Like hard foods, a large amount of water in the windpipe that encounters a blockage, such as an air bubble or a restricted windpipe, can block the windpipe entirely.
Allergens and Asthma Irritants
Allergens and asthma irritants can cause inflammation in the respiratory system, which can restrict airflow. Immediate treatment with medical devices or medication may prevent more serious problems.
Like hard foods, small hard objects may get stuck in the windpipe. Young children or seniors may swallow things that can cause blockages in the respiratory system.
Dysphagia refers to a condition in which people have trouble swallowing. It can cause choking in situations where someone would otherwise eat safely. It often requires medical intervention to treat.
Every choking hazard and choking incident classifies as a medical emergency. Seek medical assistance immediately if someone begins to choke. Avoiding choking hazards is often the best way to prevent choking incidents, especially for seniors and young children.
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Effects of Choking
The effects of choking can have both mental and physical consequences for people. The physical effects remain short-term, but severe choking incidents can leave long-term health effects. The mental effects can be problematic for anyone who has had a choking incident, although these effects usually dissipate over time. Every choking incident should receive medical attention.
Short-Term Effects of Choking
The short-term effects of choking depend on each situation. Minor choking incidents may not leave prolonged effects, while more severe cases can lead to long-lasting problems. According to Harvard Health’s article, Choking alert: Strategies for safe swallowing, the short-term effects of choking include the following.
Choking leads to difficulty breathing, which can persist after the blockage resolves. Choking involving a foreign object can damage tissue, leaving the trachea (windpipe) inflamed and constricted. Choking involving asthma or another condition can also leave the trachea inflamed, making it difficult to breathe.
The lack of air caused by choking leads to dizziness, which worsens the longer the brain does not receive oxygen.
A lack of air over a long period of time can lead to unconsciousness. Once it sets in, severe medical conditions can follow.
Choking can eventually lead to death if the brain and organs do not receive oxygen for an extended period of time. Removing the blockage and beginning CPR can prevent death or delay serious conditions until advanced medical help arrives.
Choking often causes coughing, a physical response by the body to try to expel the blockage through force. Coughing against a hard object, particularly one with sharp edges, can leave scratches and punctures in the tissue of the trachea or larynx. This damage may heal over time but will remain uncomfortable in the short-term.
If the blockage rests in the larynx, coughing or trying to talk can strain the muscles of the larynx. This will make it difficult or uncomfortable to talk for a short period and will resolve itself in time.
Wheezing is a symptom in which a blockage in the trachea lets some air through. The sound that the trachea makes when trying to force air out or in creates the wheezing sound. Wheezing refers to a partial blockage and can still result in other choking-related problems.
Fear of Choking
People who survive a choking incident may have a lasting fear of choking again. This often resolves itself in a short period of time but may become a lasting concern that could develop into a more serious condition.
Mental and Physical Stress
Choking creates mental and physical stress for people that survive it as well as their loved ones.
If someone is choking, seek medical treatment immediately. Early intervention can prevent serious complications and conditions related to choking.
Long-Term Effects of Choking
Choking can cause long-term effects for anyone that survives. The long-term effects vary for each person based on the type of choking they experienced. If a person chokes on a hard object, tissue damage may cause a long-term problem. The edges of the object can cut or puncture the tissue of the trachea, which can take a long time to heal.
If the choking incident left the person deprived of oxygen for too long, they may experience lasting brain damage. Lasting brain damage may require therapy to recover from.
Choking Risk Factors
Anyone can choke, but some populations live at a higher risk. Seniors are especially vulnerable to the effects of choking when it comes to age-related changes to eating and swallowing. Some of the choking risk factors include the following.
Dysphagia is a condition that makes it hard to swallow. People with Dysphagia may get something caught in their throat and choke.
Respiratory System Conditions
Medical conditions that change how people breathe can increase their risk of choking.
Asthma is a condition that causes inflammation in the respiratory system, reducing the size of the airway and increasing the chances of choking.
COPD is a collection of respiratory conditions that develop over a long time. They affect how people breathe and can make it difficult to swallow.
Pleural effusion is a buildup of fluid outside the lungs that can crush the lungs if the fluid does not drain. It reduces a person’s lung capacity, reducing their ability to breathe.
In any case, respiratory problems should receive medical attention. Seek medical treatment immediately.
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Respiratory System Conditions
Respiratory system conditions are medical illnesses or diseases that affect the lungs or how people breathe. These conditions can be serious and often require medication and medical interventions to treat. Left untreated, respiratory system conditions can be fatal. Even mild conditions can develop into more complicated problems and should be taken seriously from the onset of symptoms. Respiratory conditions can make choking more likely.
Most Common Respiratory Conditions
There are many respiratory conditions that can develop over time or from another illness. Some of the most common conditions also require consistent and extensive medical interventions to treat. As people age, they are more likely to develop a respiratory condition. Some of the most common respiratory conditions include:
- Asthma: Asthma is very common among respiratory conditions and can be treated with an inhaler. Asthma causes inflammation of your airways, which makes it hard to breathe.
- Chronic Obstructive Pulmonary Disorder (COPD): COPD changes the way that patients breathe, making it difficult to exhale. It can develop over time and is treated by a series of treatment options that fit the associated symptoms.
- Bronchitis: Bronchitis is a condition where patients cough often because the glands that produce mucus in the lungs are overactive. This usually happens when there is an infection, and it is treated with antibiotics and other treatments.
- Emphysema: Emphysema is a type of COPD (inability to exhale) caused by damage to lung tissue. There is no treatment for emphysema since the damage to the lungs is so extensive, it becomes irreparable.
- Cancer: Lung cancer can develop for several reasons since it is an out-of-control reproduction of mutated lung cells. It is treated like any other form of cancer with radiation or surgery.
- Pleural effusion: Pleural effusion is a buildup of fluid just outside the lungs that interferes with how people breathe. The fluid limits breathing and can crush the lungs until they cannot work. The treatment involves removing the fluid and closing the access point where it is leaking in.
- Pneumonia: Pneumonia is a lung infection and is very common. While many people recover from it, it can lead to complications and be fatal under certain conditions.
There are many other respiratory conditions and treatment options. Anyone that develops a respiratory condition or is showing signs of a condition should seek medical attention as soon as possible to prevent complications.
Medical Choking Risk
Choking is a common risk for everyone but is especially important to examine in seniors, children, and people with respiratory conditions. Choking is a blockage of the airways that stops someone from breathing. One of the most common ways for someone to choke is to eat something that is too big and gets stuck in their throat.
To avoid everyday choking hazards, make sure that the food someone eats is the appropriate size and consistency. For example, many seniors have difficulty chewing and may have fake teeth. If they fail to chew food properly, large pieces become a choking hazard. Instead, serve foods that already come in small portions, are soft, or are liquids. Age-related changes to eating and swallowing impact frailty and increase the risk of choking in older adults.
Acute vs. Chronic Respiratory System Conditions
There are two types of respiratory system conditions: chronic conditions and acute conditions. Chronic conditions, like asthma, develop slowly and are less likely to be cured. Instead, many people treat the condition and the symptoms to live with the disease. Acute conditions develop quickly and are generally severe. Most acute conditions require immediate medical attention and can be fatal.
Foreign body aspiration is an acute respiratory condition where a small object gets stuck in a person’s airway. Oftentimes, it is food related. While not all cases of foreign body aspiration are immediately fatal, they are all dangerous for the patients. The obstruction can cause breathing issues and can shift to block the airway entirely. Treat every case of foreign body aspiration as a medical emergency and seek help right away to prevent serious life-threatening complications
Steps to Keep Seniors Safe
Seniors are in the high-risk group for respiratory system conditions. To protect seniors, focus on reducing as many causes of respiratory conditions as possible. Some things to help reduce choking hazards include lifestyle changes such as quitting smoking or focusing on basic life skills like eating and swallowing. Also, seek regular medical evaluations and treatment when conditions are discovered. Seniors should see a doctor for an evaluation at least twice per year, or more often if symptoms of a condition begin to emerge. Early intervention is the key to avoiding serious long-term outcomes.
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Prevention of Choking
Choking is a risk for anyone at any age. It is a blockage of the airways that can prevent breathing. While there are ways of addressing choking and swallowing problems, the best method of treatment is the prevention of choking. This can be done by following basic guidelines for specific age groups and being aware of how to respond in specific situations.
Know Choking Signs
To react to a choking incident quickly and effectively, it is important to know the signs of choking. Several of the signs to look for are:
- Shortness of breath: Difficulty breathing or taking short, shallow breaths can be a sign that someone’s airway is being obstructed. It can also be a sign of a deeper respiratory problem and requires immediate medical attention.
- Wheezing: Wheezing is a problem where a person struggles to breathe. The breaths that do come through sound forced and make a tight wheezing sound as if the person has to focus on forcing the air through their windpipe.
- Coughing: Coughing is a physical response to airway obstruction in which the throat contracts quickly and forcefully to try to force the obstruction out. Consistent coughing is a sign that the obstruction is blocking the airway and needs to be removed immediately.
- Panic without breathing: When people start to choke, they may not make a sound. However, they often have a panicked look on their face. If a person looks panicked but cannot speak, that person might be choking.
- Dizziness: Choking reduces or stops airflow. Being deprived of air leads to dizziness and can eventually lead to unconsciousness.
- Turning blue: Another side effect of being deprived of air is turning blue. Since there is not enough air circulating in the blood, it reverts back to its normal blue, unoxygenated color. You can see this on the skin, usually in the hands and face.
There are many other signs of choking not covered by this list. If you think that someone is choking, call for emergency medical assistance as soon as possible. If you are trained in emergency medical techniques, then call for help and begin applying those techniques until help arrives.
Choking hazards are common since nearly anything small enough to each can be a hazard. Most choking incidents happen with food that is too hard to chew properly or swallowed in pieces that are too big. Grapes and hot dogs are common choking hazards. Grapes are soft and can easily get stuck in your windpipe. Hot dogs are thin enough to travel into the windpipe but not small enough to pass through. Unless you chew them thoroughly, hot dog pieces often get stuck on the way down.
Ways to Prevent Choking
The simplest way to prevent choking is to ensure that nothing larger than a dime passes through the windpipe. For seniors, this can mean limiting eating to soft foods that are easy to chew. By limiting the choking risks that seniors have access to, you can reduce the chances of choking or prevent choking entirely.
Another way to prevent fatal choking incidents is to learn CPR and the Heimlich Maneuver. Having the ability to resolve choking problems without the need for additional medical aid can be life-saving. You will be able to help seniors immediately, reducing the chances of death or serious side effects.
For seniors, there are many things that create choking risks. According to the journal Geriatrics, caregivers must address all of the risks that they can find simultaneously to offer seniors a greater level of protection. Some of these choking risks include:
- Small objects
- Asthma attacks
- Dehydration (lack of saliva)
- Swallowing problems associated with dysphagia
Consult with medical professionals to find the best ways to address these risks, and to ensure that seniors get the help that they need to prevent choking. They can also help you design a safe eating environment where seniors experience a lower choking risk.
Safe Eating Environments
Nursing homes can protect seniors from choking by creating safe eating environments that focus on safe swallowing strategies. These include removing foods that can be serious choking hazards and pre-cutting food into bite-sized pieces. Having support nearby that is properly trained in life-saving procedures is also a good idea. Plus, creating a space where seniors can focus on eating with minimal distractions or difficulties can help.
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Was your loved one hurt in a choking incident caused by nursing home abuse or neglect? It may have stemmed from a lack of supervision, an improper response to the incident, or incorrect treatment after the fact. At Pintas & Mullins, our Chicago nursing home abuse attorneys will hold individuals responsible for the injury from a choking incident, and will fight for full and fair compensation. We represent clients nationwide, and will even come to you!