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Hard to swallow

Eating challenges in the elderly population.

Article Author: Kristi Tucker

Article Date:

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Some people believe food is one of life's true pleasures. However, as you age, eating can become a challenge, leading to poor nutrition and hydration. Unfortunately, this could result in serious health issues, including:

"There are so many things that may lead to poor nutrition and hydration in the elderly," said Kayla Jones, a speech-language pathologist with Baptist Health AgeWell Center. "Often, the reason is multifactorial, and the treatment or intervention will vary depending on the cause(s)."

Eating inhibitors

Some common causes of poor eating habits are:

  • Natural aging. Less physical activity may lead to lack of appetite, or a diminishing sense of taste and smell could make food less tasty. In addition, "There are changes that happen to the swallowing mechanism of otherwise healthy older adults, called presbyphagia," said Jones. "While this is normal, it does put older adults at an increased risk for dysphagia, or difficulty swallowing."
  • Poor oral health. A recent study in Finland showed 30% of the older participants reported eating difficulties due to problems with their teeth or dentures. "Ill-fitting dentures may cause discomfort and sores in the mouth, which could make eating painful," said Lori Watkins, a speech-language pathologist with Baptist Health AgeWell Center. "In addition, broken or missing teeth make chewing difficult."
  • Mobility issues. Physical limitations may inhibit the ability to get or prepare food. "Sometimes, the effort to make a meal is too difficult," said Watkins.
  • Social determinants. Elder adults may have limited income for healthier foods or no transportation to the grocery store.
  • Medicines. Some medications for common ailments in older adults, such as blood pressure or pain medications, could suppress appetite or cause nausea and vomiting.
  • Cognitive decline. People experiencing dementia may not want to eat, or may forget to do so if they're without support.
  • Loneliness. Watkins said, "Most people prefer to share a meal with a loved one or friend." If they don't have anyone available, they may choose not to eat.

What to watch for

Jones and Watkins said there are several symptoms that family, friends and caretakers should look for in their at-risk relatives or friends that may indicate problems with eating:

  • Complaints of pain or difficulty swallowing
  • Coughing, "gurgly voice" or frequent throat clearing during meals
  • Decreased intake of food/liquid or refusal to eat
  • Frequent belching or vomiting after meals
  • Isolation, especially around meals (they may feel embarrassed to eat in front of others)
  • Spitting out food
  • Unexplained weight loss

Help is available

If medical issues are the underlying problem, Jones recommended talking to your primary care physician, who may recommend an assessment by a speech-language pathologist.

"While the cause may be complicated, sometimes a small change or modification can make a big difference," she said.

For other barriers, "Our social work team at AgeWell is wonderful about connecting our patients with resources such as meal delivery services or low-cost dentist options," said Jones. In addition, you can reach out to your place of worship, workplace or friends for references to other helpful resources.


If you or a loved one are having difficulty eating, contact your primary care physician. AgeWell has a multi-team approach that may include social services, speech pathologists, and pharmacists to provide information and guidance. Call 904.202.4243or click here to make an appointment.

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