Swallowing Problems (Dysphagia): Signs, Complications, and Treatment

December 8, 2025

By Kathryn Wamstad, M.S., CCC-SLP


Did you know that speech therapists treat more than just your speech? They do indeed! In fact, one of the primary focuses of a Speech Language Pathologist in the geriatric setting is swallow therapy. Speech therapists treat swallowing difficulty because the same muscles and nerves used for talking are used for chewing and swallowing.

 

Swallowing difficulty is called dysphagia. It can occur because of a stroke, brain injury, cancer, neurological disease like Parkinson’s and Alzheimer’s, surgery involving the neck, and other aging related complications. Dysphagia can lead to reduced quality of life with eating/drinking, malnutrition, dehydration, and pneumonia as a result of aspiration. Aspiration is when food or drink is accidently inhaled down into the airway/ lungs.

 

What Are Symptoms of Dysphagia?


  • Facial droop, drooling, losing food and liquid out of the mouth and lips
  • Difficulty chewing and controlling the food and liquids from the front to the back of the mouth, and food left in the mouth after you swallow
  • Throat clearing, coughing or choking right after a bite or drink
  • Feeling food or drink “go down the wrong tube” or get stuck in your throat
  • Wet/gurgly voice quality, watery eyes, and runny nose while eating
  • Feeling like food is stuck in your chest, sensation that food takes a while to go down, heart burn, or food coming back up (regurgitation)
  • Weight loss, malnutrition or dehydration because of difficulty eating, extra time and effort required to eat, and frequent occurrences of aspiration pneumonia

 

Assessment of Dysphagia


Speech therapists assess swallowing difficulty by asking questions and observing you eat and drink to see if the above symptoms are noted. If symptoms of swallowing difficulty are reported or observed, it is recommended that you participate in a Video Fluoroscopic Swallow Study. This is an x-ray video of the swallow that allows us to see how the internal structures of your throat are working to determine the cause of your swallowing difficulty, for creation of a treatment plan. 

A smiling person in a blue zip-up holding a glass of dark liquid and a green apple indoors near window blinds.

Treatment of Dysphagia

Swallowing difficulty can be treated through multiple modes of therapy including participation in personalized exercise program engagement, being trained on use of safe swallowing compensatory strategies, and/ or implementation of a diet change. 

 

Exercise Engagement

Strengthening the muscles of your mouth and throat can help improve your swallow function. A Video Fluoroscopic Swallow Study determines what muscles have weaknesses and need to be targeted with exercise engagement. Based on your specific muscle weakness, your speech therapist will recommend exercises such as the Effortful Swallow, The Mendelsohn Manuever, and Chin Tuck Against Resistance. There are also respiratory exercises to strengthen your lungs so that you have a stronger cough to more effectively clear aspiration.

 

Safe Swallowing Compensatory Strategies

Receiving training on safe swallowing compensatory strategies is a standard practice in swallow therapy. Adherence to general safe swallowing strategies like sitting upright, eating slowly, taking small bites and drinks is beneficial; however, completion of a Video Fluoroscopic Swallow Study can best determine if more specialized compensatory strategies like use of a double swallow, volitional cough or a chin tuck are required to reduce risk of aspiration when eating and drinking.

 

Diet Change

Changing the texture of food and the thickness of drinks is another common practice in speech therapy. Softer foods are easier to chew and swallow, and thickened liquids move slower and are easier to control from the mouth to the throat. A Video Fluoroscopic Swallow Study and speech therapist observation at a mealtime can aid in determination of what foods and liquids are safest and easiest for you to consume. Speech therapists follow the International Dysphagia Diet Standardization Initiative (IDDSI). IDDSI is a global framework that describes and defines the level of foods and liquids for those with dysphagia. See below for the IDDSI food and drink levels, https://www.iddsi.org/standards/framework.

The IDDSI framework chart: an inverted pyramid for food levels 3–7 and a pyramid for drink levels 0–4, color-coded by level.

Kathryn Wamstad is a speech language pathologist for Ascend Rehab at Saint Therese of Woodbury. She has been with Ascend for nearly five years and also provides outpatient and home health services for Ascend sites at Village Shores, Parkshore, Summit Place, Global Point, and The Orchards of Minnetonka. 

Stay Connected


Search All Posts


About

At Saint Therese, our heartfelt purpose since 1968 has been a people first approach to living well by providing senior care and services where every life we touch feels welcomed, respected, and heard. We achieve this by doing ordinary things with extraordinary love every single day. Contact us to learn more. 

Modern multi-story apartment building with a dark gray exterior, balconies, and a paved entrance area.
By Barb Hemberger • September 16, 2026
The work of environmental services professionals is often most noticeable when it’s not done. Yet these dedicated staff members contribute to nearly every part of daily life in a senior living community. They help protect residents’ health and safety, keep shared spaces clean and welcoming, and handle countless details that allow a community to operate smoothly. Just as importantly, they become familiar, trusted faces for the residents they serve. During National Environmental Services Week , Saint Therese is recognizing these essential professionals and the difference they make every day. At St. Mary of the Woods , that includes three longtime housekeepers with a particularly special connection. Connie Smith, Felicia Smith and Dorothy Clark have each worked at the community for 20 years. Over the years, they have become much more than colleagues. “We stick together,” they said. “We’re the Three Musketeers.” A place to build a career Felicia remembers driving past St. Mary of the Woods before she began working there. “This is where I’m going to retire from,” she told herself. Decades later, her prediction appears to have been a good one. The three women came to St. Mary of the Woods from very different places. Dorothy is from Avon, Felicia is originally from Alabama, and Connie came to the United States from Germany when she was 19. Connie and Felicia are sisters-in-law, while Connie and Dorothy discovered they are only 10 days apart in age. Their children are also close in age. Through years of working side by side, the three have developed a friendship grounded in mutual respect, shared experiences and a genuine love for the residents they serve. “We’re like their family,” they said. “We’re always here.” They also credit their supervisor, Dave Csalos, with creating a supportive environment for the team. “He’s so good,” they said. “We couldn’t ask for anything more.” Work that touches daily life For housekeepers, environmental services work is both practical and deeply personal. They regularly spend time in residents’ homes, where they notice the small things, share conversations and provide the reassuring consistency that helps a community feel like home. For employees such as Connie, Felicia and Dorothy, those relationships have grown over the years. Their longevity also brings something invaluable to St. Mary of the Woods: experience. They understand the community, know its rhythms and take pride in helping everything run as it should. This Environmental Services Week, Saint Therese thanks Connie, Felicia and Dorothy, along with environmental services professionals throughout the organization . Their dependable work, attention to detail and care for residents make a difference every day. ____ Shown in the photo above are (left to right): Connie Smith, Felicia Smith and Dorothy Clark.
By Barb Hemberger • September 1, 2026
How an ambitious idea, a year of persistence and a shared faith created something remarkable at Saint Therese of Corcoran
By Barb Hemberger • June 23, 2026
It is important to understand the assisted living vs memory care debate. Assisted living supports older adults who need help with daily activities , while memory care provides specialized care for individuals living with Alzheimer's disease, dementia, or other cognitive conditions. Memory care includes additional safety measures, structured routines, and staff training designed specifically for the unique challenges associated with memory loss. For many families, understanding the difference becomes an important part of making an informed decision. While both assisted living and memory care provide support in a community setting, they serve different needs and are designed for different stages of aging. If you are trying to determine which option may be the best fit, it is helpful to understand these better. You must know how each level of care works, who it is designed for, and what signs may indicate it is time to consider additional support. What is Assisted Living and Memory Care? Assisted living and memory care are both senior living options that provide support with daily life, but they differ in the type and intensity of care they offer. Assisted living is designed for older adults who remain largely independent but need help with certain activities. These can include medication management, dressing, bathing, mobility, or household tasks. Memory care is specifically designed for individuals experiencing cognitive decline due to Alzheimer's disease, dementia, or other memory-related conditions. The primary difference is that memory care includes specialized programs and secure environments. The care approaches are tailored to the unique needs of individuals living with memory loss. Assisted Living vs Memory Care: A Side-by-Side Comparison To understand the differences better, let us look at a side-by-side comparison of the two levels of care.