Words you don’t want to hear

There are some words you never want to hear.

And you need to hear this first.

  • People over 65 years of age (many without dysphagia!) have seven times higher risk for choking on food than children aged 1–4 years of age
  • After falls, choking on food presents as the second highest cause of preventable death in aged care
  • A diagnosis of pneumonitis is positively correlated with increased risks associated with choking on food

And the trend isn’t good.

Via https://cesafety.co.uk/choking-deaths-report-2019/

Most deaths caused by choking happen in hospital, and care homes are also a risk with 60 deaths in 2017 as a result of choking on food or objects.

The incidence of fatal choking incidents of people with a learning disability is almost 100 times greater than in the general population. There were 605 reports of choking-related incidents involving adults with learning disabilities over a 3 year period on UK;

  • 41% in care homes
  • 58% in inpatient settings
  • 1% outside

In one study, 42% of 674 adult service-users with learning disability had one or more choking episodes. There was a significantly greater occurrence of choking among people with;

  • a severe learning disability
  • Down syndrome
  • people who had an incomplete dentition
  • or were taking a greater number of psychotropic drugs

Foods that are consistently associated with choking and reported on autopsy findings include meat, bread, sandwiches and toast, amongst others.

Via https://cesafety.co.uk/choking-deaths-report-2019/


Sufficient stamina is also needed to sufficiently prepare the bolus for swallowing, with bite-sized pieces of meat and bread requiring more than 20 chewing strokes per bolus.

The consistencies of foods that pose the greatest risks are also listed on the IDDSI patient handouts.

How to reduce the risk of choking?

  1. Always follow the dysphagia care plan
  2. If there are any changes in the person’s condition or you see adverse signs as detailed by the speech therapist, let them know (and the GP) straight away
  3. Check out the Belfast Health & Social Care Trust Choking Awareness Guide
  4. Make sure you’re up to date on your Choking First Aid mandatory training and see the St John Ambulance advice here

Ask us about training and the resources we provide to make sure this doesn’t happen for the people you care for.

Because you don’t want to hear the words… “Coroner’s Court”.

References:

CE Safety. 2019. Report: The Un-Usual Suspects – Main Causes of Choking Deaths in the UK 2019. Online at: https://cesafety.co.uk/choking-deaths-report-2019/ [Accessed 23/05/21]

Cichero, J., 2018. Age-Related Changes to Eating and Swallowing Impact Frailty: Aspiration, Choking Risk, Modified Food Texture and Autonomy of Choice. Geriatrics 3, 69. https://doi.org/10.3390/geriatrics3040069

Dupont A, Mortensen PB. Avoidable death in a cohort of severely mentally retarded. In: Fraser W, editor. Key issues in mental retardation research. London and New York: Routledge; 1998.

Hampshire safeguarding Adults Board. 2012. Reducing the risk of choking for people with a learning disability. A Multi-agency review in Hampshire. Hampshire County Council Adult Services Department, UK.

Thacker, A. et al. (2008) Indicators of choking risk in adults with learning disabilities: A questionnaire survey and interview study, Disability and Rehabilitation, 30:15, 1131-1138, DOI: 10.1080/09638280701461625

Published by Sandra Robinson

Independent Speech and Language Therapist. Specialist Dysphagia Practitioner.

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