45 Foods for Elderly with Swallowing Difficulties

Swallowing difficulties are increasingly common among the elderly.  In the medical community we call it dysphagia, but both terms are used interchangeably.  

It affects an individual’s quality of life, diet type, food and drink intake amounts, socialization, weight, malnutrition status, and much more.

Finding foods for elderly with swallowing difficulties is important to improve food intake, reduce aspiration pneumonia, and reduce trouble swallowing.

Through this article you can find nutritious foods to improve the quality of life of someone you care for suffering from dysphagia.

elderly man eating.

What is Dysphagia?

Dysphagia is disordered swallowing.  This can affect their ability to swallow both food and liquids.

There are a few different types of dysphagia and this is how we classify the diagnosis:

Oropharyngeal dysphagia
Pharyngeal dysphagia
Esophageal dysphagia

Dysphagia can range from mild to severe.  In the severe cases of dysphagia diets are very restricted in order to reduce the risk of aspiration pneumonia.

Common Causes of Dysphagia

Causes of dysphagia can include:

Dementia
Alzheimer’s Disease
Age-related changes
Weakened throat muscles
Head, neck, throat and mouth cancer
Neurological conditions
Stroke
Cerebrovascular Accident
Parkinson’s Disease
Cerebral Palsy
Nervous System Disorder

Signs of Dysphagia

There are some frequent signs of trouble swallowing that we look for:

Coughing after taking a bite:
Coughing when drinking thin liquids
Pocketing food in their cheeks
Drooling
Tears down their face when eating or drinking (most typical if non-vocal)
Frequent chest infections
Unexplained weight loss
Hoarse voice when eating or drinking
Complaints of a ‘lump’ in their throat
Slow or delayed swallowing
Regurgitating their food
Complaints of acid reflux

If any or all of these are noticed, it’s very important that a Speech-Language Pathologist (SLP) gets involved in assessing the person.

An SLP is an expert and can diagnose a swallowing problem. They perform swallow tests either bedside, table side, or in a hospital, and can assess the underlying cause/area of problem.

These health professionals are able to recommend the best dysphagia diet that weighs both quality of life and implement safe swallowing techniques.

Dysphagia Diets

Despite swallowing difficulties occurring, the good news is that we have ways of managing it.

This is a diet designed for people who have difficulty swallowing. The foods and liquids are changed in consistency from their natural textures to be easier to swallow.

It promotes safety, reduces risk of food and fluids going into the lungs and in severe cases of dysphagia, can allow the individual to avoid a feeding tube.

Different Dysphagia Diets

There is a wide array of dysphagia diets listing foods for elderly with swallowing difficulties, and it can seem complicated to some.

So let me make it easier to understand for you.

Currently there is the IDDSI (International Dysphagia Diet Standardization Initiative), though I can honestly say I’m not a strong advocate of it at this point.

They are simply a worldwide group that promotes have dysphagia diets standardized in terms of names of diets, textures, size of foods offered, and what foods are allowed under certain categories.

Instead of going through the exact specifications of each diet, I will simply list the typical dysphagia diets we see.

  1. Regular Diet

    In this diet there are no alterations. So this is considered the standard with which we measure all the other diets against.
  2. Soft Diet

    This diet is similar to the regular diet, but where it differs is you will eliminate foods that are tough and hard to chew. These foods are softer foods than regular texture.

    Some examples include: roast beef, nuts, seeds, popcorn, and other tough textured meats. Raw vegetables would also likely be eliminated here.

    If you want a full comprehensive list of soft nutritious foods for seniors, find them all here.
  3. Minced Diet

    This diet will have the meats minced in a food processor. An easy way to determine if a meat is minced ‘enough’, is if when a fork presses down on it, does the meat come through the prongs.

    If yes, then it is the perfect texture.

    Meats tend to be the most difficult thing for someone with swallowing difficulty, so to mince this, and then have everything else soft. The likelihood of choking is minimized.
  4. Pureed Diet

    Pureed foods are put through a food processor and made into pureed texture (think applesauce without liquid).

    When pureed, foods should be firm and hold their form, but still have enough moisture that they don’t clump.

    To promote satiety with pureed foods you can add liquids such as gravies and broths to add in extra flavour.

Dysphagia diets can help people swallow foods safely and comfortably. Diet textures may need to be adjusted if disease progression occurs or continual difficulty with swallowing.

Thickened Liquids

Liquids can also be adjusted if they are having trouble with these.

Some think that if someone is having difficulty swallowing that liquids always need to be thickened, this is not the case.

If thicker liquids are needed, they can be thickened to a mild or moderately thick liquid. You can think of the texture as honey thick and pudding thick for reference.

Foods for Elderly with Swallowing Difficulties

Here are some excellent food choices to help someone with swallowing difficulty to achieve a balanced diet.

Dairy Products

Glass of milk on a counter with a glass bottle of milk.
  • Yogurt (smooth and creamy varieties)
  • Cottage cheese (smooth and finely blended)
  • Pudding (smooth and without chunks)
  • Milkshakes or smoothies (thick and well-blended)
  • Soft cheeses (e.g., cream cheese, ricotta)
  • Sour cream (thinned with liquids if necessary)
  • Mashed or pureed custard
  • Dairy-based soups or pureed creamy soups
  • Dairy-based ice cream or gelato (soft and melted)

Protein and Meat Options

  • Ground or finely minced meat (beef, chicken, turkey, pork)
  • Moist and tender meatballs
  • Meatloaf (finely blended or pureed)
  • Shredded or finely chopped cooked chicken or turkey
  • Soft-cooked eggs (scrambled, poached, or soft-boiled)
  • Pureed or mashed beans (e.g., lentils, black beans, chickpeas)
  • Smooth nut butter (e.g., peanut butter, almond butter)
  • Tofu (silken or soft varieties)
  • Pureed or blended seafood (e.g., salmon, tuna)
  • Smooth and creamy protein shakes or smoothies
  • Protein-packed soups or stews (pureed or blended)

Vegetables

plate of a variety of vegetables.
  • Soft-cooked or steamed vegetables (e.g., carrots, broccoli, cauliflower)
  • Mashed potatoes or sweet potatoes
  • Pureed or blended vegetable soups (e.g., tomato, butternut squash)
  • Smooth vegetable purees (e.g., carrot puree, pumpkin puree)
  • Well-cooked and finely chopped spinach or kale
  • Pureed or mashed legumes (e.g., lentils, chickpeas)
  • Avocado (smooth and ripe)
  • Smooth vegetable-based sauces or gravies

Fruits

lemons and blood oranges.
  • Soft and ripe bananas
  • Applesauce (smooth and without chunks)
  • Pureed or mashed cooked fruits (e.g., pears, peaches)
  • Fruit smoothies (blended to a smooth consistency)
  • Fruit purees (e.g., strawberry puree, mango puree)
  • Fruit juices (without pulp)
  • Canned fruits (in natural juices or syrup, choose softer varieties)
  • Fruit sorbet or fruit-based ice pops (smooth and melted)

Grains

barley, rice and grains.
  • Cooked and well-softened rice (white or brown)
  • Soft and moist cooked pasta (e.g., macaroni, penne)
  • Porridge or hot cereals (e.g., oatmeal, cream of wheat)
  • Soft and well-soaked bread (e.g., white bread, whole wheat bread)
  • Soft tortillas or wraps (warmed to make them more pliable)
  • Blended or pureed grains (e.g., quinoa, couscous)
  • Cooked and mashed potatoes or sweet potatoes
  • Soft and moist pancakes or waffles
  • Moistened or blended breakfast cereals (e.g., corn flakes, bran flakes)

Note that ALL of the foods must be adjusted to suit the individual for safety purposes. Consult with a Registered Dietitian or Speech Pathologist (SLP) for the best solutions for your situation.

Sometimes we need to go beyond just providing foods for elderly with swallowing difficulties.

Here are a few ways to help reduce swallowing difficulties as well

Safe feeding and swallowing techniques graph.

There is also the aspect of end of life swallowing issues that may be present. Check out this article if you’re curious how to manage that!

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Michelle saari dietitian
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Michelle Saari is a Registered Dietitian based in Canada. She has a Master's Degree in Human Nutritional Sciences and is a passionate advocate for spreading easy to understand, reliable, and trustworthy nutrition information. She is currently a full time online entrepreneur with two nutrition focused websites.

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