Parkinson’s Disease

Eating and Swallowing 

PManaging Chewing and Swallowing Concerns 

Parkinson’s disease is a progressive neurodegenerative disorder characterized by movement-related symptoms such as tremor, muscle rigidity, stiffness, slowness of movement and impaired balance. Given that chewing and swallowing rely on movement, they can also be affected.

You may experience difficulty moving food from the front to the back of your mouth (rocking tongue movement) during chewing and swallowing. You may have difficulty moving your jaw smoothly in order to chew well. Dry and more crumbly foods (such as crackers) or pills may often feel caught in your throat. You may cough or feel a choking sensation when drinking. Parkinson’s disease can also cause excessive drooling.

It is very important to tell your doctor or health practitioner if you are experiencing these difficulties. Chewing and swallowing difficulties can lead to safety issues that, if ignored, increase the risk of choking or aspiration (food or liquid entering your airway). Speech-Language Pathologists are trained to assess and treat swallowing disorders.

1. What can be done to promote safety when chewing and swallowing?

• Chewing and swallowing challenges can occur during ‘on/off’ periods of medication use and when you are fatigued.

Be aware of how your medication periods and levels of fatigue affect your chewing and swallowing and try to plan your meals accordingly.

• Eat 6 small meals instead of 3 large ones to reduce muscle fatigue when chewing and swallowing.
• Avoid using straws when drinking.
• Moisten dry and crumbly foods (e.g., use jam or butter/margarine on toast, mayonnaise on a meat sandwich).
• Take your time when eating and reduce distractions such as talking or watching television.

2. How can I continue to enjoy mealtimes with family and friends when chewing and swallowing are more difficult?

Mealtimes are often not just about eating. When we sit down to eat with our family and friends, it may also be a time of celebration (e.g., a birthday party) or simply a time to connect and discuss our day. It is important to know that you can still participate in the social side of mealtimes regardless of your chewing and swallowing challenges. Some people with Parkinson’s disease report more difficulty staying engaged in the social side of mealtimes because they need to focus more when eating or are self-conscious eating with others.

• If you are going out to eat at a restaurant, consider eating ahead of time and ordering a side instead of a full meal.
• Where possible, choose foods that are easier for you to chew and swallow for your meal.
• Consider trying modified equipment for mealtime such as cut-out mugs that allow drinking without tipping your head back, insulated plates/bowls to keep food warm or weighted cutlery/cups to increase stability against tremor.
• If you are having people over to your home, choose a mealtime that is best for your medication and fatigue levels such as lunch or an early dinner.
• For times of celebration or meeting with friends, consider planning an event away from main mealtimes such as meeting a friend for a coffee or a small dessert.

Consider contacting a Speech-Language Pathologist for more specific compensatory swallowing techniques and solutions such as posture changes, exercises (to maintain current swallowing function as long as possible) and changes in food textures.

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