How to Prevent Aspiration

Whether you are at risk of aspiration yourself or caring for someone else who is, a few simple daily practices can help you prevent food or liquids from getting into the lungs. Elderly people with certain neurological conditions are especially at risk. Good dental care, eating practices, and head elevation are key to preventing aspiration and aspiration pneumonia. It is also important, however, to work with a team of doctors and therapists to keep you safe and healthy.

Method 1 - Eating and Resting Safely

1

→ Rest for 30 minutes before eating. Stopping physical activity before a meal can make swallowing easier during the meal. Sit down, watch TV, read a book, or do something relaxing before eating.

2

→ Eat small bites of food slowly. Don’t rush yourself while eating. Make sure that each bite is small and manageable. Chew the food slowly until it is easy to swallow, and take a pause before your next bite. If you struggle with chewing or swallowing, make adjustments.

→ If it is difficult for you to chew or swallow, slow down to a speed that works for you.

→ Determine if certain foods are easier to eat than others. Some people may do better with thick, soft foods, like pudding or jello, than liquids, like broth or water.

→ If you have facial paralysis on 1 side of your face, chew your food with the stronger side.

→ If you're helping someone else, cut their food into small bites. Do not pressure them to eat faster. Let them eat at their own pace.

→ Turn your chin down slightly while you eat. This may help reduce aspiration if you find it difficult to swallow.

3

→ Sit upright during meals and for 30-60 minutes afterwards. An upright position will ensure that your food goes into your stomach, not your lungs. Sit up at a 90-degree angle.

→ Avoid eating right before bed. Always allow yourself an hour to digest your food before lying down.

4

→ Elevate the bed at a 90-degree angle during meals. If you are assisting someone who is confined to a hospital bed or an adjustable mattress, raise the head of the bed up all the way. If they don't have an adjustable bed, set up their pillows so that they are resting at a 90-degree angle.

Method 2 - Maintaining Dental Health

1

→ Brush teeth and dentures after every meal. Good dental hygiene can kill the bacteria that might cause aspiration pneumonia. Use a soft-bristled brush to clean the outer and inner surfaces of the teeth. If you use dentures, remove them before brushing.

→ If you’re assisting someone else, stand behind them and off to 1 side. Wear gloves. Peel back their lips with your fingers before brushing the teeth and gums thoroughly.

2

→ Rinse your mouth with antiseptic mouthwash. A good mouthwash will kill bacteria in your mouth, even if you don't have teeth. Swish or gargle the mouthwash for 30 seconds before spitting it out in a sink or cup.

3

→ Soak dentures in a cup of water overnight to keep them clean. If desired, add cleaning tablets to the water. When you remove the dentures in the morning, rinse them off with clean water and brush them before putting them in your mouth.

4

→ Floss once a day. Flossing helps remove bacteria between your teeth. Use about 18 inches (46 cm) of floss, and wind the ends around your forefinger and thumb. Slide the floss up between your teeth and down again. If you’re assisting someone else, make sure to wear gloves.

→ Don’t snap the floss between the teeth. Instead, slowly ease it up and down.

→ If you’re helping another person, standing behind them may help you floss more easily.

5

→ Visit the dentist at least twice a year. The dentist can clean your teeth to protect you against bacteria that can cause aspiration pneumonia. They may also do screenings to evaluate your risk of aspiration or your ability to swallow.

→ If you’re a nurse or caretaker, arrange regular dentist visits. If the person is unable to leave their bed or home, see if you can find a dentist who will perform an oral screening at your home.

Method 3 - Consulting Medical Practitioners

1

→ Determine if you are at risk of aspiration. If you have certain medical conditions, you may need additional medical evaluations to help you avoid aspiration, especially if you are over the age of 65. You may be at risk if:

→ You have dysphagia (difficulty swallowing).

→ You have Gastroesophageal Reflux Disease (GERD) and are over the age of 65.

→ You have a neurological condition like Alzheimer’s disease, Parkinson’s disease, or Huntington’s disease.

→ You take sedatives.

→ You are being tube-fed.

2

→ Undergo a swallow evaluation by a speech pathologist or swallow therapist. Your doctor or medical team can refer you to someone who can help. The pathologist or therapist will physically examine your ability to swallow and perform tests to understand your risk of aspiration.

→ For example, you may be given a barium swallow. For this test, swallow a drink containing barium before undergoing an X-ray, which will follow the path of the liquid in your body.

→ Your speech pathologist may use an endoscope, which is a long tube with a camera in it. They will lower this through your mouth and down your throat to see what happens when you swallow.

3

→ Ask your doctors to evaluate your medications. Some medications can cause dry mouth, lethargy, or dysphagia. These conditions may contribute to your risk of aspiration. Tell your doctor that you are worried about your risk of aspiration and would like to review your medications for side effects.

→ Your doctor may reduce your use of sedatives, as sedatives can affect your cough and swallow reflexes.

4

→ Talk to an anesthesiologist before surgery. If you’re scheduled for any procedure that requires anesthesia, the anesthesiologist will give you a list of things to do before surgery. If you are at increased risk of aspiration, make sure that they know.

→ The anesthesiologist may tell you to stop eating 6 hours before surgery and drinking clear liquids 2 hours before surgery. These procedures can vary between hospitals, however. Always follow the guidance of your anesthesiologist.

→ Tell the anesthesiologist what medications you are taking. This can help them determine if there could be a negative reaction with the anesthetic.

TIPS

→ Always consult a doctor about the best practices for your specific medical condition.

→ Minimize distractions during meals. Turn off the TV and radio. Try to get others in the room to sit down instead of moving around.