Choking Incidents

It is always tragic to hear about a nursing home resident’s injury or death due to a preventable choking incident. Staff at the facility is responsible for identifying which residents are at risk of choking or aspiration. Aspiration is the misdirection of mouth secretions or gastric contents into the larynx and lower respiratory tract. If a nursing home fails to properly monitor a resident who has demonstrated a high risk of choking, then the nursing home may be liable for any injuries resulting from the facility’s failure to monitor or address these issues. Such failures can include failure to update care plans, failure to ensure the resident is on a proper diet, failure to notify the treating physician of signs and symptoms of aspiration. Often these problems relate to a facility’s failure to provide enough staff to supervise the residents or a failure to properly train staff at the facility.

Symptoms

Common problems which might make an individual susceptible to choking include: Dementia, Alzheimer’s disease, strokes, and certain types of cancer. Even in circumstances where the risk of choking is severe, proper monitoring and care can help to prevent injury.

At eating time, a resident who is at high risk for choking or who has been diagnosed with dysphagia may experience severe coughing and cyanosis, or the appearance of a bluish tint to the skin. When associated with dysphagia, the gums and lips may appear slightly blue, indicating that the individual is not getting enough oxygen when he or she eats. A voice change that occurs after swallowing, that may sound like hoarseness or gurgling, can also indicate dysphagia.

Aspirational Pneumonia

Aspirational pneumonia is an inflammation of the lungs and bronchial tubes that occurs as a result of an individual inhaling food, liquid, or his or her vomit. The individuals who are at highest risk for aspirational pneumonia are elderly individuals with a history of seizures, stroke, lung disease, and those who suffer from chewing problems. Individuals who experience regular heartburn and gastroesophageal reflux disease (GERD) are at an increased risk for developing aspirational pneumonia as well.

Dietary Change

Diet modification may be necessary to address the risk of choking problems and aspiration. Thin liquids, like water and juice, may need to be thickened to avoid aspiration. Solid foods may need to be ground into a texture that makes swallowing safer. Pureed foods may need to become a staple of a resident’s diet to prevent choking and aspiration.

Exercises for Swallowing

A speech therapist may be able to provide exercises for an individual to exercise the muscles of the face to enhance the speed, strength, range of motion, and endurance required for chewing. For patients who suffer from a cognitive affliction, therapy must generally require a cognitive component in addition to swallowing therapy. A nursing home or other care facility should be able to provide you with information about its treatment plan for residents who have trouble swallowing.

Ongoing Evaluation and Treatment

Chewing or choking problems require ongoing evaluation. The first treatment plan may not satisfactorily address the problem. Speaking with your loved one’s care provider can offer insight about what treatment options would best serve you and your loved one. However, if you feel that proper care is not being given or your questions about a loved one’s care are not adequately answered, you should take action right away. If you or your loved one has suffered injury or death as a result of a tragic choking incident, do not hesitate to contact us. Through years of experience, we are here to help.