**5. Conclusions**

**Symptoms indicating the presence of presbyphagia Symptoms indicating the presence of dysphagia** Prolonged chewing in a person with no teeth or ill-fitted dentures Significantly prolonged duration of a meal

The elder drinks less Drinking fluids has become so difficult that he avoids it

He chokes seldom on his own saliva He is continuously coughing and has a wet voice

**Advices**

When you aspirate now and then on your own saliva try to think to swallow it on a regular base for instance whenever you look for the

When swallowing medication proves difficult mention it to your physician so that he can look for an alternative route of administration

He often chokes at mealtime, coughs frequently, and/or develops a

He avoids several foods and the difficulties at swallowing may

wet voice during or after a meal

influence his quality of life

Diminished taste No taste

In general there are no problems with eating, only hard consistencies

Do not speak during mealtime but start a conversation afterward.

Remain in an upright position at least 5 to 10 min following a meal.

When your food tastes insufficiently, you may add some spices.

Take your pills only when you are perfectly alert and sitting upright.

**When to consult a physician in case of deglutition problems?**

When you cough regularly during and between meals

Remain in a prone position, at least 5 to 10 minutes. Drink sufficient water during and after the medication.

The elder chokes seldom when his attention decreases

**Pay attention to a good hygiene of the mouth** Clean your dentures adequately, make them fit well Discard any food residue from your mouth after mealtime Keep your mouth moist by rinsing or drinking at regular intervals

**Pay attention to eat and drink moments**

Do not eat just prior going to sleep.

time thereby making it a habit.

(sublingual, transdermal). **General advice** Stay active

When you are worried When you choke regularly

When you eat a lot slower

When you lose weight

When you stop enjoying to eat and drink

**Adaptations of food**

**Medication**

(e.g., when talking during mealtime)

might be a challenge

62 Seminars in Dysphagia

Less appetite Important lack of appetite

Avoid eating and drinking when you are extremely tired or when your concentration is diminished.

When experiencing difficulties chewing raw vegetables or some meat, you may cut it in very small pieces.

When you aspirate now and then on fluids, chilling it and adding some flavor could be a good idea.

Swallow safety is preserved in normal aging. Yet there are a number of changes, which bring the elderly in a more vulnerable position. Moreover, the elderly are more frequently confronted with events likely to provoke a deglutition problem.

All medical personnel dealing with the elderly should be alert not to miss any sign that might suggest the presence of a swallowing problem. Finally, the elderly should receive proper advice on how to cope with changes due to normal aging.
