Progressive Supranuclear Palsy (PSP) and Swallowing Difficulties

Swallowing difficulties are also common in PSP. These include:

  • Coughing or choking on food or drink
  • Wet voice quality when eating or drinking
  • Taste changes – people may develop a preference for sweet food
  • Eating too fast or putting too much food in the mouth
  • Because PSP can cause difficulties with downward eye movement, it can be difficult to see food and bring it to your mouth. This means that some people require assistance with eating

Difficulties with eating or drinking can lead to weight loss, repeated chest infections (through small amounts of food and drink being aspirated into the lungs) and increased risk of choking. The following is some general advice:

  • Sit upright, facing forwards, chin level or down slightly
  • Avoid distractions, e.g. turn off the TV and try not to talk during a meal
  • Take small mouthfuls of food
  • Take your time, don’t rush
  • Chew carefully and finish each mouthful before you take the next
  • When drinking take single sips of fluids slowly, rather than gulping mouthfuls
  • Avoid mixing fluids and solids e.g. soup with bits in, cornflakes with milk
  • Avoid dry crumbly foods, moist foods may be easier
  • Sit upright for 20 minutes after eating and drinking

A Speech Therapist can help with these difficulties by providing a full assessment and advice on strategies, equipment, modified food and drink textures, and/or swallowing exercises. If swallowing deteriorates to the point where it is no longer safe, some people choose to have a gastrostomy, where nutrition and hydration is given by tube directly into the stomach through a small tube.

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