Marking Nutrition Awareness Week
Nutrition Awareness Week offers an opportunity to reflect on how food and drink support health, wellbeing and quality of life, particularly for people living with complex mental and physical health needs.
To mark the week, we spoke with Carla and Clodagh from our Speech and Language Therapy (SLT) Team about the relationship between swallowing, nutrition and hydration. Their insight highlights an important message: supporting safe swallowing is essential, but safety alone is not enough.
Mental health and swallowing
Many people living with dementia or mental health conditions experience swallowing difficulties, known as dysphagia. Dysphagia can occur for a number of reasons including as part of someone’s neurological diagnosis, their physical comorbidities, their eating & drinking behaviours or as a side effect of their medications
When swallowing is affected, there is an increased risk of choking or aspiration (where food or drink enters the airway). Over time, difficulties can also contribute to dehydration and reduced nutritional intake, particularly if eating becomes tiring or distressing.
Swallowing is something most of us rarely think about. For some of the people we support, it shapes every mealtime.
Managing dysphagia
Following assessment, SLTs may recommend safe swallow strategies, texture-modified meals or thickened drinks to make swallowing safer and more comfortable. These recommendations are tailored to the individual and carefully considered to reduce risk while maintaining oral intake.
However, modifying food and drink inevitably changes how they look, feel and taste, and that can influence how much someone consumes.
When “safe” isn’t enough
As Carla and Clodagh explained, modified diets and thickened fluids must still be enjoyable and nourishing. If they are not, people may eat or drink less, even when swallowing is technically safer.
Thickened drinks can feel less refreshing. Modified meals may appear unfamiliar or less appetising, particularly for individuals living with dementia who rely on visual recognition. If food no longer resembles what someone expects, it may be refused. If drinks are not satisfying, they may be left unfinished.
Over time, intake can quietly decline.
Why intake can reduce
Reduced intake is rarely caused by one factor alone. Changes in texture alter sensory experience. Dementia may affect appetite or recognition. Mental health conditions can influence motivation to eat. Fatigue, medication side effects and reduced independence may also contribute.
When eating and drinking become more effortful or less familiar, individuals may need additional support and time. Without careful monitoring, dehydration and malnutrition can develop gradually.
Supporting nutrition and hydration
Supporting people with swallowing difficulties involves more than texture modification.
Familiar foods and favourite flavours can encourage engagement. Shaped or moulded purées may improve recognition. Fortified meals can help maintain nutritional intake where appetite is reduced. Smaller, more frequent meals may feel more manageable.
These approaches help ensure that swallow safety does not come at the expense of nourishment or enjoyment.
