Is Aspiration Pneumonia a Problem?

Posted By Maryann Porosky On MAY 09,2017

Aspiration pneumonia is a lung infection that comes from particles of food that slip into the lungs instead of the stomach. In the lungs, the particles provide a source of nourishment for bacteria, and lo and behold, the person gets pneumonia. This simple detour of food can actually be quite deadly.

Aspiration pneumonia is under-recognized and has causes and risk factors that might surprise you.

Signs of aspiration
The most obvious sign that an aspiration has occurred is when someone coughs while eating or drinking. Other signs include

a suddenly hoarse voice after swallowing
a gurgling noise after swallowing

At Caring Choices, we notice there is often no sign of an aspiration that anyone in the family can remember. This is because it takes only small particles of food to go down the wrong pipe and cause a problem. These do not need to be so big as to promote a coughing reflex.

Signs of Aspiration Pneumonia
This pneumonia follows the classic signs of the other "communicable" pneumonias. In older adults, however, pain in the chest may not be something they complain about as much as other patients might. Symptoms family members tend to notice are

delirium (your loved one sees things that aren't there or doesn’t make sense when talking)
fever/chills
crackling sounds with breathing

Causes
It appears that delayed swallowing (food hanging out in the mouth) is no small culprit. Food that is able to sit around in the mouth for hours at a time can start growing bacteria before it even enters the lungs. Another cause is a weak swallow: the muscles of the throat don't push the food all the way down and into the stomach.

Who is at risk for aspiration pneumonia?

Persons who have had a stroke. This is especially true if the stroke affected their ability to speak or swallow.
Persons nearing end of life. In the natural winding down of the body, the swallowing muscles simply don't function effectively toward the end.
Persons with advanced dementia. The coordination and concentration needed to chew and swallow may be more than people with this brain condition can manage.
People with missing teeth or poorly fitting dentures. If your loved one doesn't chew completely and get a good mix of saliva, then swallowing can be delayed. Or the food can have trouble going all the way down and into the stomach.
Poor dental hygiene. Brushing teeth after every meal and using a non-alcohol mouthwash has been shown to greatly reduce the incidence of aspiration pneumonia. This is especially important with people who have dentures. They are often under the misperception that they don't need to brush their gums, tongue, and cheeks. Not so! It's not enough just to "soak their teeth." They do still need to keep the soft tissues of their mouth clean as well.
Dry mouth. This is a frequent side effect of many medications. Without adequate saliva, the mouth does not get rinsed out properly and the food does not go down as smoothly.

Preventing aspiration pneumonia
There are things you can do to reduce the chance that your loved one will get this type of lung infection. See our newsletter article on Preventing Aspiration Pneumonia for tips to promote better swallowing.

Does your loved one have trouble swallowing?
If your loved one has trouble swallowing because of stroke, advanced dementia, or dry mouth from medication, we can help you come up with strategies to reduce the chance of aspiration pneumonia. We are the north New Jersey experts in family caregiving. Give us a call at 973-627-4087. You don't have to go through this alone.