When it's hard to swallow

Swallowing problems are pervasive among the elderly and patients affected by such conditions as Parkinson’s disease, stroke, dementia, and head and neck cancer, yet few people and their carers are aware of the issue. A new app aims to raise awareness and address the problem.

Dr Karen Man Kei Chan of the Faculty of Education is spearheading the efforts and has shown that about 60 per cent of elderly in nursing homes and 40 per cent of elderly in day care centres suffer from swallowing difficulties, also called dysphagia.

“Our ability to swallow changes with age, and older people may need a longer time to process food and allow it to transit through their throat. They also have a weaker oesophageal function,” she said.  “Swallowing difficulties may cause food, liquids or medicine to go down the trachea instead of the oesophagus, causing choking or respiratory complications.”

Patients suffering from conditions or diseases related to the head or brain may also experience these problems and are additionally at risk of communication difficulties.

Yet awareness is low among both sufferers and their carers, particularly in the Cantonese-speaking population. This has led Dr Chan and her team to produce the app, KOTE – ‘Keep on Talking and Eating’.

The app is a self-help platform for people at risk of developing swallowing difficulties as a result of neurological conditions or radiation treatment.

“For example, many nasopharyngeal cancer patients often report that they were unaware that radiotherapy could have the side effect of speech and swallowing difficulties. This means they are less likely to access precautionary methods to prevent or reduce these complications,” she said.

The app provides information about swallowing and speech disorders and also features video and audio clips on exercises to strengthen the mouth and throat muscles used to swallow and speak.

“We hope that the KOTE app will help to enhance swallowing safety and communication between patients and their carers,” Dr Chan said.

In addition to the app, Dr Chan provided training to carers in elderly centres and gives seminars to educate the public about swallowing safety.

She is also researching treatments to address swallowing difficulties. One treatment is repetitive transcranial magnetic stimulation to stimulate nerve cells in the brain, another is acupuncture, which has been reported in numerous instances to be helpful but has not been subjected to randomised and double-blind studies. Dr Chan and her team plan to conduct that research to see if the results hold up to objective evaluation. She hopes to share her research findings with the public through further knowledge exchange work in the future.