Choking is often heavily emphasized as a concern in children under 4. However, there is another group of people we also need to be considering. The risk of choking is ever present through life, but children and elders are at higher risk of choking than others. Elder individuals are also at high risk for choking because they may have weakened swallowing ability, dry mouth, dentures, motor impairment, or medical conditions that might inhibit the ability to swallow well.

How Knowing Medical History Helps in Choking Prevention & Response for Seniors. 

Knowing the medical history of each individual in your care is essential for the sake of prevention, but that is only half of the battle. Prevention is the most important tool a caregiver has in his or her arsenal. 

It is important that caregivers know what medical conditions may impair swallowing or inhibit proper use of throat muscles. If an elderly individual has had difficulty swallowing in the past, has had at least one stroke, has Parkinson’s disease, or other medical conditions, it is imperative that the caregiver take necessary precautions to avoid a choking incident. 

Senior Choking Prevention Strategies:

For senior caregivers and directors, implementing preventative measures and having an emergency plan in place for choking incidents is not just procedural, it’s life-saving. By consistently following protocols like supervising meals, modifying food textures, and ensuring regular dental check-ups, caregivers can significantly reduce the risk of choking in the residents.

1. Supervise all meals and snacks. Either ensure that the individual has a companion, supervise eating in some capacity. 
2. Modify food texture to opt for softer options. 
3. Substitute thin liquids instead of thick liquids, such as water instead of a smoothie. 
4. Ensure that the elderly individual is up to date on dental cleanings and the dentures (if any) are correctly fitted. 
5. Avoid risky foods such as hard caramel, tough meats such as pork chops, grapes, popcorn, or hard candy. Where possible, cut the pieces into smaller pieces to avoid choking. 

Choking Emergency Preparedness:

While preventative measures like modified food textures and meal supervision are crucial for seniors, choking incidents can still occur. It is therefore essential to be prepared to respond quickly and effectively by following a well-established emergency plan, including awareness of choking signs and training in the Heimlich maneuver. Rapid and appropriate intervention can significantly improve outcomes in a choking emergency.

1. Safety training: Awareness and training are the best tools to equip when an elder is in your care. The heimlich maneuver is the best approach when an elderly individual is choking. In our CPR and First Aid classes for senior caregivers, we provide hands-on training for choking response in the case of a choking emergency. 
2. Make sure that you have an emergency plan in place at home and at the facility of care. 
3. Identification: You know WHAT to do, now how do you know if the person is choking?
   1. Does the person look panicked? 
   2. Is the person coughing or gagging?
   3. Is the person grabbing at his/her throat?
   4. Is there any discoloration along his/her lips or mouth?
   5. Is the person unconscious? 
   6. Can he/she talk?

If there are any of these signs present, enact the emergency plan immediately.

What if a Choking Senior is in a Wheelchair?

The main differences when assisting a choking senior in a wheelchair are:

• Wheelchair stabilization: Secure the wheelchair to prevent movement during the procedure.
• Positioning: You may need to adjust your position to be behind the seated individual, potentially kneeling or seated yourself if standing is not feasible.
• Heimlich adaptation: The abdominal thrusts are performed while the person remains seated.
• Lowering if unconscious: If the person becomes unconscious, carefully lowering them to the ground might be necessary before starting CPR.

Seniors Have a Greater Risk of Choking & You Can Help

“In the USA, of over 76,000 deaths from choking, in adults over 65 years of age, 6.5% of deaths were classified as food choking. A study conducted in San Diego County, indicated that many choking deaths were due to meat and 45% of choking episodes happened at home.” (National Institutes of Health). All caregivers of elderly need to ensure that precautionary steps are met as well as awareness and emergency plans are prepped and ready. 

With the proper response and safety measures, choking is preventable. Make sure you are prepared for any emergency with awareness, planning, and prevention. With these tools, anyone can be a hero!We provide CPR and First Aid Training for Senior Care across Georgia and South Carolina to help caregivers, directors, and staff know how to respond if an emergency arises like choking. Learn about this course here, request a class here, or join a class here.