Why is choking more common in care homes?

Choking incidents in care homes raise important questions: Why is choking more common in care homes? What steps could be taken to lower the occurrence of choking in care homes? How can training enhance care home staff to respond effectively in such situations?

In this blog post, we’ll give you answers to these important questions, providing insights into:

• what causes choking,
• the things that make choking more likely, and
• practical solutions to help those facing choking incidents.

Content Summary:

Choking is more common in care homes for several reasons:

• Elderly residents: People over 65 are seven times more likely to choke than young children, and care homes mainly look after this age group.
• Medical conditions: Many residents have problems with swallowing or weak swallowing reflexes, which makes choking more likely.
• Understaffing: Care homes often have too few staff, making it hard to supervise meals properly and ensure food is prepared safely for each resident.
• High-risk environment: Care homes have many residents in one place, which increases the chances of choking happening.
• Cognitive impairments: Some residents have conditions that make it harder for them to eat safely or spot choking hazards.
• Medication side effects: Some medications can cause a dry mouth or affect swallowing, which raises the risk of choking.
• Inadequate training: Staff may not have the proper training in how to prevent choking or what to do in an emergency.

Statistics show that choking deaths in care homes are a serious issue. In 2022, 48 deaths were reported in care homes due to choking on food or small objects. The Care Quality Commission (CQC) has said that choking deaths in care homes are “not uncommon.”

To solve this problem, care homes should carry out proper risk assessments, provide staff with training on how to prevent choking and respond to emergencies, and make sure there is enough supervision during meal times.

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1. Introduction

Choking can be a serious problem for older people. As they get older, changes in how they swallow, and move can make them more likely to choke.

This is important because it can lead to breathing difficulties, pneumonia, and even death.

To help keep our elderly loved ones safe, it’s crucial to understand what causes choking and how to prevent it.

Caregivers and healthcare workers need to know the signs of choking and how to help.

Teaching them to prepare meals properly and create a safe eating environment is essential to reduce the risk and protect older adults.

II. Common Causes of Choking in the Elderly

What is a common cause of choking in the elderly?

A common cause of choking in the elderly is difficulty swallowing, often due to age-related changes.

As people get older, their ability to swallow safely can be affected.

This might result from weakened throat muscles or medical conditions that make swallowing more challenging.

When food or liquid goes down the wrong way and blocks the airway, it can lead to choking.

What measures can care homes take to reduce choking incidents?

Care homes can take several steps to reduce choking incidents:

• Train staff properly on how to prevent choking and how to respond in an emergency.
• Make sure there is enough supervision during mealtimes, especially for residents at higher risk.
• Change the texture of food and use thickening agents for drinks if needed.
• Carry out individual choking risk assessments and create personal care plans.
• Set clear emergency procedures and invest in anti-choking devices.
• Create a calm and quiet dining space.
• Encourage residents to eat slowly and take small bites.
• Help residents sit in the right position during meals.
• Provide regular oral hygiene care before and after meals.
• Talk to speech and language therapists for residents with swallowing problems.
• Keep track of the foods served to each resident carefully.
• Remind visitors not to give food or drinks to residents without checking with staff first.

These steps can greatly reduce the risk of choking and keep residents safe during meals.

What are 3 common causes of choking?

Three common causes of choking in older people include:

• Problems with Swallowing: Many older people have dysphagia, which means they have trouble swallowing. Conditions like stroke, Parkinson’s disease, or dental problems can make this worse.
• Eating Too Quickly: Eating too fast without chewing properly or taking small bites can increase the risk of choking. Eating slowly and carefully is very important for older people.
• Consuming Poorly Chewed Food: Sometimes, older people have trouble chewing their food well, which can lead to larger pieces that might block the airway.

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What is the biggest cause of choking?

The most significant cause of choking in the elderly is usually related to difficulties in swallowing.

This can be attributed to medical conditions like stroke, Alzheimer’s disease, or simply the natural aging process, which affects muscle strength and coordination in the throat.

What are the top 10 things people choke on?

The top 10 things people commonly choke on include:

1. Nuts
2. Grapes
3. Hot dogs
4. Hard candies
5. Popcorn
6. Peanut butter
7. Marshmallows
8. Chunks of meat
9. Coins- – Particularly in young children.
10. Small toys and objects- Small parts like marbles, beads, balls

It’s crucial for caregivers and the elderly themselves to be aware of these choking hazards and take precautions to prevent such incidents.

Providing well-prepared, easy-to-swallow meals and maintaining a safe eating environment can significantly reduce the risk of choking.

III. Risk Factors for Choking in Older Individuals

Why are older people more at risk of choking?

 Older people are more at risk of choking due to changes in their swallowing abilities and overall health. These changes can make swallowing less effective and increase the likelihood of choking incidents.

What increases the risk of choking?

Several factors can increase the risk of choking in older individuals. These factors include medical conditions, dental problems, and the consumption of certain types of food that are difficult to swallow.

What are 3 risk factors for choking for an adult?

Three common risk factors for choking in adults include:

1. Dysphagia: This is a medical term for difficulty swallowing, which can result from various health conditions, such as stroke or neurological disorders.
2. Poor Dental Health: Dental issues can affect chewing and make it challenging to break down food into safe-to-swallow pieces.
3. Consuming Dry or Tough Foods: Foods like dry bread, tough meats, or sticky candy can be harder to swallow safely, especially for those with swallowing difficulties.

What is one condition that might increase the risk of choking in adults?

One condition that might increase the risk of choking in adults is the presence of neurological disorders such as Parkinson’s disease.

These disorders can affect the coordination of muscles involved in swallowing, making it more likely for food or liquids to go down the wrong way and lead to choking incidents.

 It’s essential for caregivers and healthcare providers to be aware of these risk factors and take appropriate measures to prevent choking in older adults.

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IV. Choking Hazards in Long-Term Care

What are 3 possible choking hazards for long-term care residents?

Long-term care residents may face some choking risks, such as:

• Improperly Prepared Food: Food that is not cut into small, easy-to-eat pieces can be a choking risk.
• Lack of Supervision: Residents with swallowing problems or memory issues may need close supervision during meals to avoid choking.
• Foreign Objects: Small objects, like coins, left within reach can be accidentally swallowed, which can increase the risk of choking.

What behaviours increase the risk of choking?

Certain behaviours can increase the risk of choking in long-term care residents.

These include eating too quickly, not chewing food thoroughly, and attempting to swallow large bites.

It’s essential for caregivers and staff to monitor residents and encourage safe eating practices.

Is choking a safeguarding?

Choking can be considered a safeguarding issue in the context of long-term care.

Safeguarding involves taking measures to protect vulnerable individuals, including preventing accidents and incidents that can lead to harm.

 In long-term care settings, safeguarding includes preventing choking incidents, which can result in serious health consequences.

Proper training, supervision, and creating a safe eating environment are part of safeguarding efforts to reduce the risk of choking among residents.

V. Choking in Specific Populations

Where is choking more common in?

Choking is more common in specific populations, including the elderly and individuals with certain medical conditions. Elderly individuals and those with conditions affecting their swallowing abilities are at a higher risk of choking incidents.

What causes choking in dementia patients?

Choking in dementia patients is often caused by a combination of factors.

Memory loss and cognitive decline can lead to difficulties in recognizing and managing food.

 Additionally, motor skills and muscle coordination may deteriorate, making it challenging to chew and swallow effectively.

What stage is choking in dementia?

Choking can occur at various stages of dementia, but it is more prevalent in the later stages when cognitive and physical impairments are more pronounced.

As dementia progresses, the risk of choking tends to increase.

How can you prevent choking with dementia?

Preventing choking in dementia patients involves some key steps. These include:

• Proper Meal Preparation: Make sure food is served in small, easy-to-manage portions. If needed, change the texture to make it easier to swallow.
• Supervision: Watch closely during meals to help dementia patients eat slowly and safely.
• Encourage Sips of Water: Encourage patients to take small sips of water between bites. This helps make swallowing easier and reduces the risk of choking.
• Speech and Language Therapy: Talk to a speech and language therapist if there are problems with swallowing.
• Safe Eating Environment: Create a calm and quiet place for meals so the person can focus on eating.

Preventing choking in dementia patients needs a special plan that fits their needs and abilities.

Carers and healthcare workers play an important role in keeping these patients safe.

VI. Identifying the Causes of Choking

Choking in adults can result from various causes, often categorized into different types based on the nature of the choking hazard. Here are some common types and examples:

1. Food Choking:
   • Explanation: Food choking occurs when a piece of food becomes lodged in the airway, obstructing the flow of air.
   • Example: Eating a large bite of steak or not chewing food properly can lead to food choking.
2. Foreign Object Choking:
   • Explanation: This type of choking happens when non-food items, like coins, small toys, or objects, get accidentally swallowed and block the airway.
   • Example: A child swallowing a small toy can lead to foreign object choking.
3. Liquid Choking:
   • Explanation: Liquid choking occurs when a person inhales liquid into their airway instead of swallowing it properly.
   • Example: Sipping a hot beverage too quickly and inhaling it can result in liquid choking.
4. Chemical Choking:
   • Explanation: Chemical choking happens when hazardous chemicals or substances are inhaled or ingested and cause irritation or obstruction in the airway.
   • Example: Inhaling fumes from cleaning chemicals can lead to chemical choking.
5. Obstructive Choking:
   • Explanation: This type of choking occurs when something obstructs the airway, not necessarily due to food or objects. It can include issues like a tumor or swelling.
   • Example: An allergic reaction causing severe swelling in the throat can lead to obstructive choking.

Identifying the specific cause of choking is crucial to providing the right assistance and prevention measures.

Understanding these different types of choking helps in taking appropriate actions to keep individuals safe and prevent choking incidents.

II. Responding to Choking in a Care Home

What to do if someone is choking in a care home?

 If someone in a care home is choking, take these steps:

1. Stay calm and reassure the person.
2. Encourage them to cough to clear the blockage.
3. If coughing doesn’t work, perform the Heimlich manoeuvre (abdominal thrusts).
4. Call for help or emergency services if the choking continues.

What is your first step if a resident is choking?

 Your first step if a resident is choking is to encourage them to cough to try and dislodge the blockage.

 If this doesn’t work, then move on to the Heimlich manoeuvre.

Can you start CPR when the patient is gasping?

Yes, you can start CPR if the patient is gasping. Gasping is a sign that the person’s airway is blocked or severely compromised.

CPR can help provide oxygen and circulate blood until professional medical help arrives.

It’s essential to begin CPR promptly when someone is choking and gasping for air.

VIII. Preventing Choking in the Elderly

How can the elderly prevent choking?

Preventing choking in the elderly is crucial for their safety and well-being.

Here’s a more detailed explanation of the steps they can take:

1. Chew Food Thoroughly: As we age, our ability to chew and swallow effectively can decrease. Chewing food slowly and thoroughly helps break it down into smaller, safer pieces. This reduces the risk of food getting stuck in the throat.
2. Eat Smaller Bites: Cutting food into smaller, manageable pieces is essential. Large bites increase the chances of choking. Smaller bites are easier to handle and swallow safely.
3. Stay Hydrated: Sipping water between bites can help moisten the throat and make it easier for food to go down. Dehydration can lead to difficulties in swallowing.
4. Avoid Dry or Tough Foods: Foods like dry bread, tough meats, or sticky candy can be more challenging to swallow, especially for the elderly. Being cautious with these items is important.
5. Mindful Eating: Paying full attention to the meal and avoiding distractions like watching TV can help the elderly focus on chewing and swallowing properly. Distractions can lead to hurried eating, increasing the risk of choking.

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Continuation (How can the elderly prevent choking)

1. Regular Dental Check-ups: Maintaining good oral health is vital. Regular dental check-ups ensure that dental issues, such as missing teeth or poorly fitted dentures, don’t hinder proper chewing and swallowing.
2. Understand Medications: Some medications may have side effects that affect swallowing. It’s important for the elderly to be aware of these potential issues and discuss any concerns with their healthcare provider.
3. Stay Upright While Eating: Sitting up straight while eating aids the natural movement of food down the esophagus. It’s advisable to avoid lying down while eating, which can increase the risk of choking.
4. Education: Learning about common choking hazards and prevention strategies is key. This knowledge empowers the elderly to make informed choices about their meals and eating habits.

Following this steps ensure elderly can enjoy their meals safely, reduce the risk of choking incidents, and maintain their overall health and quality of life.

IX. Managing Choking Incidents

How do you deal with an elderly choking?

When dealing with an elderly person who is choking, follow these steps:

1. Assess the Situation: First, determine if the person is indeed choking. Look for signs of distress, such as clutching the throat or difficulty breathing.
2. Encourage Coughing: Encourage the elderly person to cough forcefully to try and dislodge the object causing the choking.
3. Perform Abdominal Thrusts: If the person can’t cough or their coughing is not effective, perform the Heimlich maneuver to clear the airway.
4. Call for Help: If the choking persists or the person loses consciousness, call for emergency assistance immediately.

What are the 4 steps when treating a choking victim?

When treating a choking victim, the four steps to follow are:

1. Assess the situation.
2. Encourage coughing.
3. Perform abdominal thrusts (Heimlich manoeuvre).
4. Call for emergency help if needed.

What is the name of the choking manoeuvre?

The manoeuvre used to clear the airway of a choking victim is called the Heimlich manoeuvre.

What is the name of the technique used on a choking victim?

The technique used on a choking victim is often referred to as abdominal thrusts or the Heimlich maneuver.

How to perform Heimlich Manoeuvre (Abdominal Thrust)

When someone is choking, you can help them by doing the Heimlich manoeuvre. The Heimlich manoeuvre, also called Abdominal Thrusts, has five steps.

Here’s how you do it in 5 steps:

1. Stand Behind: Stand behind the person who is choking.
2. Make a Fist: Make a fist with one hand and place the side with your thumb on their tummy, just above their belly button.
3. Use Both Hands: Put your other hand over your fist.
4. Push Up: Push firmly into their tummy with quick, upward movements.
5. Continue: Keep doing this until the object blocking their airway comes out or they can breathe again. If the person falls unconscious, lay them down and start CPR.

Always remember to get medical help after, even if the person seems okay. This is important to make sure they are completely safe.

X. Choking Risk Assessment in Care Homes

Who requires a choking risk assessment in a care home?

In a care home, some people may need a choking risk assessment. This is important for residents who:

• Have Swallowing Difficulties: People with dysphagia, a condition that makes swallowing hard, may need a choking risk assessment. This condition can be caused by different health problems, so meal planning is very important.
• Have a History of Choking: Residents who have choked before are at a higher risk of choking again. They should have an assessment to help prevent choking in the future.
• Are on Certain Medications: Some medicines can make swallowing harder or increase the risk of choking. Residents taking these medications should be checked for choking risk.
• Have Cognitive Impairments: Residents with conditions like dementia may forget how to eat safely or have trouble swallowing. A choking risk assessment is needed to keep them safe.
• Have Mobility Issues: People with mobility problems may find it hard to eat on their own, which can increase the risk of choking. An assessment helps find out their needs.

Doing choking risk assessments for these residents helps care homes take the right steps to prevent choking and provide a safe eating environment.

XI. Consent and Choking Assistance

Do you need consent to help someone choking?

In emergency situations like choking, the priority is to save a person’s life.

Consent is presumed in such situations, meaning that you can provide immediate assistance without explicitly obtaining consent.

This principle is based on the assumption that a choking person would want help to clear their airway and resume breathing.

However, it’s crucial to communicate clearly and reassure the individual if they are conscious and able to understand.

If the person indicates that they do not want assistance, you should respect their wishes.

In cases where the person is unconscious, you should provide immediate aid to clear the airway and then seek medical help.

Remember that preserving life takes precedence over consent in emergencies like choking.

XII. Conclusion

In conclusion, choking is a serious problem that can be life-threatening, especially for vulnerable people like the elderly and those with certain health conditions.

Key points to remember:

• Choking Risk Factors: Older people, those with swallowing problems, and some medications can increase the risk of choking.
• Prevention: To prevent choking, elderly people should eat carefully, take smaller bites, have meals prepared properly, and keep good oral health.
• Choking Response: It is important to know how to respond to choking. Encourage the person to cough, perform abdominal thrusts if needed, and call for help when necessary.
• Choking Risk Assessment: Care homes need to check the choking risk for residents who have special needs to keep them safe.
• Consent: In an emergency like choking, immediate help is needed, but always respect a person’s wishes if they can communicate.

It is very important to be aware of choking risks.

Knowing the risks and taking steps to prevent choking can save lives. Safety measures like proper meal planning, supervision, and training in the Heimlich maneuver (abdominal thrusts) are very important.

Together, we can reduce choking incidents and make care homes safer for everyone, especially the elderly.

Your awareness and actions can help prevent choking and keep those at risk safe and healthy.

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