Swallowing support
Dysphagia
Careful assessment and personalised therapy for adults living with swallowing difficulties - at home, in care settings or online.
Understanding swallowing
What is Dysphagia?
Swallowing is one of the most complex actions the body performs - over 30 pairs of muscles and multiple cranial nerves work in a precisely timed sequence to move food and drink safely from the mouth, through the throat and into the oesophagus, while protecting the airway below. When any part of that sequence is disrupted - by stroke, head or neck cancer, Parkinson’s, motor neurone disease, dementia, head injury or the natural changes of ageing - swallowing can become slow, effortful, uncomfortable or unsafe. This is known as dysphagia, and it affects an estimated 8% of the global population and up to 50–75% of care-home residents.
Speech and Language Therapy is the specialist profession responsible for the assessment and management of dysphagia. A speech and language therapist will build a detailed picture of how you swallow, identify where the difficulty lies, and put together a practical plan - combining safer swallowing techniques, targeted exercises, modified textures and, crucially, mealtime strategies that keep eating and drinking as enjoyable and dignified as possible.
Your experience
What you might be experiencing
Swallowing difficulties often creep in gradually and can be easy to explain away. You (or someone you care for) may have noticed frequent coughing or throat clearing when eating or drinking, a sensation of food “sticking” in the throat or chest, needing to chew for longer, taking much longer to finish a meal, or a wet, gurgly voice after swallowing. Some people find that certain textures - thin drinks, dry crumbly foods, or mixed consistencies like cereal in milk - are noticeably harder to manage, while others experience recurrent chest infections that turn out to be linked to their swallow.
Beyond the physical symptoms, dysphagia can quietly reshape daily life. Mealtimes can become anxious rather than enjoyable, social meals may be avoided, weight can start to slip, and both the person and their family can feel exhausted and unsure what is safe. This is often the point at which people get in touch. With careful assessment and the right combination of strategies, exercises and support, most people can eat and drink more safely, more comfortably and with far less worry - and often with a much wider range of foods than they feared.
The evidence
How speech therapy helps
Speech and language therapy is the internationally recognised first-line intervention for dysphagia. NICE and the Royal College of Speech and Language Therapists (RCSLT) both recommend early SLT assessment for anyone with suspected swallowing difficulty, particularly after stroke, in progressive neurological conditions, and in head and neck cancer. Evidence-based approaches such as strengthening exercises (including the Shaker and Mendelsohn manoeuvres, effortful swallow and Expiratory Muscle Strength Training), postural strategies and carefully judged texture and fluid modification (using the IDDSI framework) can significantly reduce aspiration risk and improve quality of life.
A Cochrane review of swallowing interventions after acute and sub-acute stroke (Bath et al., 2018) found that behavioural swallowing therapy reduces the length of hospital stay and dysphagia-related complications. In head and neck cancer, prophylactic swallowing exercises during and after radiotherapy are associated with better long-term swallow function (Carnaby-Mann et al., 2012). And in progressive conditions such as Parkinson’s and dementia, ongoing SLT input helps people continue to eat and drink as safely and enjoyably as possible for as long as possible.
~8%
of the global population is estimated to experience dysphagia
Cichero et al., 2017
50–75%
of care-home residents are affected by swallowing difficulty
Namasivayam-MacDonald & Riquelme, 2019
1 in 2
stroke survivors have dysphagia in the acute phase
Martino et al., Stroke, 2005
↓ LOS
behavioural swallowing therapy shortens hospital stay after stroke
Bath et al., Cochrane Review, 2018
Your pathway
Treatment structure
A gentle, five-stage flow - from careful assessment through safer, more confident mealtimes.
STAGE 01
Referral & conversation
A relaxed initial conversation to understand your history, medical background, current concerns and what matters most to you at mealtimes.
STAGE 02
Bedside swallow assessment
A structured clinical assessment of the oral, pharyngeal and airway-protection stages of the swallow, trialling a range of textures where safe.
STAGE 03
Formulating the plan
A clear, written plan covering safe consistencies (IDDSI), posture, pacing, and any onward referrals for instrumental assessment (VFS or FEES) if needed.
STAGE 04
Therapy & mealtime coaching
Targeted swallowing exercises, safer swallowing strategies, and hands-on coaching with the people who support you at mealtimes.
STAGE 05
Review & sustain
Regular review to progress or adjust the plan, reduce restrictions where possible, and support you or your team to keep gains going.
Your appointment
What sessions look like with Claire
Dysphagia sessions are almost always face to face - typically in your own home, in a residential or nursing home, or occasionally in Claire’s calm home office. Being in your real mealtime environment matters: the chair, the crockery, the lighting, the people around you and the food you actually eat all shape how well a swallowing plan works in practice.
A first appointment usually lasts 60–90 minutes and includes a detailed history, a clinical swallowing assessment with a range of textures where safe, and time to talk through what has been observed. Follow-up sessions are shorter and more focused - trialling strategies, teaching exercises, coaching family or care staff, and reviewing progress. Where instrumental assessment (Videofluoroscopy or FEES) is helpful, Claire will liaise with the NHS or private services and act on the findings.
Continuing your progress
What happens after the programme?
By the end of a block of dysphagia therapy, most people (and their families or care teams) feel much clearer about what a safer swallow looks like for them - which textures work best, which positions and strategies help, and which warning signs to watch for. You will leave with a written plan, tailored exercises where appropriate, and clear guidance for anyone supporting you at mealtimes.
In progressive conditions such as Parkinson’s, dementia or MND, swallowing needs will change over time, and regular review appointments help keep the plan matched to how you are today. Where things are stable, many people simply return for an occasional check-in, or ask family or care staff to get back in touch if anything changes. Claire will always liaise with your GP, consultant, dietitian or care team so that everyone is working towards the same goals.
Voices from clients
Feedback from sessions
“Claire was a life saver. Not only was she extremely welcoming and very positive, Claire made me feel that there was light at the end of the tunnel.”
J.S.
“I can not state enough how Claire helped me regain my confidence and hope, with the ability of speech again. I would recommend Claire to anyone who needs any kind of help within her professional capacity.”
J.S.
Further reading
Additional Information
Where else to find information
The Royal College of Speech and Language Therapists and the IDDSI framework both offer trusted, evidence-based information on dysphagia, safer swallowing and modified textures for adults and their families.
Working with the wider team
Dysphagia care works best when everyone is joined up. Claire liaises closely with GPs, consultants, dietitians, community nurses, care home teams and family carers so that the swallowing plan is safe, realistic and consistently followed.
Concerned about swallowing?
Get in touch to discuss whether a swallowing assessment could help you, a loved one or a resident in your care.
Frequently asked questions