3 Things To Know About Dysphagia (AKA Swallowing Issues) After Stroke Or Brain Injury

3 Things To Know About Dysphagia (AKA Swallowing Issues) After Stroke Or Brain Injury

After my 46-year-old husband suffered a massive subarachnoid hemorrhage, he was on tube feeding for several months.  Because of the subsequent brain injury, the hemorrhagic stroke caused, he had to learn to actually EAT again

Often when someone suffers a stroke or traumatic brain injury, the basic things that we may take for granted, need to be learned again.  For many individuals, this includes chewing and swallowing.

Dysphagia is a medical term for there is a problem in the process of swallowing.  For individuals with dysphagia after a TBI or stroke, can be at increased risk for:

Aspiration Pneumonia: Food or liquid goes into the lungs
Malnutrition: Caused by the inability to consume enough calories and nutrients because of impaired swallowing
Dehydration: Due to a lack of fluid intake
Airway Obstruction: Including choking 

What causes this to happen?

Injury to the part of the brain related to eating, including using the mouth, tongue, and swallowing muscles.

Paralysis of parts of the mouth, throat, neck, or face makes the coordination of chewing and swallowing more difficult.

New issues with texture.

A dry mouth is caused as a result of medications, treatments, or due to a stroke or brain injury.

Poor-fitting dentures, due to weight loss following a stroke or traumatic brain injury.  

What is a modified diet?

Modified diets are generally broken down into some basic categories

Dysphagia 1: Thin liquids, which would include coffee, tea, juices, water
Dysphagia 2: Nectar-thick liquids (cream soups, tomato juice)
Dysphagia 3: Honey-thick liquids: These are generally regular liquids with the addition of a powder that will thicken them to a honey consistency
Dysphagia 4: Pudding thick liquids and foods that are softer, like mashed potatoes, bananas, hot cereals
Dysphagia 5: Mechanical soft foods, which might include meatloaf, baked beans, scrambled eggs, pancakes soaked in syrup
Dysphagia 6: Chewy foods, including pizza, cheese
Dysphagia 7: Foods that can be more crumbly or fall apart, like rice or bread
Dysphagia 8: Mixed textures

How is the best diet determined?

Most often, after someone is alert enough after a major event, such as a stroke or traumatic brain injury, they will have a swallow study and/or evaluation from a speech therapist to determine the safest place to start reintroducing foods.

Mark’s first meal was completely pureed, which meant his entire meal was basically baby food consistency food, which included meat, vegetable, and starch.  It did not look very appetizing, but I do have to say that they did their best with the presentation, and I appreciated that so much.

Throughout the process of rehabilitation after a stroke or brain injury, they will work to improve the individual’s ability to eat and swallow.  Food and meals are most certainly considered a quality of life issue.

Don’t become too discouraged if you or the person you are caring for is not eating prime rib a month after their health crisis.  

Like all things related to the brain, healing and recovery take time!

Mark is now 7 years out from his subarachnoid hemorrhage and is eating anything he likes.  

While you are home and caring for someone on dietary restrictions due to dysphagia, here are some great resources to help you!

This website has so many resources, including a variety of recipes to help keep a variety in the diet of someone with dysphagia:


Amazon carries a variety of cookbooks for individuals with dysphagia.  This one caught my attention because of the large number of positive reviews and feedback:

Dysphagia Cook Book On Amazon

Maybe you are like me and are caregiving as well as working outside of the home.  Or maybe like me, you’re not the best cook either!  

Here is a resource where you can buy pre-made meals, accessories, and supplements for an individual with dysphagia. 


I understand firsthand, being a hospice nurse for the last 16 years, food is often how we show love.  

Being able to help someone you are caring for enjoy a meal, despite their limitations helps us feel like we are doing something from a place of love and also improves the individual’s quality of life.  

As always, I would encourage you to reach out to local support groups for stroke or traumatic brain injury.  The people who have been in your shoes for a while will know all of the ways to keep the family fed and safe and SANE!  

I have even seen small, local restaurants make “specials” for customers who may have dysphagia.  You don’t know unless you ask.

In the meantime, remember I am a real person who reads all of my emails.  If I can help in any way, please feel free to reach out to me at:




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