Choking Issues in Nursing Homes


For many people living in a nursing home facility, swallowing food or may prove difficult. This means that nursing homes have to monitor or supervise the food intake of their patients. The risk of choking, possibly even death, increases when nursing homes fail to enforce diet restrictions or do not pay close attention to those patients who are susceptible to problems with choking.

Why are these issues prevalent amongst the elderly?

The reason that many elderly and disabled patients have problems swallowing is varied. Some of the most common disorders include:

  • Neurological disorders – Neurological disorders such as Parkinson’s disease, muscular dystrophy, and multiple sclerosis may all influence the ability to swallow.
  • Neurological damage – If a person has suffered spinal or brain injuries or has suffered a stroke, it may affect his or her ability to swallow.
  • Cancer – There are types of cancer that may affect the patient’s ability to swallow. The radiation treatment may also play a role here.
  • Alzheimer’s disease – Alzheimer’s patients in the later stages of the disease may find it difficult to swallow and eat.
  • Aging – Considering it takes 50 pairs of muscles and nerves to swallow, it is not surprising that wear and tear on the throat muscles can make it difficult to swallow for older patients.

While such an injury may appear to be accidental, nursing homes can be held accountable for choking incidents. If the choking occurred because the resident was not properly monitored, it is the fault of the nursing home and may constitute as a nursing home abuse case.

The same goes for suffocation. Immobile or cognitively impaired patients and patients requiring supplemental oxygen need special assistance to ensure these patients do not get their heads stuck between bed rails or entangled in other restraining devices. Oxygen tubes must be kept free from obstructions, and patients who have had tracheostomies need care that their trachea is not accidentally pulled out by the patient, other patients or overwhelmed employees.

What Are The Signs of Choking?

All of the following are choking signs and behaviors:

  • Coughing or gagging;
  • Hand signals and panic;
  • Sudden inability to talk;
  • The natural response to choking is to grab the throat with one or both hands. This is the universal choking sign and a way of telling people around you that you are choking;
  • Wheezing;
  • Passing out; and
  • The skin may begin to turn blue. This is called “cyanosis.” This blue coloring to the skin will be seen earliest around the face, lips, and fingernail beds.

Not all of these signs will be present when a nursing home resident chokes. For example, a resident with dementia may not initially realize he is choking or may not have the ability to cough or gag.

How Can Nursing Homes Prevent Choking Deaths?

When a person enters a nursing home, the nursing home is required to perform comprehensive assessments to determine their global physical, functional and psychological needs, and conditions.  Based upon these assessments, a care plan, or treatment guide is formulated in order to maintain the highest practicable level of health and function. Such care plans are required to be individually tailored to the specific resident and his/her risk factors.

This series of assessments should also include an evaluation of any risk factors that may impair the resident’s swallowing, breathing, and chewing.  In certain circumstances, the resident should be referred to a doctor or speech-language pathologist for a more thorough assessment to determine their relative abilities to eat and drink.  Oftentimes a swallow study will be performed to ensure that the resident can safely swallow certain types of foods and liquids without increasing the risk of choking or aspiration.

After admission to the nursing home, the nursing staff is required to monitor and periodically reassess the resident for any changes in their abilities or behaviors, and adjust their care plan accordingly to prevent needless injury or death as a result of choking.

Helping Families After a Choking Injury

For over thirty years, The Rooth Law Firm has represented victims of nursing home abuse and their families under a variety of circumstances, including those who have been injured or died as a result of choking in a nursing home. With proper precautions taken and diligent attention from staff, the risk of choking hazards can be reduced considerably.

If you or a loved one has been injured in a choking accident while living in a nursing home and suspect that negligent or malicious intent was involved, you may have a nursing home abuse claim. Contact us today to discuss the details of your case during a free consultation.