Part 1 · Moving and caring for the body
Dressing and feeding
Content under professional review before publication.
1Eating in the right position
The problem
Eating lying down or leaning back makes the food go down the airway instead of to the stomach. This is called aspiration, and it is a frequent cause of pneumonia in older people.
What is happening underneath
When swallowing, a small flap closes the airway so food goes to the stomach. If the person is leaning back or with their head hanging, that flap does not protect well and some of the food or liquid enters the lungs. Sitting upright lets gravity help.
Step by step
- Sit the person well upright, as close to 90 degrees as possible. If they are in bed, raise the head of the bed until they are sitting.
- The chin goes slightly forward, toward the chest, not back. Tilting the head back makes swallowing harder and is dangerous.
- If one side of the face is weaker, sit on that side and place the food on the strong side of the mouth.
- Turn off the television and the radio. A calm environment helps them focus on eating.
- After eating, have them stay seated for at least 30 minutes before lying down.
What you must never do
- Never feed them lying down or with the head tilted back.
- Never lay them down right after they finish eating.
- Never rush them or talk to them so they answer with their mouth full.
When to ask for help
If they cough, get a wet voice, or choke while eating or drinking, stop and consult. The one who evaluates and gives safe swallowing guidance is the speech-language pathologist (speech and swallowing therapist) together with the doctor.
2Helping someone eat, step by step
The problem
Feeding in a rush, with big bites, or without waiting for them to swallow, is what leads to choking. The key is patience.
What is happening underneath
Swallowing is a coordinated job that goes more slowly in an older person. Small bites, one thing at a time, and time between bites give the body the chance to swallow well before the next.
Step by step
- Let the person eat on their own whatever they can: they control the size and pace of the bite better.
- Give small bites and alternate food with sips of liquid. Use a small spoon.
- Wait until they have fully swallowed before the next bite. Check that no food is left stored in the cheek.
- Offer the food at the level of their eyes or a little below, without their having to raise their head.
- Care for the mouth: teeth and dentures clean and well-fitted. A dirty mouth is an important cause of lung infection.
What you must never do
- Never put in a bite before they have swallowed the previous one.
- Never use a straw if the professional has not indicated it: it can make them swallow too fast.
- Never feed them if they are drowsy or not fully awake.
When to ask for help
If they eat less and less, lose weight, or have more trouble swallowing, consult. There are special utensils and cups (thick handle, cup with a lid) that help them eat on their own; the occupational therapist can recommend them.
3When swallowing is hard
The problem
Sometimes difficulty swallowing (called dysphagia) advances slowly and the family notices it late. Recognizing the signs in time prevents choking and pneumonia.
What is happening underneath
When the muscles of the mouth and throat do not coordinate well, food or liquid can go to the lungs without the person feeling it. Thin liquids, like water, are among the hardest to control.
Step by step
- Watch the signs: coughing while eating or drinking, a wet voice after swallowing, food that stays in the mouth, drooling, or fear of eating.
- If they appear, do not insist by force or change the food on your own: tell the doctor or the speech-language pathologist.
- The professional decides whether to thicken liquids or change the texture of the food. Do not decide it on your own.
- Always keep the upright position and the chin forward (card F1).
- Take great care with mouth hygiene, which reduces the risk of infection if something goes to the lungs.
What you must never do
- Never give thin liquids to someone who chokes on them without consulting first.
- Never thicken liquids on your own without instruction: the exact texture is set by the professional.
- Never force someone to eat who refuses out of fear or a real difficulty.
When to ask for help
At any of these signs, consult the doctor or the speech-language pathologist. If the person stops eating or drinking, gets dehydrated, or loses weight quickly, seek help soon.
4If they choke
The problem
Choking can block the airway in seconds. Knowing what to do, and what not to do, in that moment can save a life.
What is happening underneath
If the person coughs hard, air is still passing and the cough is the best way to bring up what is stuck. The serious problem is when they cannot cough, speak, or breathe: then the airway is blocked and you must act fast and call emergency services.
Step by step
- If they cough hard, encourage them to keep coughing. Do not hit them or put your fingers in their mouth.
- If they cannot cough, speak, or breathe, or they turn blue, have someone call emergency services now.
- Lean them slightly forward and give up to five firm blows with the heel of your hand, between the shoulder blades.
- If it does not come out, do abdominal thrusts (Heimlich maneuver): hug them from behind, a fist just above the navel, and push inward and upward, up to five times.
- Alternate five back blows and five thrusts until it comes out or help arrives. If they lose consciousness, follow the instructions of emergency services.
What you must never do
- Never put your fingers blindly in their mouth: you may push what is stuck deeper.
- Never give them a drink to push down what is choking them.
- Never leave them alone while they are choking.
When to ask for help
Call emergency services as soon as the person cannot cough, speak, or breathe. And even if it resolves, a doctor should check them. Ideally, the caregiver should take a hands-on first-aid course: reading about it does not replace having practiced it.
5Dressing and undressing with a weak side
The problem
Dressing someone with a weak arm or leg, or with pain, becomes a struggle if it is done in the wrong order. There is a simple rule that changes everything.
What is happening underneath
The rule is: the weak side goes in first and comes out last. When dressing, the clothing goes first onto the weak arm or leg, which has less movement; when undressing, it comes off the strong side first, which cooperates.
Step by step
- Have the person seated and steady, ideally with armrests.
- To dress: put the arm or leg of the weak side into the sleeve or trouser leg first, then the strong side.
- To undress: take the clothing off the strong side first, and the weak side last.
- Choose easy clothing: loose, front-opening, with velcro or elastic instead of small buttons and difficult zippers.
- For the feet, closed shoes with a non-slip sole; a long-handled shoehorn keeps the person from bending over too much.
What you must never do
- Never start dressing on the strong side: the weak one then does not go in well and it hurts.
- Never force an arm or leg that is in pain or stiff: go slowly.
- Never let them stand on one foot to get dressed: have them do it seated.
When to ask for help
If dressing causes a lot of pain, or a shoulder or hip will not move, consult the doctor or physiotherapist. The occupational therapist can show techniques and adaptive clothing for each case.
What about the home?
This library is free. iliapp.com is a professional service that assesses the home to make it safer.
Discover iliapp.com- This content is for educational and general guidance purposes. It does not constitute medical, nursing, or therapeutic advice, and does not replace in-person evaluation by a qualified health professional.
- Every person and every situation is different. Every technique described should be reviewed and adapted by a speech-language pathologist, occupational therapist, or the treating professional before use. The technique for choking must be learned in a hands-on first-aid course.
- Inclusive Living International (ILI), together with its directors, employees, and representatives, shall not be liable for injuries, accidents, damages, or outcomes arising from the application of this information.
- Use of this guide is the responsibility of the person applying it. In case of pain, choking, difficulty breathing, or any warning sign, stop the activity and seek professional or emergency help immediately.
- The Spanish version is the governing legal document. Versions in other languages are a courtesy; in case of discrepancy, the Spanish version prevails.
- Use of this guide implies acceptance of the Terms of Service and the Privacy Policy.
Content based on public-health and caregiver-support guidance and on internationally recognized clinical consensus. Not affiliated with or endorsed by any organization.