What Happens During a Swallowing Assessment?

If you’re caring for an elderly loved one, you might have noticed them coughing during meals, taking a long time to finish food, or simply avoiding eating altogether. These may be signs of swallowing difficulties, known as dysphagia. Left unmanaged, dysphagia can lead to serious complications like choking, dehydration, or even pneumonia.

In Singapore, one of the first steps to address this issue is a swallow assessment—a clinical evaluation conducted by a speech-language therapist (SLT). Whether your loved one is already referred or you’re wondering if they need help, here’s a caregiver-friendly guide to what you can expect.

🩺 What Is a Swallow Assessment?

A swallow assessment evaluates how safely and effectively someone can swallow different textures of food and drink. It’s often done after referrals from doctors, or when caregivers report issues like choking, coughing, or sudden weight loss.

There are two types of assessments:

1. Clinical Bedside Swallow Assessment – This is done in a clinic, hospital ward, or even at home. The SLT observes the person's swallowing with different foods and fluids.

2. Instrumental Assessments, if needed:

   • Videofluoroscopic Swallow Study (VFSS) – An X-ray test to see the swallow in motion.

   • FEES (Fibreoptic Endoscopic Evaluation of Swallowing) – A small camera is inserted through the nose to observe the throat during swallowing.

👩⚕️ What Happens During the Assessment?

1. Interview & History Taking

The SLT will ask questions about:

• Recent coughing or choking episodes
• Eating habits and food preferences
• Medical history (e.g., stroke, Parkinson’s, dementia)

2. Physical and Swallow Observation

The therapist will:

• Check mouth and tongue movements
• Observe posture, breathing, and voice quality
• Offer small amounts of food and drink to observe swallowing safety

3. Recommendations

• Based on the assessment, they may:
• Suggest a modified diet (e.g., puréed food, thickened drinks)
• Recommend swallowing therapy
• Refer for imaging (like VFSS or FEES) if more information is needed

🏡 Prefer to Stay Home? Gentle Care Can Help

If your elderly loved one is more comfortable at home or has mobility issues, Gentle Care, the speech therapy arm of The GentleGroup, can come to you. Our therapists provide home-based swallow assessments, offering convenience, comfort, and personalised care.

It’s a great option if you’d like to avoid a trip to the hospital or need a quicker initial screening before deciding on next steps.

🔍 Signs to Watch For at Home

Not sure if your loved one needs an assessment? Look out for these red flags:

• Coughing or choking during meals or drinks
• A gurgly or wet voice after swallowing
• Food remaining in the mouth or taking too long to chew
• Avoidance of eating or drinking
• Unexplained weight loss or fatigue during meals
• Frequent chest infections (possible signs of aspiration)

Even if symptoms seem mild, early intervention can make a big difference.

🧪 Can You Do a Self-Check at Home?

While professional evaluation is key, here are some self-screening tools that may help guide your next steps:

✅ EAT-10 Questionnaire

A quick, validated checklist of 10 statements to rate swallowing difficulty. If the total score is 3 or more, a swallow assessment is recommended.
You can try it here:
👉 Swallowing Disorder Foundation – EAT-10 Tool

✅ Repetitive Saliva Swallowing Test (RSST)

Count how many times the person can swallow saliva in 30 seconds. Fewer than 3 swallows may suggest an issue, but this should be followed up by an SLT.

These tools are not diagnostic but can help highlight if further assessment is needed.

🏥 Where to Get Help in Singapore

You can access a swallow assessment through:

• Public Polyclinics (e.g. SingHealth, NHG): GPs can refer your loved one to a speech therapist at a restructured hospital

• Public Hospitals: SGH, NUH, TTSH, KTPH, and others have dedicated speech therapy teams

• Private Clinics: Many private therapists offer in-clinic or home visits

• GentleCare (Home Visits): Our team can support home-based assessments for greater ease and comfort

💬 Final Thoughts

Swallowing difficulties are more common than you think—especially in older adults or those recovering from illness. But with timely support and a personalised care plan, many people can continue to enjoy meals safely.

As a caregiver, you are the first line of support. If you're concerned, trust your instincts and reach out.

Need help arranging a swallow assessment at home?
Reach out to our GentleCare team for personalised advice and bookings. We’re here to make the process smoother—for you and your loved ones.