CEMM Virtual Library

The Caregiver's Journey

Swallowing/Appetite & Weight

Many people with traumatic injuries do not drink or eat for a period of time. As a result, they lose weight.

Once the person is fully awake and able to follow directions, swallowing can be evaluated. It is important to fully evaluate swallowing before the injured person drinks or eats.

The purpose of evaluating the person’s ability to swallow is to make sure that what he or she eats goes into the stomach, not into the lungs. When food or fluid slips into the lungs, it often results in pneumonia.

A speech or occupational therapist evaluates swallowing. This may be done in the person’s hospital room. If not, the therapist may escort your family member to the x-ray department for a video fluoroscopy. Your family member will consume a barium-laced liquid or food that will light up on an x-ray. The x-ray helps the therapist to see precisely where it is going.

Once your service member/veteran is cleared to drink or eat, he or she may only be able to consume certain types of liquids and foods. Most people do best with medium consistencies, rather than thin fluid or very chewy, tough foods. With practice, most people will return to a normal diet.

Appetite can be affected. Some people with TBI complain of a reduced appetite. Others gain weight due to boredom, memory problems, and an increased appetite.

Work with the health care team to learn how to help your service member/veteran have a healthy diet and a healthy weight.

What you might see:

  • Choking or coughing during meals
  • Pocketing of food inside the mouth and/or drooling
  • Decreased interest in eating
  • Weight loss, without trying to lose weight (possibly due to loss of taste and smell)
  • Overeating, resulting in weight gain
  • Memory problems: failure to remember when to eat or when last ate

How you can help:

  • Do not offer fluids or food until your service member/veteran has been cleared to drink and eat.
  • If on a special diet with restricted fluids and foods, work with the therapists and dietitians to learn what foods are allowed. Learn how to assist your family member to drink and eat, if special strategies are needed (i.e., eat slowly, chin tuck during swallow, double swallow, follow every bite of food with fluid).
  • Short-term changes in appetite are common. Don’t worry about early weight loss. Most often, the weight is regained once the person is home.
  • Monitor your service member/veteran’s body weight and learn what his or her ideal weight range is from the dietitian.
  • Report appetite changes to the healthcare team. These may be a sign of depression, general emotional distress, medication problems, or other medical conditions.
  • Ask for a dietitian to review dietary intake and to learn more about meal preparation and a balanced diet.
  • It is common to have reduced taste and smell following TBI. Talk with the dietitian about how to use spices and flavorings to perk up the taste of food.
  • Weight gain following TBI is common. It is usually due to lack of physical activity. But sometimes it is due to boredom. Work with your service member/veteran to remain physically active and engaged in outside activities. Establish set meal times. Discourage overeating or too many snacks.
  • Encourage your service member/veteran to be involved, as able, in grocery shopping and meal planning/preparation.
  • Write meal times in the planner/memory book. Check off meals when finished.

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