One trick I learned from a speech pathologist was to turn your head to the side when swallowing, to avoid aspiration.

Another useful combination is Duke University magic mouth wash and mucinex tablets. Together they make it possible to sleep with reduced aspiration risk., I learned this from the best ENT doctor in the state of N.C., Dr. Anita Jackson.

Finally straws are useful when drinking.

It is supposed to be a good idea to thicken liquids. I found quite the opposite to be true; Chardonnay white wine is the best for taking meds.

Thank you Alan !

we also use cold carbonned water to improve swallowing. With your idea, we ll try schweppes like drink (cold, carbonned, sweet and bitter flavor).

After trying, the swallowing test with 2 half tea spoon of cold schweppes like drink didn't work with weakened ALS patient.

The day and night prior period of breathing distress and the non invasive ventilation machine may put to great pressure on swallowing structure for the patient to be able to adapt his mouth for swallowing test

the dry mouth and tong caused by Insuflated air (helping the diminushing of salivaproduction) could also be factors of hardened swallowing.

with ALS patients, it will depend on many factors: cognitive status (as many ALS patients may have fronto temporal dementia), head control, respiratory status (reduced forced vital capacity would increase risk of aspiration and poor motor control) and bulbar severity of the condition. In initial stages, manoeuvres like supraglottic swallow and effortful swallow with postural modification like chin tuck may work. However, with progression of condition, when nutritional maintenance may be compromised and pneumonitis may be suspected, enteral feeding is appropriate and mandatory.

Dysphagia and pharmacotherapy in older adult

January 2019, DOI: 10.1097/MCO.0000000000000523

Swallowing intervention should be carried out cuatiously especially in ALS patients who have poor vital capacity. If you have facility for carrying out instrumental assessments for swallowing and have a speech language pathologist, you could assess the efficacy and then recommend