[Dysphagia] Gagging

[Harmony.Turnbull at dadhc.nsw.gov.au (TURNBULL Harmony)]

Does anyone have any suggestions here?
I saw a client today who is 52, has Down Syndrome and diabetes. She has some communication skills and usually answers y/n appropriately to most q's. She is a very fussy eater and prefers to eat dessert (dont we all?). She feeds herself and needs pretty consistent encouragement to eat her main meal (minced consistency). She has little difficulty at the beginning of the meal, but when she gets about 1/2 way through she starts to gag. Initially we thought she was putting her spoon too far into her mouth triggering the gag, but today it looked more like a response to the food she was eating (minced spinach, sweet potato and meat). She looked like she didnt like the food and only ate with lots of encouragement but I was afraid she would make herself vomit if she continued. She then went on to eat icecream and puree fruit for dessert with no probs. We have given her a shorter spoon so she cant put it as far back in her mouth, so it really seemed that it was an objection to the food.
I work in a large residential facility with a limited menu to offer clients. Does anyone have any other suggestions since this lady would only eat dessert all day long if we let her??
Thanks,
Harmony


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