title: Balancing Eating With Breathing: Community-Dwelling Older Adults' Experiences of Dysphagia and Texture-Modified Diets.
abstract: Although many older adults suffer from dysphagia and are required to eat texture-modified diets, little is known about the experiences and challenges faced in doing so at home. In this study, we explored the perspectives of community-dwelling older adults as they struggled to balance dysphagia symptoms and recommended diet modifications with their preferred lifestyles.
  
  
  
  Using an interpretive descriptive design, we conducted 37 in-home semi-structured interviews and 5 member-checking interviews, participant observations during a meal, and reviewed the medical charts of 20 participants recruited through maximum variation purposeful sampling. Meaning units and codes were identified and synthesized into 4 themes.
  
  
  
  Participants faced a frightening choice between eating and breathing. Hiding dysphagia symptoms from the public eye was important to preserve self-identity. Following the recommended diet created a feeling that life was "falling apart." We also found that adhering to the diet was not an "all or none" phenomenon.
  
  
  
  Given that correct adherence to the restrictive diet is rare, to effectively manage dysphagia symptoms, clinicians must appreciate the full range of impact of dysphagia and texture-modified diets on the lives of older adults.
authors.affiliation: University of Rochester School of Nursing, New York.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Seshadri
authors.affiliation: University of Rochester School of Nursing, New York.
authors.forename: Craig R
authors.initials: CR
authors.lastname: Sellers
authors.affiliation: University of Rochester School of Nursing, New York.
authors.forename: Margaret H
authors.initials: MH
authors.lastname: Kearney
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000178:diet therapy / Q000503:physiopathology / Q000523:psychology; D004035:Diet Therapy / Q000379:methods / Q000523:psychology; D004435:Eating / Q000502:physiology / Q000523:psychology; D005260:Female; D005526:Food, Formulated; D006801:Humans; D057187:Independent Living; D008297:Male; D018529:Nutritional Support / Q000379:methods; D010349:Patient Compliance; D012649:Self Concept