Swallowing, Parkinson’s Disease, and New Tools That May Help: What Patients and Caregivers Are Telling Us

Swallowing changes are a common and often stressful part of living with Parkinson’s disease. Difficulty swallowing pills, coughing during meals, feeling food “stuck,” or changes in saliva can affect not only physical safety, but also confidence, independence, and quality of life.

At True Self Speech Therapy, we work with people with Parkinson’s disease and their care partners to address these changes early and safely. Alongside traditional swallowing therapy, we may incorporate tools like expiratory muscle strength training (EMST) and neuromuscular electrical stimulation (NMES) when appropriate.

Recent research (Perceptions of neuromuscular electrostimulation of patients with Parkinson’s disease and their caregivers: the impact on swallowing and speech from a qualitative perspective, cited below) helps us better understand how these approaches may support swallowing and what actually matters most to patients and caregivers.

How Parkinson’s Disease Affects Swallowing

Parkinson’s disease can impact swallowing in several ways:

• Reduced tongue strength and coordination

• Slower or less efficient chewing

• Difficulty managing saliva (dry mouth or drooling)

• Increased risk of coughing or choking, especially with pills and liquids

  
  

These changes don’t always feel dramatic at first, but even subtle swallowing difficulties can increase anxiety around eating and medication routines.

What Is NMES?

Neuromuscular electrical stimulation (NMES) is an FDA-approved therapy for dysphagia (swallowing disorders). It uses gentle electrical stimulation to activate muscles involved in swallowing, often alongside traditional exercises guided by a speech-language pathologist. We use VitalStim Plus at True Self Speech Therapy.

In Parkinson’s disease, NMES is thought to:

• Support activation of underperforming swallowing muscles

• Improve sensory awareness inside the mouth

• Potentially support neuroplasticity when paired with active therapy

  
  

Importantly, NMES is not a stand-alone treatment. It is most effective when thoughtfully integrated into a comprehensive swallowing program.

What Patients Reported

In a recent qualitative study exploring the lived experiences of people with Parkinson’s disease who received NMES as part of speech therapy, most patients described the treatment as:

• Non-invasive and well tolerated

• “Strange at first,” but not painful

• Easy to participate in with guidance

  
  

Many patients noticed improvements in swallowing particularly with:

• Swallowing pills

• Managing solid foods

• Feeling more control of the tongue during meals

  
  

Some also reported changes in saliva, including less dry mouth or better saliva control, which made eating more comfortable.

Not everyone experienced noticeable changes, which is an important reminder that Parkinson’s disease affects each person differently and therapy must be individualized.

What Caregivers Noticed

Care partners offered valuable insights into daily-life changes, including:

• Fewer choking episodes during meals

• Less need to modify food textures or thicken liquids

• Shorter, less stressful mealtimes

• Increased confidence and motivation in their loved ones

  
  

Several caregivers also shared that participating in therapy helped them feel more empowered and better equipped to support swallowing safety at home.

What About Speech?

Speech changes remain emotionally significant for many people with Parkinson’s disease. In this study, most patients did not report major speech changes following NMES, though some caregivers noticed improvements in clarity or fluency.

This highlights an important truth: swallowing and speech may respond differently to treatment, and expectations should be discussed openly with your speech-language pathologist.

Our Approach at True Self Speech Therapy

Swallowing therapy is never one-size-fits-all. We focus on:

• Thorough swallowing evaluations

• Individualized treatment plans

• Education for patients and caregivers

• Tools like EMST and NMES when clinically appropriate

  
  

Most importantly, we focus on what actually improves daily life — comfort, confidence, and safety at the table.

If you or a loved one is experiencing changes in swallowing with Parkinson’s disease, early support can make a meaningful difference.

Reference: de Almeida Simão et al. Perceptions of neuromuscular electrostimulation of patients with Parkinson’s disease and their caregivers: the impact on swallowing and speech from a qualitative perspective. Journal of Patient-Reported Outcomes. (2025) 9:122

Disclaimer: This blog post is for informational purposes only and should not be considered a substitute for professional medical advice. Please consult with a qualified speech pathologist for a personalized evaluation and treatment plan.