A 74-year-old patient with decreased laryngeal closure but a strong cough would most likely benefit from which dietary modification?

• A. Thicker foods
• B. Liquids
• C. NPO
• D. PEG tube

Answer: (A)

When laryngeal closure is reduced, the airway is more vulnerable to material entering the airway during the swallow. Slowing and tightening the bolus helps the swallow stay in control long enough for the protective mechanisms to engage. Thickened foods form a more cohesive, slower-moving bolus, which reduces how quickly material reaches the laryngeal inlet and gives the swallow more time to protect the airway. Because the patient still has a strong cough, any small amount that does enter the airway can be cleared effectively, making thickened textures a safer oral option than thin liquids. In contrast, thin liquids flow quickly and are more likely to bypass the impaired protection and lead to aspiration, and opting for NPO or a PEG tube unnecessarily limits oral intake when a safer texture can be managed.