A patient with Parkinson disease: which nutrition management change is appropriate?

• A. His masklike face makes it difficult to communicate, so I will use a white board.
• B. He should not socialize outside of the house due to uncontrollable drooling.
• C. This disease is associated with anxiety causing increased perspiration.
• D. This patient may have trouble chewing, so I will offer bite-sized portions.

Answer: (D)

Parkinson disease can impair the coordination of facial and pharyngeal muscles, making chewing and swallowing more difficult. Because of this, nutrition management focuses on textures and portion sizes that are easier to handle during feeding. Providing bite-sized portions helps the patient chew and swallow safely, reducing the risk of choking and aspiration while improving overall intake. In addition, for safer eating, moist, soft foods and careful pacing during meals are often helpful, and meals should be taken with the patient seated upright and given time to swallow. Other considerations that don’t address swallowing safety aren’t as directly relevant to nutrition management in this context.