Pill-Swallowing Methods for Simplifying Medication Administration


According to an online Harris Interactive poll, about 40 percent of American adults have trouble swallowing pills. Commonly cited issues include gagging, a lingering aftertaste from an incomplete swallow and having a pill become lodged in the throat. These problems can be even more prevalent in seniors with conditions such as Parkinson’s disease (PD), Alzheimer’s disease, other forms of dementia, and stroke, all of which can affect one’s ability to swallow.

A group of researchers from the University of Heidelberg has unlocked the secret to taking oral medications in pill form, even for those with mild dysphagia (difficulty swallowing). Scientists tested two techniques for taking pills on more than 150 men and women. Some of the participants had preexisting problems with swallowing and some did not.

“Both techniques were remarkably effective in participants with and without reported difficulties swallowing pills and should be recommended regularly,” study authors say.

Tips for Swallowing Pills

According to the researchers, different techniques work best for different types of pills.

The Pop-Bottle Method for Swallowing Tablets

  1. Take a plastic water bottle that is flexible enough to squeeze in when you drink from it and fill it with water.
  2. Place the tablet on your tongue and close your lips tightly around the mouth of the bottle.
  3. Drink from the bottle by pursing your lips and sucking in water. Keep the mouth of the bottle entirely covered by your lips and refrain from allowing air to get into it. You should see the bottle begin to bend inward as you drink.
  4. Immediately swallow the pill along with the water.

Why it works: Sucking on a water bottle helps engage your swallowing reflex, enabling you to overcome the gag reflex that kicks in when trying to down a large tablet.

The Lean-Forward Method for Swallowing Capsules

  1. Fill a glass, cup or bottle with water.
  2. Place the capsule on your tongue.
  3. Take a medium drink of water, but refrain from swallowing it.
  4. Close your mouth and tilt your chin down towards your chest.
  5. Keeping your chin and head down, swallow both the water and the capsule in your mouth.

Why it works: Most capsules float, making them difficult to swallow in the traditional way with your head in a neutral position or tilted backwards. Tilting your head forward while you have water in your mouth helps position the floating capsule at the back of your mouth so it slides more easily down your throat.

Other Options for Seniors Who Can’t Swallow Pills Anymore

Nearly 97 percent of people who tried the lean-forward technique for capsules said the strategy was helpful, while 88.5 percent of people who used the pop-bottle technique with tablets said the same. These two methods were highly effective for many people, but there is no one-size-fits-all approach to making medications easier to take, especially for older adults with swallowing issues and those who struggle to understand and follow instructions.

Fortunately, there are some alternatives that seniors and their caregivers can try. For example, some pills can be cut into smaller, more manageable pieces or crushed and added to food or drinks. Soft yet thick foods like yogurt, pudding and apple sauce are commonly used to facilitate medication administration.

Certain medications can even be prescribed in a liquid form. Drug compounding services are an important resource for seniors who need their prescriptions specially prepared in liquid dosages. However, liquid medicines aren’t necessarily a cure-all. Many older adults with moderate to severe dysphagia must use food and beverage thickeners to eat and drink safely and prevent aspiration. In some cases, taking medications with these thickeners can affect how they are absorbed by the body.

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Doctors and pharmacists are key sources of information about medications. Always consult one of these health professionals before trying anything new with a prescription, over-the-counter medicine or supplement. If a senior is experiencing difficulty taking their pills, a swallowing study may be needed to determine and address the underlying cause. Helping a loved one find a safe and comfortable method for taking their medicine should improve medication adherence, their health and their quality of life.

Sources: Harris Interactive Survey online study between May 27 and June 4, 2003. Schwarz Pharma, Inc. (http://www.harrisinteractive.com/); Two Techniques to Make Swallowing Pills Easier (https://doi.org/10.1370/afm.1693); A spoonful of sugar helps the medicine go down? A review of strategies for making pills easier to swallow (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065591/); Crushed tablets: does the administration of food vehicles and thickened fluids to aid medication swallowing alter drug release? (https://pubmed.ncbi.nlm.nih.gov/24934549/)

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