The answer to last month's question should be item 1 below: 1. Various direct and indirect causes can affect the resident's ability to swallow, including stroke, pain, lethargy, confusion, dry mouth, and diseases of the oropharynx and esophagus. 2. More advanced swallowing studies are almost always required to assess for dysphagia in people who have suffered a serious CVA. 3. A clinical evaluation of swallowing may be used to evaluate whether a person is aspirating fluids. 4. Aspiration pneumonia is a common consequence of untreated swallowing disorders.