[Purpose] We focused on the assessment and care of the swallowing and coughing of an elderly patient with dysphagia. The purpose of present study was to wean the patient off mechanical ventilation (MV) by the prevention of ventilation associated pneumonia (VAP). [Subjects] An elderly patient with dysphagia who had not been weaned off MV. [Methods] We focused on respiratory monitoring of oxygenation, the rapid-shallow index, swallowing, coughing, and the physical action. We carried out physiotherapy that focused on improving the range of motion of the tongue bone and the mobility of the suprahyoid muscles. [Results] The patient was successfully weaned off MV after 60 days of admission. She did not contract VAP while in the hospital. [Conclusion] We suggest that VAP can be prevented in mechanically ventilated patients by care for swallowing and coughing which assists weaning from MV.