What can I do to prevent my wife with Alzheimer’s from choking on her liquids and food? It is terrifying and I feel so helpless and don’t know what to do.

We are giving my mother Ensure, however she says she wants to eat and we give her small amounts of food. She sucks on them and spits them back out.
She wears dentures and we can not tell if it is her dentures or if she can't swallow. She won't tell us. Any ideas?

plgalb@aol.com

Hi plgalb, I am the caregiver of my brother-in-law who has dementia and we too have had this problem, He just forgets to chew his food so I have started putting his food in the blender and I have to constantly tell him to take small bites and chew it very good. It seems to be helping with him. And I also put some icecream in the ensure and make a shake out of it and he likes it that way, maybe you could try that. Hope this will help with you also.
Brenda

Hi..
My dad was just diagnosed with Aspiration, which is when he eats food particles and liquid are going into his windpipe/lungs instead of his esophagus (sp) causing him to choke. This can also cause pneumonia because the elderly do not have a strong enough immune system to fight off bacteria and break down the food particles. It causes him to choke when he eats too fast. You might want to check and see if this could be part of your mothers problem. Here is what we have done to avoid the choking:

Cut food in smaller pieces
Slow down when eating, he shovels it in like someone is going to take it away from him.
Make him chew his food good. If your mom wears dentures make sure they are secure in her mouth and not slipping when she chews.
The most important one of all is get them in the habit of lowering their head into their chest when swallowing. This closes off the windpipe so that food particles have a harder time getting into it and are forced into the esophagus to the stomach.

Aspiration is very common in the elderly because the muscles in their throats get weak and don't function as they should. The dementia doesn't help the situation and can lead to Aspiration if they don't already have it which is what happened to my dad.
The hospital said a feeding tube is about the only way besides changing eating habits that will help. Even with a feeding tube they are still in danger because saliva will still go into the lungs. At 87 years old I was not going to take away the only thing my father has left that he enjoys doing and that is eating.
With constant reminders to chew, put your head down, dad is eating this way like its routine now, and has not had any problems with choking at all.
Hope this helps, and good luck to you.
Cindy

I fully agree with the suggestions above. The position of the 'eater', especially sitting up straight with upright head and neck, can be crucial. We found the height of the table to chair was a factor too. Food 'size' and consistency is also essential to consider. 'Thick and Easy' is a tasteless thickening agent (a powder) that you can use with both hot and cold liquids. Good for getting an appropriate consistency for soups, stews and sweet dishes as well. Shouldn't need a prescription, but was certainly easier to get once prescribed (also then came without charge). Even just a little - hardly enough to notice if your swallowing is normal - can make a profound difference for someone with swallowing difficulties. My Father-in-law's swallowing could be very variable - he could have several days of no problems at all, then profound - and horrendous - choking. Apparently unrelated to tiredness, denture-fitting, head and neck position or food consistency. Like cindy98989 above, we felt very strongly that eating was one of his last enjoyments in life, so were not keen to change to liquids-only. And if we had tried a naso-gastric tube, he would have removed it. Using a smaller spoon helped restrict the amount of food he took in a mouthful, but he still needed close supervision to try and stop the next 3 mouthfuls going in before he swallowed.....

Chickpea,
I literally had to hold my fathers hand to keep him from shoveling more food in his mouth before swallowing what he had in there already. After about a week of constantly sitting with him I have now gotten him in the habit (unless its something he loves to eat) of putting his spoon or fork down after each bite. I felt like a broken record says "Small bites, slow down, chew it good, head down and swallow" but it's working and we haven't had any problems with food going into his lungs or aspiration pneumonia since. With liquids is rather difficult for them to keep their heads down and swallow but I find a straw does the trick pretty well.
We have not used thickeners on dads liquids as of yet. He hasn't had any problems choking on liquids...thank God! If he should start, that will be our next course of action.