Dementia and Swallowing

We all need to know that dementia patients move towards sweet things to eat as savoury puts the taste of meltalic in mouth. I have looked after my mum 3.5 yrs she only eats kids yogurts, but loads of them.last night the muscle stopped working in her throat. Now is the hardest time of all.

There are now more details, Scientists have taken detailed images of one of the proteins involved in Alzheimers Disease for the first time! I found the article under the Health section of www.newsgrit.com

Jcrowley1 it might be time to start introducing more softer meals, even pureed meals.

Mitch6666 It's time for at home hospice.

We lost Dad when he started having trouble swallowing. He had a speech therapist, and when I asked, said he was having trouble. But I ate with him frequently, and never noticed him struggling or choking. I actually thought he just wanted more attention. He did get a cough a couple months later,and I took him to the Dr. who said it was a virus, and not pneumonia. He was wrong, and Dad had aspiration pneumonia, which quickly developed into sepsis. Lost him in 4 days.

jcrowley, what kind of help are you looking for? Have you considered meals on wheels? She may also eat more if offered small snack sized portions throughout the day vs a few bigger meals.

Swallowing is actually a complex activity, and it's typical that swallowing difficulties occur in brain diseases. Your doctor can refer you to a speech therapist. They are the ones that help people with dysphasia.

My sister, who has Alzheimers, does not want a person to come into her home and help with meals and housework. She says that is for "old" people and she isn't old yet (78). Her husband tries to take care of her but she doesn't want to eat very much so we wanted someone to come in 3-4 day a week. I live nearby and can do the other days. Should we force this on her or just do the best we can helping her. She can still get angry at you so we hate to insist on this.

I went to a Teepa Snow conference this winter - she explained why dementia patients don't want to eat or why they pull back in the later stages. One reason may be that, as the disease progresses, their vision narrows to tunnel vision, so when you try to feed them, it catches them by surprise and they pull back. She shows techniques that cue the body and mind that it is going to be fed. In this link, she shares more information on how to understand what's going on when the patient is not swallowing properly: https://www.youtube.com/watch?v=sNPAESrllgQ Teepa Snow is a great resource.

Mich, instead of worrying that she will be "dehydrated and starved" understand that she will no longer feel hunger or thirst (although she may be more comfortable if you were to moisten her mouth if it is dry), in fact forcing food and drink on someone at that stage is more cruel because it causes pain and distress.

I have watched my mum slowly go from bad to worse. She now lives with me after only a few months since being told her brain is srinking, this is called dementia. It's been 2.5 yrs now, mum hasn't spoken for 2yrs has been completely bed bound for the past 2 yrs. she has had normal food to blending food to now protein milk shakes and nothing else. Shakes have been for 8 mths now. Her swollening is getting harder and harder and each feed time it's heart breaking. I have read up and can now only guess my mothers throats has started and will close. I had hoped one morning my mum would of past in her sleep, the easier way for us her family watching but I fear she will stop completely on the shakes and starve, it's says the DN would put her on the pathway to help her sleep pain free until she passes. Dehydrated and starved. This will be the most trying time of all for both myself and daughter to have to wait and watch. I choose to look after mum 3 yrs ago and feel to quit now would make the last 3 yrs a waste of time. What if she new she was being taken from the house, what if she died all alone in a strange place. I don't believe that they are in dementia 24/7 as only this week I was cutting my mums nails as she handed me each finger as I finished the other one.

Anyway I feel a weight off my Trouble mind just for putting pen to paper,

Thank you ❤️

I have found that poptarts broken into pieces provide some solid food, because the "filling" is a liquid, and my mother can eat that broken into pieces and hand fed, as a good snack with some sips of coffee.

cwillie, GardenArtist, thanks for the advise.

However, my mom will not do any of the above. She likes orange juice, ginger ale and water. She sips one sip at a time. But it's how she sits when she drinks. She won't listen to me so she does things her way and I don't want to argue with her because she gets aggressive.

GardenArtist, we have an appt for her coming up and I am definitely going to mention this to her doctor. It's not food she chokes on, it's only liquids. I cut her food up in small pieces so that won't be an issue. And she actually does pretty good with sandwiches. I make her tuna, salmon and turkey ad she loves those options.

So, we'll figure something out. She doesn't even like sneezing anymore. She reacts the same way as if she's choking...she fights the motions natural to stopping it. Not sure why.

CTDC, speech therapists have advised tucking the chin down when swallowing.

Has your mother ever seen a therapist? She might not be interested, but it would help to clarify the extent of her dysphagia, as well as help you identify the foods that are safe to eat.

Choking for 20 minutes is frightening. As CWillie advises, there are methods of coping with dysphagia.

Google "dysphagia diet levels" and spend some time becoming acquainted with the various foods that are appropriate at each level. And document which ones make your mother choke and/or cough.

Beyond the discomfort and concern, there's the issue of aspiration pneumonia. We discussed this last week with our pulmonologist.

ctdc3000, are you thickening her liquids with Thicken Up or one of the other thickeners? There are also special straws and cups that only allow one swallow at a time. With my mom thin liquids, especially water, were the first things to cause problems, we now have to keep here diet mostly finely minced and moist.

My mom is doing that now...not as bad as some others in this thread. She chokes a lot when she's drinking. When I ask her to raise her arms, she fights through it making it worse. I don't want to make her do it but at times it's neccesary.

Once she had a really bad choking spell that scared me. It took nearly 20 minutes before she stopped, but she wouldn't raise her arms. I know it's only going to get worse but the problem is when she's at home at night. She has someone living with her but she isn't as concerned about certain things as I am.

Candy, you might get better responses to your question if you created a separate thread. Since this one addresses swallowing issues specifically, anyone reading the title would most likely check out the thread for the same reason I did - b/c I have an interest in dysphagia.

Since you're interested in dementia and driving, something like that might be a good title for a new post so that people interested and knowledgeable on that topic would respond.

My husband was diagnosed with cognitive impairment 5 years ago. He is now 76. He now coughs and chokes on his food so I know his muscles are getting weaker. Can anyone tell me how long it will be approximately before he will not be able to drive alone. Now he does show his judgement is impaired but he knows his way around well and never gets lost. I should say he has always put his head in the sand and we are not able to talk about his problem. Thank you.

These communications have been very helpful as I have noticed my mother choking on her food. She does indeed eat too fast and fills her mouth with food before swallowing the previous bite. She has an appointment soon to be checked for dementia, which her doctor and our family believe she will be found with it. sskape2....thank you for mentioning that some days your mother is able to feed herself and other days, she needs help......I too, see this happening more and more with my mother. Thank you and may God bless you all!

This is tough for anyone to watch and to cope with.
If you haven't read this Agingcare article it may be of some help: https://www.agingcare.com/articles/dysphagia-how-to-help-a-loved-one-eat-and-drink-safely-187010.htm
Carol

My Mom has been coughing at every meal.. I'm sure she'll end up with pneumonia if the dementia doesn't get her first..

My mother started pocketing her food. She seems to forget what happens next after chewing. So we have moved to pureed food. She sometimes also holds liquids in her mouth. I suspect we will be moving to thickened liquids soon.

We will not be using a feeding tube.

Dad's been choking a lot now on fluid. I'm commenting here so that when I have time, I can easily find this discussion to read and take notes.

Also he is accepted the feeding tube and so far so good. With the power of God

My husband lost him ability to swallow because of dementia. It caused him to have pneumonia twice back to back because the speech therapy in the rehab decided to give gim pudding. Anyway he ended up in hospital 2 times and rehad 2 times with a consecutive 2 months in hospital. We just brought him home 3 day'sago. I a sister in law who is sstudying to be an CNA come over from 9am-1pm. Then a friend of family who is very capable to come in from 5pm-whenever we get him to bed. If you choose to do this make sure you document everything. Good luck to you.

Change her diet consistency. You can start with soft mechanical diet and if doesn't help go for pureed in a very small blender. Also, you may start with thickening her fluids with Thick It(from Costco or any pharmacy). She has the risk of getting aspiration pneumonia if you don't do anything about it. The part of the brain helping or guide them in performing this task is damaged so, it is a progressive disease with no way back. So, get yourself mentally prepared for the challenging things will see in their behaviors.

Hi Rahroo7
Thanks very much for that tip about tucking your chin into your chest before swallowing. Sounds so simple. We're seeing the speech therapist and she has spotted a delay in swallowing liquids and we're still having problems but this simple tip might just help. Will try and see. Thanks Cathy2

My mom has Dementia, a history of choking and has had 2 strokes. She had no lingering effects from the stroke. Saying that, she got Occupational Therapy for assistance in "tucking her chin to her chest", following the stroke and a swallowing test to see where the food/liquid goes before she swallowed. It would get hung up ( I don't know the term) but it goes into their lung, which can cause
pneumonia. Mom is in a nursing him now and on a mechanical diet and thickened liquids. We let her sneak regular water, so does the nurse, but not without that reminder, tuck you chin to your chest before you swallow. There is help out there. Wish you well.

My father, age 82, has just been diagnosed with a swallowing problem. He does not have dementia, has not had a stroke, does not have Parkinsons or any other neuro disease. The docs really do not know what the cause is but say it is common in the elderly. He has severe COPD but is otherwise ok and able to go out and about.

We use a thickening product (I like Simply Thick, it's a gel, mixes better than powders, and mixes more quickly than the other thickeners.) For anyone whose loved one is choking on liquids take a look at Hormel's website. They have a home healthcare unit and we order prethickened drinks, including powdered coffee and tea. Prices are reasonable and there is free Fed Ex shipping.

He has a mechanical soft diet which means ground foods, well cooked veggies. He can more easily eat things like meat loaf, chicken croquettes, meatballs, pasta, any soft, ground meats. He's to stay away from foods hard to chew like pork chops, steak, peanut butter, raw veggies. He is also finding it easier to swallow his pills with a spoon of applesauce.

We see a speech pathologist for this.

My mother is in the late stages of dementia; she can not even feed herself. She started choking on regular food so she is now eating only pureed foods and taking Ensure. She coughs when she drinks regular liquids, so I add a thickening agent to it (from a drug store) and she does better. Swallowing difficulty is a part of the disease process; remember that it's like feeding a baby who can't help it that she can't eat everything yet. I also use a couple of specialty cups which I bought online: a "nosey cup" for thickened liquids and a "provale" cup for the Ensure. The provale cup only delivers a small amount of liquid so she won't choke by taking in too much at a time. Until I got these cups, I had a hard time controlling how much liquid I was pouring into her mouth-they have helped greatly. A speech/language expert (SLP) can give you valuable knowledge and suggestions; please talk to one for more information.