How do you prevent someone with Alzheimer's from choking on food and liquid?

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Q: What can I do to prevent my wife with Alzheimer’s from choking on her liquids and food?

A: I'm so sorry for you. I know it is so hard to watch a loved one choke. It happened with my father too and scared the daylights out of me. Unfortunately, when swallowing becomes impaired and choking begins it is usually a sign that the dementia is progressing further. Be sure to report this symptom to her doctor ASAP and ask about using a thickening agent in her liquids, which helps some patients quite a bit. She will probably start to lose weight now too, so discuss with the doctor about adding a product like Ensure Plus (365 calories a can) with the thickening agent.

Whenever my father ate, I had to sit with him and remind him to slow down or otherwise he would shovel food in so fast anyone would choke, with or without dementia. A couple times when I wasn't there, a caregiver I hired even had to give my father the Heimlich Maneuver—so be sure you know how to perform that in case of an emergency. I suggest that you always cut up your wife's food into very small portions before giving it to her. Also, make sure she is sitting up straight before she begins eating. And with each bite, calmly and lovingly remind her to slow down and chew thoroughly, and hopefully that will help keep her from choking.

Jacqueline Marcell is a former television executive who was so compelled by caring for her elderly parents (both with early Alzheimer's not diagnosed for over a year) she wrote "Elder Rage." She is also an international speaker on elder care and host of the popular Internet radio program "Coping With Caregiving."

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13 Comments

There are also physical therapists who specialize in regaining one's ablility to swallow. They usually deal with elderly patients.

check with your insurance to see what is covered.

I wish I had known this for my own father, who was given tubal feeding almost immediately. I was locked into graduate school when he was hospitalized and many miles away. Even though I visited him every other week, it wasn't nearly enough. He ended up being denied one of the best parts of life, to taste and enjoy one's nourishment. No one ever offered the idea of helping him to swallow again. (Don't let that happen to your loved one.)

Now I'm taking care of my mother who as of the last two months was not swallowing and choking up her food. It had to do with her medications. she was having terrible reactions to the amiodarone, captopril and simivistatin she had been prescribed. Fortunately she has changed doctors and her new one has been great about pulling her off so many heart meds which were causing her throat to swell. Her improvement in swallowing has been painstakingly gradual but she is back to solid foods she enjoys and she no longer chokes. Chocolate protein Oddwalla drinks helped. They were convenient and healthy and without the high fructose corn syrup of ensure or the carnation drinks. I have since moved on to bringing over the blender and making both of us smoothies every day and that has been a huge help (for me too!) It's like a daiquiri first thing to start the day which, of course, is the the big fantasy of old age. I got big straws from the local starbucks (tee hee) and never serve it as medicine.
Best of luck to everyone. When someone is choking, it is about the most disconcerting thing to deal with. Also as a caregiver, it's not a bad idea to get a doctor or other professional (the Red Cross, the YMCA, etc.) to teach you how to do abdominal thrusts gently, effectively, i.e. correctly. Life ain't the movies.
My mother (95 when she departed this life on Dec. 15, 2010) began choking. She suffered from Parkinson's and Dementia. Exercises would have been out of the question because she understood very little of what we told her. The choking sounded like anyone who strangles on food. The morning of Dec. 4, I gave her some juice and the choking elevated to a new level. The choking was wet sounding and I thought she was drowning. At the hospital, a speech therapist attempted a swallow test but the wet choking began anew. Without a tube, we were told Mama would not be able to swallow and would ultimatey starve to death. Before her dementia set in, she did a living will and was adamant about not wanting a feeding tube. Our only choice, accoding to all the professionals, was put her under hospice care and dehydrate her to death. Which we did and 10 days later se passed away. I have so much guilt about letting Mama pass this way. I feel we engineered her death and I'll always regret not doing something to help her.
Also have the doctor review any recent medications - sometimes sawllowing can be worse due to antipsychotics or antispasticity meds, especially baclofen.

My dad did great on thickened liquids, but for someone who just won't drink them there is something called the Frazier protocoal which allows plain water between meals with optimal oral hygeine instead of tube feeds, and it makes a lot of sense for a lot of our loved ones with dementia.