Dementia and Swallowing

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.

Hi Patthehat
I'm not a medical person but I have read an awful lot on this just lately and that its a very common problem - the swallowing reflex in stroke victims and that's why they use thickening agents. My husband just laughs it off even when he vomits but I am absolutely terrified quite apart from what other people think if we're out. We don't eat out in public anymore.
It's all a learning curve I suppose but I'd have been grateful to have known a bit more about this years ago and what I might expect in the future. I was using my liquidiser today to make soup and I must say it really got me to thinking what the next stage might be - not very appealing so shall try not to think about it too much then

Wow, thank you very much for this thread, I really never gave anything like this any thought!
I guess I've noticed my Mama had started coughing, and doing a little gagging, a bit more often when she eats, maybe sometimes in the last year or so.
Maybe I should point out, that her mental state is being affected from limited blood flow to the brain, from arterial blockage in her neck arteries...nothing they can do really, what with her age, the level of hardening, and her already precarious cardio concerns.
Now I just figured she was just getting some bits of food or liquid down the wrong pipe, maybe from her dentures possibly needing adjustment, and she's not getting enough chew action or something.
She insists they're just fine & dandy as candy (which by the way, she seems to have absolutely no trouble with what so ever, so at least I know her sweet tooth is in great shape).
Also asked her if maybe her mouth was getting too dry, possibly from a multitude of various medication adjustments, and she said, with the just proper amount of annoyance, that it wasn't any kind of problem..."I've got plenty of spit, you worry about yours!", *SNORT*, she's so damn cute:-) !
She says that she just took a breath at the wrong time, but then she would..
But it's happening with enough more frequency, it's become more noticeable, and I have to admit, becoming worrisome.
I am planning on sneaking in an appointment to have them chompers checked out, at the time of her next heart doc appointment...well see, getting her to her cardiologist is hard enough, but doing something like getting her to go to a "silly" denture check up, that's like pulling teeth (pun not really intended, but I'll take a really bad one where I can get 'em).
Big time food for thought (there I go again..can't help it, I know, I'm hopeless), and thanks again, you guys are filling me wee little brain with real time, close to home, helpful information, that I don't seem to be able to get anywhere else, and it's quality info I can use!

The nurse told me to think of this alz as a window that is open some times and closed at other times. If my mom needs help being fed just do it, other days she'll be able to feed herself. It made sense, sometimes the signals get through and other times not.

Your uncle cannot be the only caregiver for your aunt. There should be someone in the house at least for a few hours to support the uncle. If she has alzheimers, her eating and other issues will get worse. It is a great responsibility for him to watch if she chokes and it is difficult for anyone to see a person you love deteriorate. Her eating will get worse. Make sure she's on Namenda and Aricept or Excelon to slow the progression. Bring her to a neurologist.asap. She will eventually need to have all her foods mashed, then eventually she will need to be fed by him or another caregiver. You can always supplement her diet with Bottles of Boost or Ensure Plus Each bottle is 350 calories.
I suggest any person who is having trouble getting proper nutrition in an Alzheimer's patient to use these bottles. Sipping is easier than chewing, if the time comes. You even can buy a can of Thickener at the drug store that you put in water, or liquids that would help the person drink nutrition without choking. If you see your loved on choking on foods, it is time to reevaluate his swallowing abilities and start on pureed foods until you can assess what their swallowing abilities are. Food can aspirate into their lungs if they throw up which could cause infection. My mom with alzheimers primarily drank 4 boost plus's per day, (1500 calories) for about 5 months before she refused food completely. Then the big question: Do you put in a feeding tube???? Please. please think about this carefully and know that most Alzheimer patients stop eating, because their brain is not giving them the signals. I was not able to accept that my mom was dying when she refused food and water. I thought she was just a disabled person who I had to help. I regret putting in the feeding tube, although I have had 3 months more so far with mom. The quality of her life really is not good, even though she is home with loving caregivers. Try and be realistic and come to terms with the fact that Alzheimer patients do not get better. As they decline and the issue of food becomes problematic, think about what you are going to do if you are faced with death vs. feeding tube. If your loved ones have early stages, please have a conversation with them to know what their wishes are. That would have helped me. Good Luck.

Since the brain is slowly dying if the person has Alzheimer Disease, helping by cutting food, serving soft foods, and finger foods make sense. I started softening apples in the microwave when I noticed my mom coughing while eating them. I also put prunes in her coffee water just before microwaving the water. They soak up the hot water while I am preparing her breakfast. By the time I take the prunes out to put on the plate, the coffee water has cooled down enough to be safe to drink. I work on ways of getting liquids into my mother. She doesn't want to be bothered with making a trip to the bathroom so often. Does anyone have a parent that refuses to eat foods of a particular color? My mother will not eat anything green.

I thought Parkinsons at one point, but he's had every test under the sun and has been seeing a neurologist. No mention of Parkinsons. Thanks, though.

glad i saw this before shuttin it down , my dad has dementia and yes he has pblms with swallowing . ear nose throat dr said its common and one day the muscles in the throat will quit working . feeding tube is the next option , sadly dad said no ,
i keep his food so soft and smash if needed . no more meats unless its meatloaf . chock milk seems to be easier to swallow than it would be with water , apple juice , anything thats thin liquid .
tell ur uncle that he needs to stop harpin at his wife .

my ex has dementia and Parkinsons. The neurologist says this is common for people with Parkinsons. I suggest you check with her neurologist about this. It is a problem that needs to be dealt with.

We are having a similar problem with my father who has been diagnosed with dementia/alzheimer's. He hasn't choked, but he does have difficulty at times with his utensils. My mother and I always want to help him - cut his food up for him, fix his coffee, feed him at times - but my sister thinks it's better to make him do it himself. I agree with her, but it's too hard for me to watch him struggle. Other odd things that have only happened a few times - we've caught him eating his napkin and once my mother found him chewing on a plastic coffee creamer. Scary because he could easily choke.

my mom with dementia has been having difficulty with using utensils. She seems to be losing the coordination to bring the fork or spoon to her mouth. Sometimes I end up feeding her myself. Has anyone been through this? I don't know if it is better to keep encouraging her to feed herself, try to serve foods like sandwiches that she can pick up, or just help her eat. Helping her will mean that she will get used to it and then expect to be fed, she'll forget how to do it herself. Just wondering if anyone else was at this point.

I too have this problem with my husband who now has dementia following a stroke 10 years ago. In his case he holds liquids in his mouth while thinking about swallowing. He often chokes and vomits. I too get cross because he's not concentrating on what he's doing. He also puts more food in his mouth while coughing. Both of these are very frightening to watch but he's not overly bothered by it. I think me getting cross doesn't help but it is a natural reaction and I'm afraid I forgive myself for it
Cathy

This could be physical, but with Alzheimer's the body eventually "forgets" how to function. She may not be able to help herself. Yelling, as you know, isn't helping. He's afraid so he's yelling at her, but she won't get that and it just frustrates her.

Some people may have grown up in a time when there wasn't enough food. Then, when Alzeimer's takes them back to that time, they feel they'd better eat now or it may disappear. There are just so many reasons this can happen, that she needs to see a doctor and her husband needs the problem explained to him by a professional. He'll be more likely to take their advice.

Take care of yourself, too.
Carol