My wife was diagnosed in 2018 with having Cerebral Amyloid Angiopathy (CCA). She was told in all probability this would advance into Alzheimer’s. She has experienced some signs of this for two or three years now. She began finding it difficult to find the right word she was trying to say. Other than that, no memory issues. However, when telling about recent events, she rambles on and on and the sequence of the event are out of order. This has become more noticeable recently. When given or giving driving directions, or what roads she was on, she gets frustrated in that she doesn’t remember the names of the streets. She has no problem with navigation when out driving alone. She is very aware of where she is and why. Throughout the day, she often asks the same question several times. She makes many written notes to herself as reminders for various things. All that being said, I am concerned about the progression and timeline of further issues. One that is of great concern is taking medications. She has extreme difficulty in swallowing her medications. No issues with swallowing food, just pills. Presently, she is able to manage by a meticulous method of adding crackers with her pills and water, but this often requires more than one attempt. She complains that her mouth and throat are so dry all the time is the cause. My concern is when the time comes she is no longer able to manage this on her own and I cannot convey to her the process. How on earth will I administer her medication?

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My mother has a swallowing delay diagnosed last October. She is on pureed foods with honey consistency liquids. I called her pharmacy to ask what meds I can open and crush. Most of her meds can be crushed. I use applesauce and mix it well with her meds. I then give her thickened water as ordered by the doctor. This works very well, of course she is 90 degrees upright when she eats and takes meds. I would discuss this with her doctor and see if he/she can order a swallow evaluation. It a safe procedure and one family member can be present. The best to you.
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By that time, the importance of her medication may have receded.

What is she taking that is of real, demonstrable benefit to her? If you can get a good, conscientious doctor to go through the list, you might be startled by how many drugs can be got rid of without risk of harm.

For those that really are essential to her continued wellbeing: many come in different formulations. There are syrups, suppositories and patches, just for example. With any given medication, if you go to its manufacturer's website and look the drug up, you will be able to find out what formats it's made in.
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As a precaution, I’d want a swallowing study done by a speech therapist with a specialty in feeding/swallowing disorders. Look for a person who has the credential “CCC/Speech” following his or her name, and ASK a potential examiner if they have training/experience/expertise in “swallowing evaluation”.

A baseline study may be useful if this problem increases, OR if any medical specialist in her future questions her about this issue.

There may be other suggestions available in the evaluation report you receive from the examiner who does this test. Keep in mind that SWALLOWING is part of the physical “equipment” of “speech and language”, whether your wife has a speech or language issue or not.
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Rather than crackers it is common to use something like a spoonful of applesauce, pudding or even jam. I find for myself that the more I think about it the harder it is, when I'm having difficulty something that helps me is to take them in the middle of a meal or snack when I've already "primed the pump".
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neeniedith Mar 2020
this is so commonsensical and doable. it's exactly the type of actual constructive advice for people that just want to do something that works instead of more and more evaluations, especially right now.
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