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Lucysmom501 Asked May 2015

Any suggestions on drinks with nectar consistency and a chopped moist diet?

Dad suffered a stroke on May 1st. He's 95 and has dementia. I noticed he choked on his liquids in the hospital, but they continued to give them to him, but they had him on a chopped diet. At rehab, they put Thick It in his beverages and continue with the chopped diet. Had a modified barium swallow test done today at the hospital and the speech therapist told me that it will probably be this way the rest of his life. She gave me some recommendations on what to drink like V8 Juice, Naked Juice, etc. He's been refusing to drink water and anything with Thick It in it, therefore he was dehydrated and they had to give him an IV to rehydrate him. He's coming home on Tuesday and will have a live in aide. Suggestions on what to give him to eat would be appreciated. I was thinking maybe chunky soup, with most of the juice removed and the meat and veggies cut up may be an option. The hard part is his diet was awful before the stroke. He existed on Nestle Crunch Bars and tuna salad sandwiches for dinner. I know dad can't be the only one with this problem after a stroke. Like I said, any suggestions will be greatly appreciated!!!

GardenArtist Jun 2015
Thanks for the response. I was going to do some investigation on the interactions of these pills, and may do that anyway. I'm curious what meds could cause such a drastic response.

Lucysmom501 Jun 2015
GardenArtist, I'm sorry, I didn't find out the name of the meds. As soon as the script was put in my hand and I asked what the med was for, I ripped them up. I do know that the sleeping pill began with an M..........

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GardenArtist Jun 2015
Lucysmom, great news!! This is such a wonderful outcome and so good to learn that the dysphagia wasn't permanent.

I wasn't aware that antidepressants (if that's what the NH gave him) and sleeping pills, or a combination of them, could cause swallowing difficulty. Would you mind telling us the name of these meds? I'd like to make note of it....just in case.

You must feel so relieved - I'm so glad this worked out well and is still improving.

Lucysmom501 Jun 2015
UPDATE: Once he got home from rehab, a speech therapist came to the house to evaluate him. She gave him a cookie and he ate it with no problems. She asked me if they had him on any tranquilizers at rehab. Well, yes, they had him on "happy" pills plus a sleeping pill. I found out the day I brought him home! No wonder he wanted to sleep all the time at rehab! We had another Modified Barium Swallow test done last Friday and guess what..........he's fine. Speech therapist seemed to think that the meds helped cause the swallow problem. He's now back on his regular food and drink, but we're going slowly and as of the day I picked him up from rehab, he's off their meds too!!!!

cwillie May 2015
Thick It Clear is a xanthan gum thickener that doesn't continue to thicken the way regular Thick It does, so it may be a better option. I know it seems more expensive, but you use less of it so it evens out I think. You can definitely experiment with the degree of thickness that works for him, just be aware sometimes that can vary if they are having a bad day.
A minced diet is a relatively easy one compared to pureed, almost anything you would normally eat can be finely chopped. While slow cooker stews and casseroles are good, offering him regular meals with separate entrees and sides occasionally will make his food seem more appealing. Unleash your inner chef and have fun experimenting!

Lucysmom501 May 2015
The problem with the Thick It is that if you don't drink immediately, it turns to almost a gel. The blender is a great option! I was thinking of taking my slow cooker over there and having the aide cook meats in it for him. His diet is chopped, regular food, but cut in small pieces. At the rehab he's had mashed sweet potatoes and white potatoes, looks like steamed squash and zucchini cut in small pieces, mixed veggies, mac and cheese. The meat to me appears almost like diced. The speech therapist who did the test today suggested Naked Juice, Carnation Instant Breakfast with a banana blended in it, fruit nectar juices and even regular ice cream as long as he eats it before it starts to melt. Everyone has given me such good advice, I thank you all ! We will get him settled in and with help from the visiting speech therapist and the visiting nurse, we'll figure out things that he will eat and enjoy eating. I can't blame him for not wanting that Thick It, but I also think that they use too much at rehab. If he can drink V8 juice, the water doesn't need to be as thick as they make it. He would almost have to use a spoon to drink it!

blannie May 2015
My dad had a stroke and had to drink nectar drinks. I'd get different fruit flavored ones at markets that had ethnic (Hispanic) sections. My dad enjoyed them. I also bought a thickened nectar cranberry drink (had to buy a case of the stuff) that he liked too. He refused to drink stuff with the Thick-it in it. I tried coffee once and I about upchucked when I mixed it up, so I am not surprised that your dad doesn't like it. It's just a consistency thing. Ugh...shudder.

The other ideas about pureeing foods with a blender or giving him softer foods are good too. I'd be giving him different kinds of beans (excellent source of protein and fiber) and peas.

And just an off-topic FYI, my dad had a paralyzed vocal cord, which made his talking sound like a whisper. It also hurt his ability to swallow effectively. He had a little silicone piece put in (outpatient by an Ear/Nose/Throat doc) that helped him a lot with speaking and I believe swallowing (if I remember correctly).

Good luck, it can be nerve-wracking trying to make sure they eat enough and don't choke while doing it.

GardenArtist May 2015
Have you consulted the speech pathologist regarding speech rehab exercises when you spoke with her after the barium swallow? I learned about them from a top notch speech therapist during post ventilator recovery. They're difficult though, and depending on your father's post stroke limitations as well as the dementia, it might be kind of hard for him to follow the exercises. But they worked.

These are some of the exercises, of which the Head Lifting Maneuver is the only one with which I'm familiar. There's another one which involves making guttural sounds of two consonants together, something like "ungh" which is repeated a specific number of times. We joked that there were Neanderthal exercises.

I reference these only for descriptive purposes; they're obviously not to be done w/o medical instruction, and as advised by our speech therapist, definitely not for anyone who isn't medically indicated. But perhaps they might help, or perhaps you could even ask your father's physician to script for home care, including a speech therapist.

On the food issue, I've never had V-8 and can't guess at the thickness, but I do know that there are specially prepared liquids for dysphagia, if that's what he has.

I like the idea of a blender or food processor.

cwillie May 2015
Tuna salad may actually work, if it is something he likes. If bread is moistened it can even be made into sandwiches depending on his swallowing ability. A small food processor or baby food mill is a good start and can be used to grind up almost anything, but if he is resistant try to start with comfort foods that already have a smooth consistency, think things like mashed potatoes, cream soups, polenta, refried beans, ice cream, puddings, very tender mac & cheese etc. Meats can be challenging, but I find that processing them and then adding gravy makes them quite tasty.

For hydration think foods with a high water content, for example pureed fruits can make wonderful sorbet or popsicles, soups are good as well. Some swear by smoothies, and we like ensure drinks to add calories as well as fluids. Nectar thick fluids are really not too bad, what specifically is his objection to them? I think that drinking through a straw if he is able bypasses the lips and front of the tongue and may get past the "ick factor".

There are other threads on this topic with some great ideas, try searching the site for more ideas.

BarbBrooklyn May 2015
I would get a blender or food processor to process his foods. Make sure the aide knows how to use it.

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