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Mom has been doing a lot of pocketing of her food lately, then spitting it out. We serve her soft food -- fish, mashed potatoes, spaghetti, mac n cheese, etc... She doesn't have a large quantity of food on her plate, but she shovels it in her. We try to tell her to slow down, but that doesn't last long. She chews a long time. This seems to go on at dinner time. Today, she finished eating, but I knew she has some in her cheek. Ten minutes later, she spit it out. It was chewed up. She has not choked on food, thank goodness, but she does choke on liquid, mainly water. (She will not drink it with Thick-it). Does anyone have experience with this? Is this a frontotemporal dementia symptom? What can I expect?

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msfits, good to know that SimplyThick changed their formula. ThickIt is cornstarch and maltadextrin. There are always balls of cornstarch at the bottom of the drink.... Who wants to drink that???

Lynina, smoothies are a great option. Thanks.

Llamalover, thanks. The doctor knows, as does hospice. They won't do anything at her age....
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This could lead to aspiratiom pneumonia. So she should be seen by her doctor stat.
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My mom had the same issues. I used to make her "smoothies" that were supplemented with carnation instant breakfast and ice cream. She loved them and no pocketing. Soups work the same way. Her favorite? Broccoli cheddar soup. You can get a lot of nutrition in with these two food types. Aspiration pneumonia is a real risk with this condition.
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My Dad has dysphagia and can only have blended/pureed foods and thickened liquids. SimplyThick recently redid their formula and it is MUCH easier to thicken things and does not leave lumps or globs. If she still resists, at least try smoothies or something thicker like that. We were told at swallowing tests that thin liquids, such as water, are the worst for choking on because they go down so fast. The pocketing is frustrating and I don't have any real answers for that other than sitting with them at mealtime and reminding them to keep swallowing and take small spoonfuls.
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I'm wondering if she is served very small amts, when all gone serve little more. My hubby has had trouble w meat so I now take scissors & cut it very small. He now separates all food like eats tomato out of salad then cut up fine spinach then onto mashed potato etc. I've had him spit out if he can't chew.
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My mom was doing the shoveling food for 3 days. She had a TIA. I'm not a dr n this isn't medical advice, but it was uncharacteristic for my mom. The dr enlightened me n i went to internet for more info. Changes in their normal behavior is always a red flag. Dementia has so many early symptoms. Check with ur mom's Doctor. Blessings..
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People who have trouble swallowing often pocket their food, especially when there are memory issues. They automatically take a bite, confident that the process will naturally complete itself, and then when it doesn't they're not sure what to do ... so take a second bite.

The hospice folks can provide a swallowing evaluation by a speech therapist -- which might at least tell you what she can manage most easily. Some folks have more trouble with 'smooth' and others with 'chunky' and so on. Lots of people have trouble drinking something that was familiar but is now 'the wrong thickness' because of a thickening agent. It's often easier to offer them a new drink, already thickened, because it won't taste 'wrong', just 'different.'
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Lostinthemix, I know a lot of the diseases associated with the elderly are different for everyone. At the same time, wouldn't it be nice to know where we are in the process and what to expect? Too many variables, I guess....

Mom seems to only pocket dinner. She eats sandwiches for lunch and has no problem. She is eating slower at those times than she used to (at dinner she shovels in the food)... She does refuse her pills at dinner, but hasn't done that much in the morning. Putting the pills in pudding helps, but she only has 2 small pills, plus Senna Plus. (The Senna won't dissolve.) I am just at the mindset now to not force her to take her meds. My brother, on the other hand thinks it is worth it...
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Lostinthemix Jun 11, 2018
Yes, it definitely would be nice to know where they are in this. I've said it before, there are too many moving parts. And the medical professionals seem to be just as lost as I feel I am. My Trainor at the insurance company I worked at used to say it is written, but I don't agree in this instance.
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My mil pockets food, pills, etc and has on occasion spit it out. I know because I have found it. She spits it out wherever. I used to just have trouble with her evening pills and just today, it was difficult getting her to take the morning pills.

This has been a journey, for sure.

And now I understand why the friend of mine didn't have any bedding on her bed, even though she's got lots of bedding.

And she suffers from GERD so she must sit up after every meal, which is always a big deal between her and I.

I have no answers for you, just know you're not alone in this journey and every person with this awful disease is at different stages.
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If your mom is pocketing food..you'll need to swab out her mouth after eating to make sure that all food is out and keep her from aspirating it (breathing it in, causing aspirational pneumonia..when they breath food into their lungs).
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Eyerishlass, thanks for the reply. As far as I know, Mom's weight is about the same. Hospice checks it once per month by measuring her arm. That is the last place you lose weight, though. She should be measured this week.

Any kind of tests are out of the question, I think. She really can't follow commands, if that is what it takes. But, the doctor won't do anything anyway because of her age (94).
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Pocketing food is a symptom that her chewing and swallowing are going to be affected. It's a choking hazard. It's called dysphagia. I wonder if she's losing weight.

Mashed potatoes, mac -n- cheese, and spaghetti may be too thick for her.

She may need a swallowing test. Contact her primary doctor and make an appointment, get the ball rolling.

It's impossible for us to determine if she has dementia but discuss it with her doctor.
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You might need to offer foods that are smoother in texture that don't require much if any chewing at all. Meats of any kind are difficult and were the first thing that gave my mom any difficulty so I began to puree them before I added them to her soups, stews and gravy. Bread can also be a problem because it forms a doughy mass that can be hard to swallow.
How thick are you making her fluids and have you tried xanthan gum formulas ( like thicken up clear)? Mom found them more palatable with a straw. And as GardenArtist has mentioned, some beverages seem more natural than others, I found the pre made fruit juice smoothies were often thick enough right out of the carton.
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I think it's part of the dysphagia syndrome. In my experience, they don't realize they're pocketing food. It's normal to chew a long time, especially if the meats aren't pureed enough. Ham was especially challenging and eventually was eliminated.

If she won't drink water with Thik-it, try juice. Dad had thickened water with lemon (stimulates the swallowing muscles), or orange or cranberry juice. The rehab facility bought the juices already thickened.

My father didn't have any dementia, just dysphagia. Everything you're describing is an aspect of dysphagia.

Unfortunately, you can't expect that it will get better, although it might if she's able to do swallowing exercises. It might stay the same, but eventually it'll be harder and harder for her to swallow, but everyone is different and she might stay the same for quite a while. My father deteriorated as he became weaker and closer to death, and the swallowing muscles deteriorated as well. Eventually, he could only take less than 1/4 cup of water in an entire day.

You can ask for the"stims", little foam squares on a lollipop type stick. Wet them, wet her lips and her tongue. There's not much water on them, but it helps allay the thirst.

Dysphagia is challenging for the patient as well as the family. I wish I could offer some hope, but I didn't much once Dad began to deteriorate. I hope your mother isn't that far along.
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Lostinthemix Jun 10, 2018
How far along, funny you should say that, because my mil has been doing the pocketing thing since she came here to live with us in November, but I always thought she had her stages mixed up. Did you ever feel that way?
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