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What is this all about and why? He is watching television and his mouth is clenched tight, he will not talk to me, becomes confused about what to do with it or where to go while I am trying to show him and direct him to spit it out. He says no by a shake of the head, becoming agitated by clenching his hands. I also am seeing the pills will go into a pocket, so, I am dealing with the held spit, pills now in the pockets, plus his agitation. What's this about? Any suggestions on what I should do? Thank you for your help.

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Go over the important pills with his Dr and see how many are really essential and stop the rest.. Any that are not extended relief can be stopped and essentials such as anti anxiety can be crushed and mixed with anything soft he likes and is able to swallow. I don't know how to get him to deal with the sputum. I would try getting a special pot for him to spit in and actually demonstrate how to do it. He may no longer be able to process instructions. Does he just have ALZ or are there other conditions at work such as heart failure or COPD. Is or was he a smoker?
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The situation puts him at a higher risk for aspiration pneumonia. Prepare to decide if your brother wants to be treated in the future such as full life support. Is he capable of expressing his wishes? It is important to have this conversation in a casual manner. His Alz is slowly taking away his ability to swallow. You may want to get a speech consult but he may also refuse to open his mouth for the exam. 
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Blessings4Ever, my heart goes out to you. No words can do justice in response to what you are going through. I wish you strength and courage during this difficult time.
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Thank you cwillie. I do notice the drooling when he is napping. The sputum is being held in the mouth during the night as well, while sleeping though the cycle is broken. The sputum is there in the a.m., he will relieve it in the shower if directed. I am noticing his head is more in a downward position these days and his posture slumped while sitting and walking. He is still drinking and eating on his own, but I do notice more dripping of the food and the appetite has decreased resulting in a weight loss. He is slower in eating at times or will leave it unfinished, go back to napping. A physical therapist did try to work with him on posture and the shuffle of feet, unfortunately, not a whole lot of success. The doctor is aware of the weight loss, we are supplementing his diet. I guess part of the progression? Devastating to watch.
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My guess would be that he is having swallowing difficulty - dysphagia. Is he also coughing a lot, drooling at night, having trouble drinking or eating? His doctor can refer you to a speech pathologist, who can evaluate him for dysphagia and offer coping strategies.
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