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My wife has a severe imbalance problem, and has to go to the bathroom frequently. Because of her balance problem, she only gets out of bed for meals and to go to the potty chair beside the bed. While in bed, she insists on laying on her back, with a pretty small pillow. Lately she has been experiencing what she describes as "choking." I try to get her to lay on her side; she won't do it. I try more pillows, to be in a more of a sitting position; she won't do it. She probably is getting some phlegm in her throat, but she doesn't seem to be able to clear it. Instead, she calls me or wakes me up to go to the potty, where instead of "going" she sips some Gatorade. She is probably experiencing some early dementia problems. Is this "choking" something that is common? Any suggestions on what might help?

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She might have dysphagia my mom had it and is on meds.
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>  She is probably experiencing some early dementia problems.

It's worse than that. What you are describing can definitely cause dementia and cause other kids of dementia to get worse (loss of O2 to the brain).

You apparently already know she has to sleep on her side or make her head almost vertical to her body, "but she won't do it", so you have to wake her to do it when she starts "choking."

Her doctor will know what to do and when she sees the sleep specialist ask them to prioritize something to prevent her from rolling over on her back over machines.
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OldDog4321: Imho, perhaps you can change to an alternate bed style, e.g. one where the head of the bed can be put in a raised position akin to a hospital bed. This may be an option for you as currently she refuses to use different and/or multiple pillows. However, I do see in your profile that your wife, Sweetie suffers from dementia. Prayers sent.
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My husband has vascular dementia, his last hospitalization was for aspiration pneumonia, in testing him they found swallowing liquids was a problem, now on thickeners for drinks, soft chewy foods not a problem, no straws,seems to be working. He had a barium swallow test, but he does get that little cough, especially, He could go all night, no cough and then suddenly anywhere give or take 5am he has this cough. It usually passes as he gets it up, raise the hospital bed head, but sometimes, I’ve given him via spoon full of honey and even used the Vicks and it works. Afraid he’ll choke on cough drops. They feel it is just another neurological decline of muscles. He can no longer stand, walk, completely incontenance and now we face this challenge, otherwise stable and we go forward each day.
watching his swallowing while eating and drinking very carefully.
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OldArkie Oct 2021
My wife has LPR or "Silent Reflux" from a giant hiatal hernia that has allowed he stomach to migrate entirely into her chest cavity. Instead of going straight down to her stomach, her esophagus makes a sharp bend and allows reflux constantly. She sleeps most of the night in her recliner after getting choked and coughing and throwing up a cup or so of mucus about 3 A.M. I give her Omeprazole twice daily and she takes a sip of mylanta every hour or so when she is awake. Her Alzhiemers caused memory loss requires me to be especially vigilant and it is wearing!
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Is there a way to rent or borrow a hospital bed so the head portion can be raised a few inches? I doubt she would even notice that. Or you can buy a foam type wedge in a medical store to raise the upper half of the body a bit when they are lying in bed. she might have a hiatal hernia and gastric problems and one of the things is that no one should lie flat with this condition. Check with the doctors about that. Good luck.
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Discuss all concerns with her doctor for complete diagnosis. After that and her doctor's advice, tell our forum how your wife's conditions are doing. Prayers go to you and your wife.
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I agree get her to the doctor. My mom kept complaining her throat hurt and she had a little cough which was aspiration pneumonia which ended fatal for her. When patient have End stage dementia this is one of the symptoms. Best of luck
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I've been taking care of my mom for years. I moved her and my disabled sister in with me last November to simplify my task. Every morning and every night Mom would get up hacking phlegm and spitting saying she was throwing. She gets up at least 3 - 4 times through the night and the upstairs bathroom is attached to my bedroom. She never ever ever closes the door so I never get to sleep. I moved downstairs to the family room. It's overwhelming...I've lived in my home alone with my dogs for 20 years and thought retirement would be a peaceful stretch. Being a family caregiver is a full time job with no vacation. MOVING FORWARD. A few weeks ago I started giving her turmeric tea at night before bed and putting "Vicks" on her chest and nostrils. She's breathing a lot better and not getting up gagging. I also noticed when she's eating sugar or candy she has more mucus. I took the candy bowl away from her night stand and replaced it with cough suppressants. So she eats those like candy. STOP. I added a little fresh lemon to the tea and continue to do the Vicks on her chest and nostrils at night. It seems to be working most of the time. She sleeps through the night and only gets up once to cough up mucus. The coughing is my signal to make her a cup of hot tea. She won't ask she just coughs or makes enough noise to let me know she's up..It gets a little annoying but I know what to do. She'll even call me to ask me if she can wake up my sister to make her some tea. She has to walk past my sister's bedroom to get to mine. SO - I make her a cup of hot tea with lemon and she's relaxing until I get up to make breakfast. Sometimes it's overwhelming but sometimes the simple things seem to work.
Warm tea is relaxing and my mom is 98 years young. The "Vicks" Vaporub is also a little relaxing and provides aroma therapy. Finally I burn a scented candle in the bathroom which permeates throughout the 2nd floor. That also helps her to relax. She's been sleeping better for the last to weeks and coughing and gagging a lot less. Be blessed and encouraged.
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The choking sensation would probably go away if you switched to an adjustable-frame bed that could be raised at the head. It would not only let gravity help solve the problem, but might also make it easier for her to breathe.
I changed to this kind of bed about six months before the death of my fiance, and I honestly think it was one of the best things I could have done to make him more comfortable, especially when he deteriorated to the point that he needed supplemental oxygen.
At least check it out. Almost every mattress store sells these frames and the more-flexible mattresses that go with them—and they are the ONLY kind that some companies such as Mattress Firm now sell. Box springs are not required.
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I would suggest that her doctor evaluate her or get a referral for a neurologist. "Choking" symptoms may be related to some impairment of the brain for swallowing or of the structures of the throat. Try a foam wedge that reaches down to midback or waist or putting the top of the bed on some blocks. They sell these at Bed, Bath, and Beyond or Walmart, so the head of the bed is higher than the foot.
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Has she been tested for Parkinson's ? All the symptoms and many more that may be going unnoticed are symptoms of Parkinson's . The are many medication that could be tried to treat her symptoms . Please discuss this with the family doctor and request referral to neurologist and/or movement specialists!
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Thanks for all of the advice and concern. I'm not sure whether it is just a mental condition or if there is something physical going on. I have been avoiding getting a hospital bed since it would probably end up in the living room. But maybe that is where we are heading. I do think raising her head would help. The other reason for my hesitancy is that she has had a number of ailments that seem to disappear after awhile for no reason. I have been kind of hoping this situation might pass on its own. I think the constant up and down is probably a form of OCD. We have been to so many Doctors and taken so many tests I'm more focused on making her comfortable. Her heart is fine, there is no sign of cancer or UTI, or any other serious condition. It just seems to be her balance and overactive bladder, plus some early dementia. I have been struggling with the question of whether to put her in an institution of some type, which she would hate and which I don't want to do. But it is really wearing on me.
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The choking sounds postural.. like when people snore or have sleep apneoa if lying flat on their back.

Have heart issues or stroke been ruled out? I don't mean to alarm but these can cause problems. I have seen sudden choking (someone with both issues). Saliva going down the wrong due to swallowing difficulties? Build up of fluid in lungs? I am not trained to know. Sitting more upright does seem to help though.

Strange your wife won't...but then, maybe she feels dizzy when upright?

The getting up & down so often could be obsessive thinking? Then again, symptoms of an UTI may be causing increased urge/frequency?

Are you wanting to start the merry-go-round of doctors, tests & specialist appointments towards treatment & cure?

Or are you more looking to provide relief of this symptom for her?

I think getting a good night's sleep should be moved up the priority list. For both of you. I hope you can find some advice that works.
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OldDog, seconding what Barb said about asking for a bed to be prescribed I'd add that it's important to get a proper one with the full range of movement. Adjustable beds in the ordinary sense only allow you to raise your head and torso; whereas a hospital bed can be tilted at the head or foot as well, and has a knee lift so that you can stop the person slipping down the bed uncomfortably. And of course they go up and down which is helpful both for reaching to support the person in it, and for helping her to get in and out of the bed. Don't buy in haste!
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RetiredWorking2 Oct 2021
You are absolutely right. I had a hospital bed for my mom post surgery. She stayed with me for several months after her operation and it was a benefit to get in and out of bed and to sleep comfortably. That was 10 years ago and I think I am going to get another hospital bed since she's 98 years young and coughing up phlegm every night. I put her pillows at a angle and give her hot turmeric tea at night with lemon. We also added a little Vicks to her chest. She's sleeping better and gagging a lot less. Thanks so much for reminding me about the hospital bed. Your post was a blessing and I am so grateful that I read other post for your concerns.
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My dad had actual choking issues for which the doctor prescribed nitroglycerin. They were caused by muscle spasms, and while he wasn't truly choking, sometimes food got hung up where it shouldn't be. The nitroglycerin stopped the spasms in his throat and esophagus.

Your wife might be having similar spasms. It's worth having her checked out to determine what's going on.
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OldDog, does your wife not have a hospital bed, ordered by her doctor and paid for by Medicare?
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Olddog, has any doctor recommended trying dramamine?

This happened to one of our pets and the dramamine really helped her with her balance.

Not comparing her to an animal but, the ears are very similar and when we lose those bones that are for our balance we walk like we have had to much to drink. So did my dog. It helped her readjust and she walked fine for 5 more years.

Just a thought.
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Cashew Oct 2021
Some doctors do not prescribe Dramamine (and Meclizine) to people aged 65 or over because it may produce an increased effect of dementia and amnesia and lead to greater confusion.
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There is a neurological issue called globus, too, which could be related to brain function problems. Trouble is, I'm not sure it would help even if this could be confirmed or ruled out because your wife isn't in a position to understand and therefore be reassured by explanations. I'm also not sure if anything can be done to relieve it - I'll have a look-see.

Otherwise, I second the idea of a hospital or "profiling" bed - useful for both this situation and future reference.

Here you go - basic but clear leaflet for patients at https://www.hey.nhs.uk/patient-leaflet/globus-sensation/
Hope you can access it okay.
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OldDog4321 Oct 2021
Thanks. I read the leaflet. I don't think she has Globus, but I'll try to see if anything seems to fit. I think if I could get her to sit more upright it would help, but she is pretty uncooperative. I think I will look into an adjustable bed, if I can find one for a reasonable price.
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Thanks to all who responded. Yes, we did the Epley Maneuver, which is good for vertigo, but it won't help her condition. He problem is caused by an inner ear sensor that is no longer functioning. The experts tell us it is permanent. She does have a walker that she uses to get to the kitchen for her meals. Her "choking" doesn't occur when she is eating or drinking. She complains of it when she is just in bed. We don't have a hospital bed or an adjustable bed; that might be the next step since she refuses to let me put pillows under her head. I know her immobility is not good for her, but she flat out refuses to do anything. About the only exercise she gets is getting on and off the potty chair. I think a lot of it is mental. I have detected some early signs of dementia. She constantly wants me to get her out of bed to the potty chair, then back in bed again, very much in robotic fashion. This sometimes can be every few minutes. I ask her why she has to go again, and she just says she "has to," only occasionally actually peeing. We have had a variety of physical therapy, but they have all "fired" us because she makes no effort to improve. I have caregivers come over for some nights, but the moist recent one just quit; she couldn't handle the constant up and down all night. Not sure where this is headed, but thank you all for your suggestions.
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Daughterof1930 Oct 2021
Your wife is blessed to have you. I hope you’ll be able to find caregivers so you can practice self care. You getting out and doing positive things for yourself is important too. Ask her doctor about meds to help her be calm for night time sleep
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There’s a test called video fluoroscopy that examines swallowing. This will give you more information on whether your wife can adequately process liquids and solids both. Has your wife had the Epley Maneuver for her balance issues? My dad had this a few times while dealing with extreme vertigo and it was a huge help, really fixed the issue after doing it a couple of times. In his case a chiropractor who was well trained in this did it. Does she have a rollator or walker? Staying in bed all the time is dangerous territory as muscles and skin break down. I hope you can find some answers to have her getting up more
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If she won't agree to more pillows you can try putting small blocks (2" -3" high) under the legs of the top of the bed to see if that helps.

Swallowing problems do occur in the very elderly for a variety of reasons. Besides altering her food, physical therapy might be an option depending on the diagnosis and if recommended by her doctor...and she is cooperative.
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I would discuss this with her doctor if it is a new occurrence.
Is she in a Hospital bed? If so try raising the head of the bed. That will gently raise the torso rather than an actual seated position.
Does she have problems with thin fluids? It is possible that fluids need to be thickened. If fluids are going down the trachea rather than the esophagus they can end up in the lungs and this can lead to what is called Aspiration Pneumonia and it can be fatal.
This should be evaluated.
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