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It seems as though the nursing home is being very diligent in encouraging the patient to eat- specifically to finish her nutritional drink. After she finishes, the family has often observed what seems to be gastrointestinal distress- slight vomiting, crying, moaning- things like that. She does settle down after a time but it is hard to see her in distress.


She is having trouble swallowing solid food. It was explained to us that this is sometimes a symptom of Alzheimer's. The body is not getting the proper signals to initiate swallowing. I wondered if the same thing might be happening in her gastrointestinal system. Maybe her stomach isn't emptying as well as it should or something.


I am not family so my questions to the facility are unanswered. I just wondered if someone with advanced Alzheimer's can be allowed to choose whether or not they want to eat. I imagine if the drink were left with her and she could work on it little by little, that might help. She can still feed herself- except for swallowing the solid food.


When the drink was brought to her, she indicated that she did not want it but was strongly encouraged to finish it by the dietary staff member. (It seemed like the staff member wasn't allowed to leave until it was finished.)


However, there may be laws requiring the facility to ensure she gets the proper amount of nutrients. And the patient's husband most definitely wants her to eat. He thinks it will make her better and 'then she can go home'.


This is hard to watch.

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Her body could be shutting down and eating is causing her distress. Like said, swallowing becomes a problem when ALZ reaches the part of the brain that controls it.
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It is hard to watch. If I were you I'd make a formal report of it. There is a line to be drawn between 'encouraging' and 'forcing' - the first is good, the second obviously isn't - and I respect how difficult that can be to judge; but if you are witnessing distress on the part of the person, and if she is actually being made to drink so fast that she belches or vomits, this has clearly crossed the line. Don't get mad, don't make accusations, just get out your whistle and blow.
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anonymous594015 Jan 2019
Thank you Countrymouse. The Dietary department did speak with my husband. They explained that since she is losing weight involuntarily, they are required to document their actions with feeding. They agree that she shouldn't be forced to eat. They will speak to the aide that encouraged her so strongly to finish the shake. They told him that sometimes she drinks the shake so quickly that they have to try to slow her down. So....it goes both ways.

They cannot leave the drink with her to sip as she is at risk of aspiration or choking. They try to assign an aide to sit with her but when short staffed, it is not always possible to take as much time as they would like.

I understand that. Her roommate is too weak to lift a fork to her mouth and needs to be fed. They are doing their best. Thanks for your reply.
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