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Dad just came home from nursing home with a feeding tube. Unable to walk. My mom is arthritic - difficult for her to attend to him. Nursing will be coming in to assist. Dad cannot have any food or liquids by mouth. He is insistent that he CAN eat. We are concerned because this can lead to aspiration pneumonia. Dad won't listen to anyone. Any suggestions? We feel he may have been discharged from nursing home a bit prematurely.

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Just some thoughts. Coughing definitely can be a result of acid reflux which can also lead aspiration pneumonia. Feeding tubes are notorious for this. Yet acid reflux in and of itself is not a reason for putting in a feeding tube. Did he have the reflux before or after the feeding tube? Does he have a nasal or a PEG tube? He should be on a stomach acid reducer so any burning from the reflux is not as bad and sleeping or resting in an elevated position to cut down on the reflux as well. May be he should be referred to a gastroenterologist for an endoscopy to make sure what is causing the reflux if it was occurring before the tube placement. Sometimes bronchoscopy is done to "clean out" the lungs from aspiration pneumonia, too.

Best regards.
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If the nursing is not beeing helpful and understanding your concerns call the Board of health in your state they will have to follow up looking into this matter and make a reconmadation and do as the others have suggested call his doc and tell he can not be taken car of at home if he will not comply did they even teach his wife how to do the feeding and giving of meds and have her demestrate that she can do this proceedure even nurses in hospitals run into trouble at times. They are so much in a hurry to throw people out now a days the social workers have so much education now and less common sense. Let us know how things go your experience will go a long way to help others-I have had to fight the system many times our regular nursing home started to refuse my husband which was the best thing to happen he went to another where the social worker was so great she was a God send to me-she got it and we became good friends.
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I want to thank everyone for their input on my mom and dad's situation. This is the first time I've ever used a message/blog and I am very impressed with agingcare.com. When going through situations with aging parents, one forgets that there are so many in a similar or more severe situation.
Outside staffing has been coming into my parents' home this past week. Speech therapist believes my dad has acid reflux and a possibility of a diverticuli on the side of his throat area, which she says could be causing the coughing. She had some very negative opinions about his aspiration pneumonia. She gave him a trial of water, apple sauce and apple juice. He began coughing only with the water...
The bigger concern now is my mom. Bless her heart -- she's a trooper but we can see she is looking tired and her arthritis and fibromyalgia has exasperated. My dad is demanding, particularly towards my mom. Changing his diaper and dealing with hygiene has been a concern, too. My niece has been going over in am and pm to change him and get him into bed...my dad's getting a bit "lazy." We've seen him do things on his own but on occasion now, he'll say he can't.
Really, at this point, we're concerned about my mom. Yet, how can we say, "dad, this isn't working out at home..."? Very difficult.
Family dynamics are quite interesting right now, too. Stress, emotions, finger-pointing,...come conflict.
Very difficult...
My appreciation and love goes out to all of you. Blessings and encouragement to you. We all need to stay strong and support one another.
Prayers go out to everyone.
B
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Perhaps keeping his stomach full via the tube would to a degree help alleviate his desire to eat. Of course, that may lead to other difficulties, but at least you'd worry less about him choking. Good luck. V
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i am in agreement with kitty. you should talk to everyone who will listen and ask all the questions that you can to try and understand why he was discharged from the nursing home to go home. especially when your mother is arthritic and will have difficulty tending to his needs. and as far as his being able to eat. when was the last time that a "swallowing test" was done. that is a test that is done to tell how a person's swallowing capabilities are. and yes if he says he can eat you should try and have that reevaluated and get him on a puree diet with soft food and shakes. we did that with my mother-in-law when she got to where she could not eat solid food anymore. in the end she had a feeding tube but by that time she was in a coma-like state due to a frontal lobe stroke. my prayers go out to your and yours. chin up.
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Tell him in the nicest way you can that you are in charge while he has this tube and the answer to eating is no, I went through a similar situation with my mom who has copd, I took away her cigarettes, she told me she hated me but that only lasted a couple of weeks, now she feels better and we are back to normal. so if he says mean things, do not take it personally, he will get over it and you know he loves you, you have to do what is best for him, lots of hugs
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You haven't said he's demented. Maybe he does understand, and he'd rather eat, take the risk and possibly die, than live a lot longer unable to walk and with a feeding tube.
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So does he have a condition where it is not possible to eat by mouth at all? When my mom had a feeding tube I still requested she be given soft foods by mouth. It all depends on the individual patient. Aspiration pneumonia is just as likely because of the feeding tube not because of eating by mouth. Patients need to sleep elevated to prevent aspiration regardless of whether they eat by mouth or not.

It is not unusual for a patient to be sent home with a feeding tube. The patients are discharged to their "home" after the procedure, whether that is a nursing home or their personal home. There has to be someone who can take care of the patient wherever they are sent. The nursing home may believe that the nurses coming to the home are sufficient. As far as a nursing home discharging your dad, I am not for sure what to think of it. I would definitely talk with their patient representative and your dad's doctor about the situation as well as learn as much as possible about feeding tubes and your dad's particular need for one.
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If Dad is able to get up and attempt to fix his own food that will be a big problem. Can't take food away from Mom. Is his mental status such that you can talk to him and explain the consequences if he tries to eat? If not, I would really consider placing him back into the nursing home.....if that is out of the question.....how about around the clock assistance from an outside agency? Good luck......
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can u call the doctor/nurse who was in charge of his care/discharge?
write down a list of any questions u might have,
the name of the person who discharged him-the doctor/nurse/
the name should be on his discharge papers-
if not if u call, all of that is on record- whether they are going to be helpful or not is another story-
but if u can speak to someone there- they should beable to tell u.
maybe contact the patient advocate-usually there but for some reason, no one tells u that.
be strong- and persistant- u have a right to get the info u need to care for your dad-
good lock-
k
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If you feel your dad was sent home too early - follow your gut!!! - especially if your mom can't handle him at home. Watch for signs of trouble and at the first sight - call the doctor and see if you can get him admitted to the hospital. If you get him to the hospital, tell everyone there - anyone who'll listen - the doc, the nurses, social services - ESPECIALLY social services - that he's not getting the care he needs at home. Hopefully, they'll send him back to nursing care or rehab.

the eating thing is difficult. he probably craves food - can he have candy to suck on? anything that will dissolve but isn't really "substantial" food? I wish I had some advice but that's a new one to me. Best of luck
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Oh my gosh, how awful that would be to suddenly NOT be able to eat normally after decades of not having a problem? Is there anyway of explaining to him exactly what's going on with his esophagus that makes it impossible to eat anymore? Can he have absolutely nothing? I mean can he suck on a lifesaver for instance? It would drive me around the bend if I could NEVER put something in my mouth again.
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