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Hi. My father has been dying for a few years but seems immortal. He has trouble eating now. Today, I reheated some lima beans for him. He coughs often with eating and was per usual. But, then he stopped coughing but was still making the motions one does when they're trying to cough. He looked to be in distress. I asked, "Are you choking?" I said nothing. He didn't shake his head either way. I then asked, "Can you breathe?" Again, nothing. I told him "Stand up. I'm going to give you the Heimlich." I said it again, and he stood up. I made three thrusts under his rib cage by standing behind him. Nothing came out but he started to cough. I then turned to face him and could see his mouth was full of food. I picked up the plate and said, "Spit it out." This time, he shook his head no and kept chewing. He couldn't explain anything but later, when I asked again, he said, "I couldn't swallow." I've heard this is common with the dying especially those with dimentia but did I do the right thing? I followed the protocol for people choking but he can't communicate normally.

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You can buy that powder in any pharmacy, you don't need a prescription. It's call Thicket. It can be used with fluids to possible avoid aspiration. Unfortunately, many people don't like this consistency, stop drinking, and then become dehydrated. I would agree with considering a hospice evaluation. You don't need a doctor's order, you can just call them yourself. They can tell you over the phone if he meets criteria. And yes, they will come to the home for an evaluation. This is covered by Medicare, they will tell you during the eval. Good luck.
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He also could be aspirating which could cause pneumonia. This may come toward the end of a person's life. When my husband was in hospice care in our home, the nurse had me buy a powder to thicken what he drank and it helped. There is also a little cough when one aspirates.
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Is he getting Hospice services? It may be time to ask for that evaluation to be done. I believe that they will come to one's home.

Not remembering how to swallow, I'm told, is a sign of late stage dementia.
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The coughing is a sign if I remember correctly. Maybe that's what you are saying cwillie. Some evaluations can be done in the home. Its speech therapy I think.
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Then you need to take steps to educate yourself about swallowing problems and what you can do to help. You can't just keep feeding him the same old foods knowing full well that he can't handle them, that would be neglect. It may take a lot of trial and error, but you will eventually be able to come up with a diet plan that is both safe and palatable. You mention that he was coughing "per usual", which tells me he has been having difficulty for some time. My mom didn't have a swallow study either, but she also no longer eats burgers and fries. I figured it out by reading everything I could about dysphagia, so can you!
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Can't say that I blame him.
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He refuses to go to the doctor.
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If the food or liquids go into his lungs it can give him pneumonia and he will be in serious trouble very soon. Be careful with straws. Get him the swallow test ASAP.
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Often in the later stages of dementia people have difficulty swallowing (called dysphagia), but it doesn't necessarily mean they are dying, just that they have entered a new phase. My mom has also had episodes of choking, usually not totally blocking the airway but where food would not go down nor could she get it out, it's scary!! You must mention this to his doctor and ask for a swallow study, they can watch how he eats and make helpful suggestions. You may need to modify his diet, he may need his food to be moister, mashed or minced. He may be having problems with liquids too, often they choke on thin liquids like water but are fine with thicker things like smoothies. There are many products available to help with this, and there are many many tips on this site from others who have encountered the same problems. Try using the search box and typing in "dysphagia" or "swallowing problems". Best wishes!!
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