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My friend does not want a feeding tube and has a severe hiatal hernia. I need to know the safest way to allow her to eat as she always has but still keep the safety in mind. Surgery is too risky, probably would not survive the operation but is adamant that she does not want a feeding tube. She aspirates stuff in the lungs and it seems to lead to bouts of pneumonia. we just need to know how to help her eat more safely without any more surgical intervention

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Thanks to all who have responded to this everyone had something that was helpful
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Oh yes, we also make sure she is upright in her bed - she has a hospital bed in the family room and she is under hospice care.
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I'm not sure if this will help, but we are using a syringe to feed my mom a thickened liquid diet as she is in end stage alzheimer's and can no longer chew or even open her mouth very much. But she will suck on the syringe as we slowly depress the plunger waiting for her to swallow before more is given. My dad has gotten very good at making her smoothies using greek yogurt as the base. I hope this might work for you!
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Thank you for leads. She is 73, has had over three yrs of other physical problems and the last one the surgeon totally messed up her knee by doing something he had no approbate training to do….causing a break farther down her leg and left her unable to do most things for herself. She has a wonderful husband who takes great care of her, but she now feels she is a terrible burden on him..he does not feel that she is, but you know how that goes. The depression has been bad. She has just been released from the hospital now(entered because of pneumonia) and at this point they discovered the issue of the hernia. It does not have to be thickened and soft diet seems to be the ok, but I don't understand all the restrictions for chocolate, oranges,citrus etc…she do not have anything to irritate, just very narrowed passage way into the stomach now. We are both older adults and in a small couples group, so we are all trying to help her husband cope at this point . I feel they got sent home with very poor information. Thanks again for your leads for me
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Do an internet search for hiatal hernia diet. Lots of reputable sources such as WebMed and Mayo Clinic and other clinics have good information for your friend.

I am wondering if she has other health issues. How old is she? Why was a liquid diet recommended? And was it a thickened liquid diet?

Keep in mind that it is possible to aspirate on any diet -- even with a feeding tube one may aspirate saliva. So the goal is only to reduce the risks. One way to reduce the risk is to sit up perfectly straight when eating. Slumped on pillows or leaning back in a recliner increases risk. Swallowing twice after each bite helps (so food is completely cleared before the next bite.) That is all I can remember from when my husband refused a feeding tube, but Google how to avoid food aspiration for other tips.

Your friend is lucky to have you for support and encouragement.
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Is hospice an option?
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