Mom has dysphagia and it is so hard to feed her because she doesn't like the pureed food. Any tips?

I went through this with my dad last year. He was put on a pureed diet and hated it. He died after a couple of months. In retrospect would have had him eat normal food. He would have enjoyed eating more, and not lived that much shorter than he did anyway. What be miserable eating to add a few more weeks?

Pureed food sounds and looks unappetizing, but soups sound great. You can heat up the pureed meal and serve it as a stew/soup dish along with a soft bread or crackers. Also the smoothies that lynina2 suggested are a great idea for calories. My mom loves both.

when my dad went on pureed foods he began to eat much less. I urged him to eat. He replied, would you want to eat this s_it? I laughed as he was very prim before and didn't talk that way, but his moxie sort of made me feel he still had life in him.

Some doctors said, have your loved one eat whatever they want. Sure, it may cause swallowing problems, but their last months will be happy, they will enjoy eating. We didn't do that with my dad as we wanted him to last. I sort of question the wisdom of that now

cream soups are good... crackers get soft... any type of pill that cannot be crushed I make sure her water bottle has that nothing can fall into the bottle. salisbury steak, mash potatoes. My mom has it as well. Medicaid initially would not renew her dentures being replaced, but we submitted claim as a medical need not cosmetic because her food has to be ground (chewed) fine to entertain the hiatal hernia. She finally got approved. She chews better now. (just in case that may be an issue)

Blended drinks can be made by adding different foods to make it more nutritious - try something that would be appealing and able to swallow in tiny sips even.

I used to make mom smoothies made with ice cream, yogurt, frozen banana, milk, frozen strawberries/peaches, and 1/2 packet of Carnation instant breakfast. She enjoyed it quite a bit. I would also try various "cream of" soups (add thickener if necessary.)

My friend had dysphagia also and refused the puréed foods. My belief is quality of life vs quality when they are 89 or older. So I let him eat regular food. He went for a year like this when he became sick in Jan 2018. After a week in the hospital which they gave him puréed foods only and then isolation in Skilled Care where he received puréed foods, he didn’t know that regular food existed anymore. Once back in the dining room, I kept fresh flowers on his table so he had a hard time seeing what other people ate. He lived another 15 months on purée and just passed away last month. I was happy I didn’t force the purée on him. I think he lived a lot longer. I fed him lunch and dinner every day and watched others wither away. You do what you can do, but at 89 I would let her eat what she wants. Make her happy. To me that’s all that counts. If she is happy it will make your life much easier. God Bless.

Do you think cameras in NH would help? I read about residents not being fed and it scares me. Should family go at meal times themselves to feed a parent? Just curious about this.

Toward my mother's end, it was too much effort to chew a lot. So the home she was in made sure the food was soft- cooked things rather than raw, etc. There was a time when she failed a swallowing test and was ordered thickened liquids. She would not drink. With quality of life and her love of black coffee important for someone whose situation would only get worse, we overrode the thin liquid, realizing that she could aspirate. I am glad we did that as for the next 5 years, she never had aspiration pneumonia. Up until the end, food was about all she enjoyed and sometimes needed assistance eating and sometimes did not. The last week of her life she was not really interested in eating and seemed to have lost the ability to swallow. She was in a small memory care/assisted living place (I detest the word facility) with Hospice support for two years. Not all food is bad and not all care homes are uncaring as you suggest. You just haven't found the right one.
Many times there is not a clear idea of what our loved one would want. While we might understand DNR or no tube feedings; the whole feeding thing is stressful. I believe let them eat whatever they want whatever the risk. What is the point of anything else at this point in life?

Such a terrible things... dementia, Alzheimer's...and so unfair. I'm so sorry you are going through this. Over the past year my Mom had a few episodes of water retention which landed her in the hospital. First 2 times her lungs were fine. The last time, this past January, she had high blood pressure, low oxygen and was starting to aspirate her food. Her lungs were somewhat cleared during her last hospital stay...but filled up again after eating and before leaving the hospital. She was given 1 week to 1 month and passed away the following day in the hospital.
Dementia robbs its victims of nearly every single thing and I have found peace with my wonderful Mom being gone. As I said before, I will miss making her happy, forever.
We were very lucky to have found a wonderful memory care/assisted living and had planned to have her go back there under hospice care. I know there are certain terms that someone must be in a skilled nursing...but she was not at that point.
It's tough and so unfair and every single victim is different. I wish you the best. We have to be great advocates for our loved ones, no matter where they reside.

My father had some problems chewing and sometimes swallowing, partially because of the deterioration of his teeth and partially because of Parkinson's. For Dad, just cooking things to a very tender stage was enough; he hated pureed anything. I basically boiled beef and chicken in some savory broth until it would separate and mush with little effort, then use that meat in recipes since most vegetables cook soft enough. Vegetable beef soup, chicken noodle soup, meatloaf, beef tips, chicken and dumplings, chicken pot pie, etc. along with vegetables cooked until soft with seasonings and butter to add flavor and very ripe fruit became diet staples. Dad loved baked potatoes (white and sweet) and baked apples so he would also eat those. Soups had very little broth so the were more like stews. He also loved puddings, milk shakes and smoothies. When Dad went into MC, I prepared food at home and delivered frozen single servings to the MC each week for his dinner and the staff would reheat. My brother purchased his lunch from grocery store hot bars during the week until CHF got bad enough Dad needed very low sodium, then brother purchased fruit and we added other foods at the MC. He could and would eat some food the MC served, but preferred to depend on something we brought in as his main meal. Not sure if he liked my cooking that much or just the extra attention from requesting "something my daughter fixed".

We were lucky that Dad remained able to feed himself so the MC staff was willing to spend a little extra time heating something up in the microwave; the 24/7 kitchen was a "feature" of his MC so getting a milkshake or smoothie was included in the basic service/price. It probably also helped that my brother went almost everyday for about 6 hours.

I hope some of this is helpful.

I tried a lot of mom's food, sometimes it was awful but that was when the cook was having a bad day and everything was awful, mostly it's just hard to eat smooth textureless food for every meal. Also with a regular diet there is a difference between roast pork, pork chops and spare ribs, or between baked potatoes, scalloped potatoes or mashed potatoes, but once they are modified they are all the same so it's hard to have any variety. Some things just couldn't be pureed so there were substitutions and that drove me crazy - don't tell people lunch is grilled cheese and bacon sandwich and then bring them a plate of pureed cottage cheese with "bread pudding". And then there were the strange things like pureed caesar salad - it actually tasted like it should, but really, would you want to eat that more than once?

Our nursing home grouped those needing assistance together and usually one PSW sat at a table of four, two of those might have needed to be fed while the others needed coaching. What was eaten was charted at every meal, nobody was doing without unless they refused to eat.

My mom also on puree food and this is not true that NH does not feed the patients, they do have speech therapists, who do this especially with a new patients on puree. For my mom, who has a dementia and does not understand that she can not eat not a puree food the main thing is to be seated only with those who eat also puree. If she saw somebody eating normal food, then the hell started...Sometimes helps when I tried her food and say thats its eatable. But its eatable, at least in her NH. But overall its very hard, especially if its happened suddenly. I suggested to find a speech therapist there and work with her.

I sense, you wonder if it is necessary as well as difficult. My first action would be to find out why the sudden change in diet. Next if the reason is logical, see how it can be changed to make it enjoyable for your mom.

When my mom was moved from an AL facility to NH, they did a swallowing test, and said she choked on water. Therefore placed on thickened liquids.(I believe thickened liquids are for people who will regain swallowing ability) So I explained my mom was just doing fine drinking and eating a mechanical soft diet. The mechanical soft was ordered because she would tire of chewing and stop eating. She has had no choking episodes in the 4 mos at the NH.

Next food battle: enhanced diet. Mom has been losing weight, so they have given her protein enhanced food, as well as double portions. She eats anything that touches her lips, including her toothbrush. She is overweight. She is in bed most of the day and transferred at times to a broda chair. She is 15 years into dementia, 11 years with an actual ALZ diagnosis. She is losing weight because of the disease process.

I keep my mom out of nursing homes because staff will not spend the time to feed the patient. That's a possibility why she has been losing weight--they simply forget how to feed themselves. My mom takes over an hour to feed her and with infinite patience. I knew a woman who put her mom in a nursing home and she lost a lot of weight. I told her take her out of that institution of death because they are not feeding her right and simply chart "refused" so they go downhill and slowly starve to death. She took her out, started gaining weight because she has a daughter who is willing to care for her mom. However, she also has family support who contribute to her care.

Yes my mom has end-stage Alzheimer's and yes she has swallowing issues..BUT she can still eat using thick-it and ***infinite patience** feeding her. As for her swallowing issues--her latest chest x-ray just last Saturday showed clear lungs. So I am doing something right.

A nursing home will simply chart "refused" and that's the end of that story.

There are several reasons:
(1) Probably because the food tastes like puke.
(2) You will most likely have to feed her with INFINITE PATIENCE (it takes over an hour to feed my mom, often 1-1/2 hours for a single meal).
(3) If this is new behavior check for infections such as UTIs.

My mom has very end-stage Alzheimer's and she does great with extremely heavy ice cream mixed with HIGH quality protein shakes; I MUST feed her. I mix in some thick-it. Separately, I crush and mix her routine medications with honey. I include a crushed multi-vitamin with iron mixed with honey with lunch (separate from her regular meal). Mom is an insulin-dependent diabetic but her sugars are always great despite this kind of diet. Then again I know how to deal with her insulin so manage her sugars very well.

Isn’t sometimes not eating also a result of wanting to let go? I tend to think if this happens to me I’ll be the stubborn old lady who says, “This is what life is now? Oh honey, I’m ready to go then.”

Clara, has your mother only just moved into this nursing home? Did something happen that took her there, such as a stroke or anything like that? It's just that your profile states that she lives at home, so I'm guessing the change is very recent, that's all.

Is it practical for you to be with your mother every single day? If it is, and you can keep it up, then one solution might be to prepare the foods you know are her favourites, and then either pack them into an insulated carrier or bat your eyelashes at the staff and see if they'll let you reheat dishes in a microwave.

Almost anything can be *made* to be honey thickness at the point of eating, with a firm hand and a fork and some gravy or sauce; but for the NH kitchen and the staff this would not be realistic.

And, of course, there's soup: infinite variety of flavours and vitamins to be packed in there and blended down, with lentils or eggs or milk for protein. Ice cream, full-fat yoghurt, custard, egg flips and fruit fools - there are plenty of high calorie snacks that would meet the swallowing criteria. But the key question: what does your mother really like?

Sometimes dysphagia is part of the dementia progression. As the illness progresses, the complex muscle control needed for swallowing fades away. I don't know where she is in her end-of-life process, but there also comes a point where the body isn't making use of the food and where food can even cause discomfort because the belly isn't digesting it well. Obviously I don't know this patient's situation, but I have too often seen nursing-home patients who compliantly eat when someone they love is feeding them, and then refuse food at other times, complaining that they're not hungry and really don't want to eat.

It's a tough time for all concerned.

Adding this to the question from clara190

What would cause her throat to be too sore to swallow? She's saying her throat hurts, wether it's warm or cold it's something that hurts her throat. Is that normal for somebody going through Dysphagia?

I don’t know if this would work for everyone, but I was caring for a woman on puréed food as well. She hated it. So I spent some time figuring out how to purée foods that she loved. I added marinara and blended pasta and lasagne, milk or cream and blended oatmeal, grits, and soups, sharp cheddar and enchilada sauce to Mexican dishes. I made sure to add spices. Then I tasted all of them to make sure that the flavor was delicious. I always told her exactly what she was eating, and that I had tried it. After the first two weeks of refusing food, she ate normally again. I don’t know what the deal is with commercial puréed foods. They taste bland, and have a strange texture. You can’t make all of her food, but maybe one meal a day. Milkshakes help on days that she won’t eat. Good luck. It is really touching how much you care.

Honey thick refers to her fluids, her solids would be one of the National Dysphagia Diet Levels:

NDD Level 1: Dysphagia-Pureed (homogenous, very cohesive, pudding-like, requiring very little chewing ability).
NDD Level 2: Dysphagia-Mechanical Altered (cohesive, moist, semisolid foods, requiring some chewing).
NDD Level 3: Dysphagia-Advanced (soft foods that require more chewing ability).
Regular (all foods allowed).
Modified Regular Food Diet

If this is new they may still be experimenting to see what works best and willing to alter things a little. Try to meet with the dietitian to see what changes you can make, and ask for a supplement to boost calories.

I've got to say that wrangling over the food was one of my constant stressors in the nursing home. Lunches were the most awful because the meal mostly included things like sandwiches and salads - these do not puree well🙄. Because of the way meals are structured it was impossible for the dietary aides to be flexible and allow variations to the diet plan, so although my mom could handle some items that were not pureed they were never offered - I just rolled my eyes and said I understood and took responsibility as I fed her crackers with her soup or asked for a side of potato chips. You may find that she's doing better with her other meals, breakfast oatmeal isn't too different when pureed, mashed potatoes are familiar, soups should be acceptable etc.

Just popping back to add that I watched a couple of ladies whose families over rode the advice of the dietitian and insisted on a regular diet - the poor dears couldn't eat at all and staff were powerless to do anything about it.

Have you tried the putrified food? If not you should. Then you can understand why she won't eat it. Most of that stuff is horrible. I tried Luz's and it was awful. Only the french toast was what I would call edible.
I would suggest you bring in some soft foods she might eat. Like puddings, etc. Or maybe you could find the right seasoning to give it some descent taste.Experiment with it at home. Sweet potatoes Maybe, etc.
Good luck.