Mother with Parkinson's is choking a lot. Is there something I can do?

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My mother in law had the same issue, would cough and choke when she was eating, it was like water or food was going down the "wrong hole" so to speak, it would cause a coughing fit. Speech Pathologist came out, determined she had esophageal dysphagia. Her throat was damaged during a TEE where they had to intubate her, making swallowing difficult. They put her on what's called a "slick" diet....she has to take pills with something soft like pudding, yogurt, applesauce, etc. and when she swallows, she has to lean her head forward. Everything she eats must be soft foods, noodles, gravy covered, wet down and soft foods/soups for now. We have a whole list of foods to avoid. No nuts, cookies, crackers, or larger peices of meat, anything that can scratch her throat going down. She also can't drink with a straw or out of a bottle, she has to drink from a glass, and always has to put her head down when she swallows. They said if water or liquids were to go into her lungs, it could cause pneumonia.

Parkinsons Disease and nerve issues could cause problems like dysphagia. My mother in law had a stroke, and the muscles and nerves that help move food through the throat and esophagus were not working correctly.
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My mother, now in a NH, has had Parkinsons for 15 years and has pretty much full blown dementia. She had another stroke a few months ago, went to hospital and was returned to the NH deemed palliative. Since the stroke her voice is low and gravelly and sometimes she can't get the words out. She has bouts of coughing from time to time. The last time she saw her own doctor in the city, 2 years ago, he said there was nothing more he can do for her.

Day care and visiting therapists is impossible as she can't sit up or stand alone. I can't lift her, the nursing home staff aren't allowed to help get her in the truck and I have no-one to help. In any event, with the dementia she'd just throw a screaming tantrum and refuse to co-operate.

Meal times are thoroughly supervised and when a resident can lo longer feed themselves they are moved to a separate dining room where they're fed by staff one on one.

I can't/won't run down there to feed her every day as she's an A1 narcissist, rants and raves at me all the time and my health has been suffering. She's a vegetarian which doesn't help. Right now she weighs less than my big labrador and keeps trying to get out of bed or her wheelchair and ends up on the floor. The NH staff are fantastic but I think she's beyond help at this point. I don't think she can go much further.
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I cut my mom's food up in small pieces, serve mostly soft foods that are easy to swallow, and listen for choking alot. She loves Ensure type products. There is also a free program at a local hospital for PD patients, I believe it's called "Speak Loud". It is designed to help speech and swallowing. Look into these programs.
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Another suggestion is to consider adult day care for your mom so that someone is always with her when she eats. There is a day care for individuals near our new apt for individuals with Parkinson's. There is no charge and it is run by the state affiliate of The National Association for Parkinson's. Take care of yourself.
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Is your mom's neurologist a movement disorders neurologist? If not, you might want to think about finding one and possibly changing neurologists. You need a neurologist that specializes in Parkinson's and movement disorders. Keeping the chin down is a suggestion my husband uses as he needs to keep his head facing forward. Swallowing is harder for him if he turns his head. Great suggestions in the other answers to your question. If your mom is on Medicare check to see if it will cover a speech therapist. I crush my husband's pills in applesauce and that works for him. Look into nutritional supplements for your mom such as ensure. Look for a Parkinson's support group in your area. There will be lots of suggestions and ideas from members. Do call visiting nurses. If the neurologist does not support this idea, call you mom's primary Dr for the referral if you need one for visiting nurses. Will the insurance co pay for the other swallowing test if your mom's primary writes a referral to that hospital? We have a HMO and Tom's primary Dr does an yearly referral so we can see a movement disorders specialist that is outside of the HMO. We had to justify why Tom needs a movement disorder neurologist instead of a neurologist. Trying to get the needed services and dealing with insurance is frustrating. Don't give up, you mom needs only the best care.
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Here's what the National Parkinson's Foundation says about choking. Lots of good tips on here.

http://www.parkinson.org/About-Us/Press-Room/NPF-In-The-News/2013/January/Difficulty-swallowing-can-be-fatal-for-people-with
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Ask the therapist if she can recommend any ways to avoid or minimize problems. Some of the things my husband was told:
Sit up straight, in a hard chair (not the recliner)
Chew very well, swallow, and swallow again before putting more food in the mouth.
Tilt the chin down toward the chest (this one works for me if I get a pill caught in my throat.)
These suggestions were based on my husband's test. Ask the therapist for suggestions for your mother.

Also ask if a different consistency of food would work better.
Would it help to thicken her beverages (there is a product made for that purpose)?
Might she do better with her food pureed?
Would crushing her pills and adding them to applesauce be easier?

I hope you can come up with some improvements for your poor mother. Being afraid to eat would be very distressing!
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bbljenny, I hope you have a visiting nurse to help you. and have them do an in-home evaluation.
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Do you think she would do better with liquids? You might try a blender just to get some nutrition into her for the night. And you can talk to her doctor tomorrow about what other options you have for the swallow test as far as the insurance. Does her doctor know you are having to give her the heimlich maneuver once a week?
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mom had the swallow test her neurologist said it was fine the lady taking test said no it was not fine and she said need another from a different hospital that had a better test but moms insurance cant go there. I give her hymlic once a week or she throws up everyday mostly pills stuck in throat therefor her Parkinson symptoms are worse. she only eats now to take pills and is afraid to eat at all she says shes came so close to choking to death. she is losing weight fast and I cant be around every time she drinks or eats.i am only child and have to work. I don't no what to do.
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