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Hello. My mom has late stage Alzheimer's but she is very alert, and attempts to communicate. She can say up to 3 words now, but mainly gibberish talk. However, eating is a big issue. Although she lost some of her teeth, I am not going to ignore other factors that could contribute to this. Her right lip is drooping slightly now and she drools a little from that. Also, we switched her to pureed foods, which is better. On solids she used to keep a small piece of food in her mouth and not swallow it, more play around with it. The food was small enough to swallow but she kept moving it around in her mouth. This would cause more resistance in accepting more food. Also, 2 years ago she lost the strength in her voice, and it is more raspy. I am not sure if this is connected to the eating difficulty. So to sum up, she is doing better with pureed than solid food. She doesn't choke on solids but really resists them. I am still concerned her issues might be from more than not having enough teeth. I was wondering if other caregivers noticed similar issues with their Alzheimer's patients?

Yes this happens with late stage Alzheimer's (& other dementias) - called dysphagia as other have noted.

Having a texture she can tolerate & safely swallow is important to avoid asperation. Actual prompting to swallow becomes necessary - by verbal & non-verbal cues.

In later stage people will probably reduce intake to very small amounts of preferred foods only, custards, jelly, apple sauce etc.

Many people may benefit from hospice care from here on. Certainly support (from Hospice or other sources) for family is beneficial too. Many families will experience a new level of grief when their loved one ceases to eat.

Warm thoughts to you & your family.
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frustratedinny Jul 13, 2021
Hi Beatty. Thanks for your very helpful input. At this stage, she can still swallow larger portions, but the pureed food is tolerated so much better than even very small pieces of whole food. It's scary how, in the earlier stages of dysphagia, symptoms can be missed since she isn't gagging on food or drooling. We can tell ourselves she is struggling with eating due to have some missing teeth, or "she will eat when she is ready." I have gotten some really great advice from everyone on this forum. Thanks.
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I would ask her doctor about a swallow evaluation. I would not give her ensure priduvpcts if she has diabetes. Very high in sugar.
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frustratedinny Jul 12, 2021
Thank you. We will definitely speak with our dr. about the evaluation.
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Difficulty in eating, more precisely swallowing, is a common symptom of late stage AD. Pureed food can help. In late stage AD, your mom may have forgotten how to swallow, or it may cause pain, so she retains solid foods in her mouth. Does she swallow her meds whole? If not, you can crush them and add them to her pureed food. Some meds should not be crushed, ask the pharmacist. If you feel she is not getting enough nutrition, you can supplement her diet with products like Ensure. If you are feeding her, give her small amounts at a time and make sure she swallows it before offering more. You may even have to tell her to swallow.
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frustratedinny Jul 12, 2021
Thanks for or all of your suggestions. Since she can't communicate, we wouldn't know if she is in pain. Also, as I have mentioned, she plays around with solid food in her mouth and she doesn't do this with pureed food, which goes down much easier. Also I agree about the swallowing being a complex process. We take it for granted since we swallow so effortlessly. I have been reading about dysphagia. One thing about our mom, she doesn't choke on her food so I feel my brother, who is her guardian, might not realize that she could have dysphagia. Definitely asking about the evaluation.
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Swallowing is actually a very complex process and as dementia becomes advanced it is quite common for people to have difficulty. Medically it is called dysphagia, and if you search that term you will find all kinds of information. Aside from pureeing her food you may also find you need to thicken her fluids, there are special products for that available at your pharmacy (Thick-It ® or ThickenUp ® are two)
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frustratedinny Jul 12, 2021
Thanks for your very informative suggestions. As I have posted to sjplegacy, it is not very obvious since she isn't choking on her food or spitting it out. However, playing with her food in her mouth and having an easier experience with pureed food, could be a sign that she has dysphagia. Her voice also lost its strength 2 years ago and it is weaker. Thanks again.
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