My mother has dementia and is on a feeding tube, she holds a large amount of saliva in her mouth. What to do? Most of all, why? Help!

I would suggest you get a vac assist medline suction unit HCS 7000. 185.00. U can suction out saliva, fluids & even brush her teeth with it.

She can swallow ice cream, sherbet, and jello but not saliva? I don’t have knowledge or experience in this matter but it struck me as odd that there are three things she does take by mouth, rather than the feeding tube, but she is not able to swallow saliva.

I haven't read all the answers but could you try this. gently touch her cheek and have a kleenex ready..........just push gently on her cheek on the side where most of the saliva is (now while talking to her gently about something she likes) and hopefully the saliva will come out of the corner of her mouth. wishing you luck.

Knscipio66: Imho, perhaps she needs to be seen by an SLP (Speech and Language Pathologist) to determine why she has lost the ability to swallow.

Grandma 1954–the poster says her mom, with the feeding tube, takes sherbet, ice cream and jello — by mouth; that’s why NYCmama referred to her intake of sweets and dairy.

Why is she still taking food through her mouth having a feeding tube? Is it going to be removed or is it permanent?

Does your mother understand what's happening to her? Speak to her doctor about her difficulty swallowing and getting rid of the saliva. Get connected with caregiving groups in your area so that you can discuss these things with other people and learn how to handle different things that come up. Some people who have difficulty swallowing need to have thickened liquids. This is something that you need to discuss with a medical professional.

If mom’s lost her ability to swallow, she’s at risk for aspiration. If you feel her saliva secretions have increased, it’s important to communicate this to her doctor.
I would contact her MD and request a home health nurse visit for hands on oral hygiene education. They can reassess mom’s situation, clarify questions and bring the proper daily supplies required to help keep mom both safe and comfortable.

In the hospital, we tend to use a wall suction and a special tube (Yankeur) to remove secretions from the mouth. You can try using the suction tip on the insides of her mouth near her back teeth to remove extra secretions.

To stimulate her taste sensations for pleasure, avoid excess liquids. The extra liquids will cause her to have issues with coughing. Instead get glycerin swabs which are like huge q-tips that are slightly sweet. Some have different flavors.

Try to find somebody to rent you a suction set-up on a trial basis, reather tham buying outright.

Perhaps her intake of sweets and dairy products are producing more phlegm? If it's watery saliva, maybe she will suck on a disposable oral swab? Best to talk with a dysphagia specialist for proper guidance.

Small strokes (TIA’s) symptoms usually disappear shortly after, CVA’s have a longer duration where some sadly, don’t ever fully recover from. Maybe a different doctor could Re-evaluate mom in a stroke unit/hospital? (CVA vs. TIA)? (a second opinion)

Getting to the bottom of things faster gives mom a better chance of recovery. If mom did have a full stroke then she may need to be on medication.

I'm not a doctor but know many who’ve suffered both TIAs and CVAs.

wishing you both some answers.

Use a swab to remove a build up of secretions. Or you can turn her on her side and allow the fluid to drain.
If using swabs do not go back into the throat as that can cause a gag reflex.
She can not swallow and with dementia she may not “know” or understand how to spit.
When my Husband was on Hospice the nurse had the doctor prescribe drops that were supposed to help dry secretions. (Off label use of an eye drop called Atropine) they worked a little but I generally used a swab or rolled him to his side.

Has anyone, such as a speech pathologist, evaluated your mother to determine if/how the stroke affected her ability to swallow, and specifically if there is anything that can be done other than suctioning?   If the stroke caused permanent damage, it may be that suctioning is the only option.

If you do have to suction, ask one of your mother's physicians, probably the one who diagnosed the stroke and/or is treating her for it, if home speech therapy can be ordered to show you how to suction properly.   A nurse could also demonstrate this.

Another issue to raise is whether exercises, such as the Shaker exercises, could be helpful.  My father did these to recover from his dysphagia and regain the use of his swallowing muscles.  Initially I did them with him, but was advised by our speech therapist that I should NOT do them since I didn't have a swallowing disorder, and the exercises could affect me negatively.

Another issue to raise is something that might dry up the secretions.   Dad was treated with scopolamine patches, but I don't recall if it was specifically to reduce secretions or to dry them up, but both options would be helpful.

If she was in the hospital the nurses would vacuum the excess saliva. Unfortunately you do not have the appliance at home. Your mother is starting to pocket her saliva. It may lead to aspiration and pneumonia. Unfortunately this is part of the process of physical declination of your mother. You may be able to divert it for awhile, but it will return. If you have an oximeter make sure her oxygen level is 95-100%. If she develops breathing problems take her to the ER.

Why can't you use a manual suction device like the NoseFrida used for babies? The tube could be placed inside her cheek and still remove saliva. Its worth a try.
I know there are meds available to help dry oral secretions.
Contact her doctor for help.

Has she always had large secretion build up or more lately?

My mom also had a stroke and feeding tube etc - she was weaned off and fully eats but anytime she has an infections/dehydration it affects her cognitively and she has sometimes had this same secretion build up as well as not swallowing string enough and I have to change her diet until her infection is gone.

Just letting you know if it seems like a sudden increase then make sure to rule out infection.

They make drops that you can put in her mouth that will dry up her saliva, along with patches that you can put behind her ears. Get with her Dr. and they can prescribe either or both of those.
There is also a contraption that will suck it out of her mouth, but you have to be able to get the mouth piece at least inside her cheek. Good luck.

When someone loses the ability to swallow, it could be neurological or GI related. It sounds like the muscles are not working properly. There are speech therapy exercises for the mouth and tongue, if speech therapy is an option for your mom. I know this is terribly distressing to deal with.

An additional option are medications. I do know neurologist's use botox for this problem, and some have great success. I did not, unfortunately.

Ask her doctor about this. There are meds to dry secretions.

If she has forgotten how to swallow that is why the build up. Her body doesn't automatically do the necessary things any longer.

Best of luck.