Follow
Share

My mother swallows her food and medication fine. She holds saliva in her mouth and refuse to spit it out. This started a few weeks ago. Why is saliva building up in her mouth? How can I get her to spit it out?

My Mom would also squirrel pureed food in her jaws. When she had to go to the nursing facility for 24/7 care. The CNA's discovered it and told me so that when I fed her myself, which I did sometimes, I would be aware of it. They had to start thickening my Mom's water too after her 3rd year there. If you notice your Mom strangling, be sure to put in a request for a speech therapist to check her. Mom had one twice. Difficulty swallowing can sometimes come along with the dementia. Been there with Mom. Mom had to be x-rayed 3 times for aspiration and in her final days, she DID aspirate and passed away from pneumonia due to aspiration. It is on her death certificate. The nursing home said she didn't have pneumonia and I made them call EMS and take her to the hospital and they confirmed there that she did indeed have pneumonia and it was aspiration related. Anytime I was worried about her enough to make them take her to the ER, she had a UTI or something when they got her there. Stay behind them in that nursing facility. Some CNA's do not take enough time to properly feed them and give them the amount of water they need. Some would dispute this but Mom was in there 4 years and I was there on a regular basis. They did not like me much because I would jerk my Mom out & take her to a "real" doctor in a skinny minute if I suspected they were not checking her well enough. She needed the outside help every single time I did it too. Medicare/Medicaid had no problem paying for the trip and the hospital either because she was always diagnosed with needed medications and I would follow the transport van back to the nursing facility to get her settled back in with her all out of sorts and give them the prescription for the proper medications. It is not easy but I was the only one to see about her and I did the best I could. Just things to look out for and not to alarm you. Be aware, that's all. Good luck to you. God bless.
Helpful Answer (0)
Reply to elaineSC
Report

This question should be directed to her neurologist.
Helpful Answer (0)
Reply to Llamalover47
Report

If she is in a facility, ask for a swallow evaluation, usually done be a speech therapist. If she is safe for thin liquids, have a sports bottle around with water in it. Anyone coming on the room should offer her a sip anytime they come in her room. The idea is to encourage her to swallow. Oral care specifically tooth brushing goes a long way to reduce the chance of aspiration pneumonia.
Helpful Answer (2)
Reply to Robinlynn
Report
elaineSC Nov 19, 2019
Good advice.
(0)
Report
I am humbled by so many of the posts about such difficult situations. My heart goes out to all of you dealing with these problems day in and day out. I hope you all also have a few moments each day of joy and peace.
Helpful Answer (1)
Reply to RedVanAnnie
Report

Usually you would swallow after eating/drinking something & that is hard wired from infant time so because she hasn't had anything cross her lips she may not realize the need to swallow - what happens if you offer her some liquid to drink?
Helpful Answer (1)
Reply to moecam
Report

Nothing like reading the posts here to generate gratefulness...as at the moment my problem is not constant...but the reverse: I want to STOP my mother from spitting...she pigs out on grapes (yeah, at least healthy) and although seedless, she seems to spit the center rib and the skin of them into the kitchen sink drain where they come to rest in a pile. I.e. she stands at the sink doing this...eating and spitting. I did get a new NO SPITTING sign...but have not had the guts to put it up and face the frustration of her taking it down. The international picture is quite amusing...a head slightly lowered with black blobs flying out LOL.
Helpful Answer (1)
Reply to robinr
Report

Ririwoo,
Thank you for your post. I am dealing with a similar situation.
My mother's dementia truly manifested itself when she began to have difficulty swallowing liquid, not food.
She had a couple of sessions with a speech therapist to assess her swallowing and yes, it does seem that she is beginning to forget how to swallow, and must be coached. I understand this is not uncommon in cognitive impairment.
At first it was an easy fix, she took her pills with apple sauce and I gave her
the mucous-thinner Guaifenesin (OTC), in combination with Benadryl, which curbed her compulsion to spit constantly.
As her dementia progresses, all bets are off, and every day presents a new challenge or raises a new question.
I wish you well.
R27
Helpful Answer (3)
Reply to Ricky27
Report
sanhoro12 Nov 18, 2019
She didn't forget to swallow. She has awareness of the quality of the food in her mouth. If she is afraid that she can't swallow it whole without taking some into her windpipe, she will hold back. It can be for a variety of reasons. My mom will spit out nuts or chocolate chunks in ice cream since she can't control them. My neighbor can't eat Rocky Road ice cream for the same reason. It is the same thing with pureed lasagna with large chunks of meat or with pureed stir fry vegetables. The meat can't be broken down or there are too many stringy food parts left after the puree. The solid food has to be like thick sauce to be eaten.
(2)
Report
My mother does this too. She's in late stage dementia now and it's been going on for well over a year. I've found no real solution other than extreme patience.

She's been hospitalized for aspiration pneumonia once and she had a swallow test done then. Switched to a soft diet and nectar thickened liquids but she won't drink the thickened. Tried them again last month as she was doing more coughing during meals but she refused to drink so back to regular water, juice and milk. Hospice has been giving me guidance with these decisions.

I'm not really sure that it's strictly the swallow reflex that's causing my mom to pocket food, meds and not swallow saliva. I find she does it more often when she's tired usually at the end of a meal or in the case of saliva when she's drowsy right before nap time. It's almost like she doesn't know what it is in her mouth. And then she's too tired to get her brain to tell her how to spit it out.

Besides patience, I use clothing protectors (we call them aprons) and spit trays to try to contain the mess. What doesn't work for my mom is trying to remove food manually - she will bite, trying to get her to drink more to "wash it down" - she will hold it all and create a bigger mess, or massage her cheeks - staff tries this to no avail.

Yesterday I sat with her for two hours trying to coax her to spit out some saliva and Magic Cup. But she refused and fell asleep. So I tucked two napkins under her chin, alerted staff to the situation and went home for awhile.
Came back at supper and of course she'd managed to spit/dribble it out on her shawl.

Like so much of this disease there's no rational explanation or solution. But I understand your frustration and concern.
Helpful Answer (3)
Reply to madzeena
Report
cetude Nov 18, 2019
It took 1-1/2 hours to feed mom a single meal. Her Alzheimer's got so bad she ended up with a PEG tube because I didn't want her to die slowly of dehydration. Worked out great and she lived quite a while and could have gone on for more years...until she went into liver failure; she had liver cancer. Feeding and hydration was easy after the peg tube and she never bothered it. she never had a single infection after it was put in; before the PEG tube she had chronic UTIs and lived off of antibiotics for months. That went away after the PEG tube.
(1)
Report
See 1 more reply
Pouching is usually a symptom of stroke patients and folks having swallowing difficulties. Ask your doctor for a referral for a swallowing evaluation - usually a special physical therapist who will evaluate you mom's ability to swallow different textures and thicknesses of liquids. and foods After the evaluation, you will know which foods and liquid thicknesses are safe for mom. The therapist can also let you know about thickening agents you can buy to thicken liquids to appropriate consistencies.
Helpful Answer (2)
Reply to Taarna
Report

It's called pouching. She may have difficulty swallowing. The saliva or other food backs up in her mouth. The more it backs up, the more difficult it is to swallow due to its size and her anxiety.

There are suction devices for dementia.
Helpful Answer (4)
Reply to sanhoro12
Report

Drink more water
Helpful Answer (2)
Reply to PussJr
Report

Oral care is very important -- if bacteria build in her mouth she can aspirate it and the bacteria infects lungs turning into pneumonia. She may not be swallowing all her food and meds. She could be pocketing it in her mouth. I brushed my mom's teeth and used a portable water pic at a low setting to rinse..eventually she was not able to tolerate that so I resorted to mouthwash and oral swabs. If you do not clean her mouth at least a few times a day, she will get pneumonia.

I did buy a portable suction device from Amazon.
Helpful Answer (4)
Reply to cetude
Report
Ricky27 Nov 18, 2019
This is good to know, thanks.
(0)
Report
See 1 more reply
Can you ask her doctor to get a speech evaluation? You may get some recommendations how to handle this. Yes, there is a time with some dementias that aspiration issues can happen. Meanwhile if you say she has no problems with food, try offering her some items that you know she can swallow to see if the thin saliva can be just swallowed down. This is an interim suggestion.

Suction is an option if you are willing to stick the catheter or wand far back in the throat. Either she will demonstrate a gag reflex or not. A speech therapist can help determine if this is a way to go.

There are other suggestions, but a professional eval may get the fastest option out to you
Helpful Answer (2)
Reply to MACinCT
Report

"Remembering" to swallow is often a problem.
Another problem arises when the body does not realize that swallowing a liquid, or anything for that matter the things that need to go to the stomach has to be diverted from the lungs. If the body/brain does not realize that it is a fluid or solid it may not divert and the food or liquid can end up being aspirated. This can lead to "Aspiration Pneumonia" and that can be fatal.
There are medications that will decrease the saliva. Or you can use swabs designed for this purpose.
It may also be the time that you need to start thickening fluids as well as chopping or pureeing solids.
To confirm this the doctor could refer her for a swallow test.

You probably can not get her to swallow or spit as she will not remember when to do it. Start looking for "clothing protectors" (aka bibs, I don't like the terms bibs or diapers for adults)
Helpful Answer (4)
Reply to Grandma1954
Report
Ririwoo Nov 14, 2019
Hi Thank you.
(1)
Report
Ririwoo, this is such an awful disease for everyone involved.

Hugs for all you do!

Please remember to take care of you during this difficult journey. The stress of watching a loved one slip away one brain cell at a time is greater than we think, it is so important to find a release for yourself, because if we don't leak we will blow. Your body is telling you something, listen.
Helpful Answer (3)
Reply to Isthisrealyreal
Report
Ririwoo Nov 14, 2019
Hello Thank you!
(1)
Report
My Mom is my best friend. I Love her so much.Today I broke down and cried. My left hand started shaking uncontrollably.Thank you for the comforting words,information and suggestions.
Helpful Answer (4)
Reply to Ririwoo
Report

I have seen products for suctioning the fluid out of her mouth. This may be a solution for you.
Helpful Answer (3)
Reply to Isthisrealyreal
Report

Maybe she can't rember she need to swallow it. Brain is weird. Ask her PCP.
Helpful Answer (2)
Reply to JoAnn29
Report

I'm sorry to see the news about your mother. I'm not sure about the answer to your question about saliva. My LO does that too, but, she didn't start doing it until she was in end stage dementia. I have read various reasons as to why this happens. I hope someone else can explain it. I think it has to do with the person forgetting how to use the muscles that cause swallowing, but, I'm not sure.
Helpful Answer (3)
Reply to Sunnygirl1
Report

Ask a Question

Subscribe to
Our Newsletter