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 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.
"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)
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.
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.
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.
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.
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.
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.
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
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.
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.
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)
I did buy a portable suction device from Amazon.
There are suction devices for dementia.
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.
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.
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