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Dad is 96, has end stage Dementia and Silent Aspiration. He was hospitalized in August 2016 due to double pneumonia. He had been in AL but was moved to a NH. He went from honey thickness pureed to pudding thickness. He "drinks" with a spoon his liquid is so thick. The muscles that propel the food to the back of the mouth for swallowing are weakened. Either he can't or he forgets to swallow and must be reminded to swallow. It takes a long time for him to swallow what is in his mouth. Now I notice that he drools occasionally. He also has coughing fits without eating. My thinking is that he is choking on saliva. Yesterday I heard it in his throat, as well as some wheezing. I had the nurse check his lungs. Fine she said. My suspicion is that it just isn't to the point where he becomes sick. They give him breathing treatments 2 or 3 times a day. Blood work came back good the last time. His pulse ox has been 90. I truly believe he is aspirating again. At my 3 month meeting with the NH last week I was asked about a feeding tube if necessary. I won't subject an almost 97 year old man with Dementia to that.This site has become my go to site.... We all know what doctors and nurses don't or too busy to care about.

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Yes, Lucysmom, many people with dementia eventually have serious problems with swallowing/breathing and that often leads to their death. It sounds like your dear father is in the final stage and that hospice care is appropriate.
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I wondered how your dad is doing.

We have a family friend who had significant dementia. He broke a hip, went into rehab, developed aspiration pneumonia, was treated, improved, and within a week developed it again and passed away within a few days. It all happened pretty quickly.
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Lucy, my Dad [95] was doing the coughing but we never paid too much attention to it because he had been doing that for a number of years. We figured it was allergies, which it probably was back then.

Then I noticed that Dad was coughing a lot while he was eating. I knew nothing about aspiration so I just figured he was eating too much too fast. And he would keep on eating.

The one day he was running a fever and was quite weak, so the facility called 911 and Dad spent a few days in the hospital where swallowing tests were done. The test showed he couldn't swallow correctly and food was going into his lungs, thus he had developed aspiration pneumonia. A few days later he was gone, he went that quickly.

Dad's Living Will stated no medical efforts to extend his life, thus no feeding tube which he wouldn't have liked anyway. He was ready to be with my Mom who had past a year earlier, and sure enough he went.
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Most definitely they will work with Hospice. I wonder how long he will continue the way he is. I see a big decline since the beginning of September. Sometimes he has trouble talking, when he does talk. His speech is garbled. Other times it's clear. I believe it's mostly due to his swallowing. Just a few minutes I got a call from the NH.... His left ear is bruised. He doesn't know how it happened, they're assuming he hit it against the bed rail. His skin is paper thin and he gets skin tears often, so I can understand the bruising. His right carotid artery is 70 to 90 percent blocked. He's just so pathetic!
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I agree with not putting him through having a feeding tube. He is 97 years old and has not had an easy past few years. Will the NH work with hospice to help to keep him comfortable?
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