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I believed it is not dementia related. I have been a registered carer for a friends grandmother who has dementia and has reached the grand age of ninety and i have been looking after her for nearly five years. Several moths ago she started to cough and had problems with swallowing food but it was spasmodic, but sadly it got worse, on numerous occasions i asked the old ladies daughter to report this to her doctor eventually she did. The reply was negative and less than professional which upset the daughter who then was reluctant to pursue the problem any further, unbeknown to me as i was maintaining my stance on seeking medical advise. Finally she told me to ring the doctor myself, i promptly got an appointment for the following day, as was expected the examination was less than satisfactory and i didn't believe the explanation given by her doctor for the choking problems of this old lady. Three days later i spoke to Freda and ask her if she would like to go to hospital A & E to be examined and to ask for a second opinion of which she nodded yes i also explained that she might have to have something down the back of her throat again she agreed and is & was totally aware of what was being said " I must say the B R I was excellent in their approach and concern for this old lady". The doctor asked why it had taken so long to get to this point in bring her to the hospital, and yes he believed there is a problem or an obstruction preventing Freda from eating and drinking, this conclusion was baste on the fact the Freda answered his question with a full sentence and was completely alert to what was happening to her she also gave her full date of birth when asked in different departments,during examinations i also explained that we go for a walk regularly around the park with Freda pushing her own wheel chair which aids as a support for her, the doctor at the B R I concluded the Freda was in excellent health for her age except this one problem and wanted to admit her to hospital the same day. Unfortunately this was a little bit to much for Freda so i had to decline for fear of frightening her to much "Of which i now regret" So back to her local GP of which i would have liked to replace with another GP but on ringing the local surgery was told that Freda GP was not available today and another doctor was standing in for a ring back to discuss the way forward. well what a surprise when Freda's own doctor returned the call, so i then proceed to explain that we went for a second opinion and the B R I believes there is something wrong with the old ladies throat. Obviously the GP had not read the report sent to her by the B R I and again proved to be rude and very unprofessional towards myself, whereupon she refused to discuss it any further and wanted to speak with the daughter so i duly gave her the mobile no: and put the phone down. About an hour later Maria returned home and told me the doctor had contacted her , having discussed Freda's daily activities the GP must have now realized that Freda is not in the advanced stages of dementia as she had first thought, her reason for thinking she was is Freda does not respond very well when in the presence of her doctor. And now the outcome, the gp suggested that Freda have an endoscopy or a barium meal at the hospital , so Maria decided on a barium meal, when i donot know as we are back in the doctors hands so this may be weeks away before the appointment,not idea when you can no longer eat or drink properly also i'm afraid that either course is now not suitable for this old lady as it can take upto 2 hrs plus just to drink a glass of water. So please can someone advise on my next course of action to save this old lady from further suffering and very sad to say but certain death if this is not resolved quickly.

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Thank you for your comments, unfortunately we have tried all types of combination of foods and liquids nothing seems to works, she is now starting to cough/choke long after meals been finished there is also lot of noise from the digestive tract i have also asked her if it hurts to swallow no is the reply its just hard to swallow anything and her face is so heart breaking to see , i have now decided to return to the hospital but first i will speak with Freda to confirm that is what she wants as i cannot sit around waiting for anointment.
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The videoscopic swallow test isn't that difficult; my father's had a few of them. It is an excellent way of determining whether someone can swallow or is aspirating fluids into the lung.

An endoscopy is more extensive and definitely uncomfortable, even with light anesthesia. It wouldn't be my first choice.

Older people can also choke and cough on things like bread and cracker crumbs as well as chocolate. I've seen that happen frequently.

I'm wondering if you've noticed that the coughing occurs with specific foods?

I would work with her family to get her to agree to the videoscopic swallow study, and also ask about seeing a speech pathologist who might be able to recommend different ways of eating....e.g., make sure to clear the mouth of all food before adding another spoonful. It's surprising how many people don't do this, then if there is a restriction or just older muscles trying to swallow, the food gets backed up and coughing starts.

Hot and/or cold foods can also provoke coughing; I've seen that too.

You seem very concerned about this lady; that speaks well of your care for her. I hope you're able to find some relief for her.
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If she will not agree to hospitalization, she should fill out a MOLST or Advanced Directives. There is no point going to the hospital if she is going to refuse admission and treatment. My MIL said NO to feeding tubes, no pacemakers, respirators or IV fluids. Without a written MOLST (medical orders for life sustaining treatment) the medical professionals will do everything and anything to keep her alive, and it won't be pretty.
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A lot of older people have to modify their diets due to swallowing difficulties. Thin liquids like water can go down the wrong way, so you may need to buy thickeners at the drug store. Often food will need to be minced finely or even pureed. Try searching the site or on line about dysphagia diets.
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