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My 94 year-old mother has been eating seemingly well. But, lately, she has been putting more and more food in her mouth, but not swallowing it all. I just gave her some mac 'n cheese with ham. She ate it. Then she had some pudding. She ate that, too. After that, she started spitting out the ham. My brother said she did the same thing with meat last night. The food is chewed up enough to swallow. I understand that people with dementia eventually have problems swallowing. She has not been diagnosed with that, though I wonder if she has started with vascular dementia (memory not affected that much yet). Is this spitting food out the first stages of not being able to swallow?

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She is pocketing food. My mom does that too. I am lucky enough to have a daughter who is a speech language pathologist (specializing in eating disorders). She does a swallowing evaluation on my mom at least once a month. At this point, my mom is hand fed but we have to watch and see if she swallows each bite. If not, I prompt her verbally and by gently stoking her throat top to bottom. For us, this is working. It also helps to give small bites followed by a small drink.

I suggest you request a swallowing evaluation by a speech language pathologist. They might then recommend a full swallowing study. We have not yet had to do that.
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I can't answer your questions as to dementia and not swallowing, but it does sound as if she's developing swallowing issues (dysphagia).

Unfortunately, what we might be able to chew and swallow isn't the same as what someone with dysphagia could swallow.

Many of us here deal with this and have learned to puree foods to a consistency that be more safely swallowed. That doesn't completely eliminate the possibility of aspiration, but it's safer.

It would be helpful for her to have a swallowing evaluation by a speech therapist, who can observe swallowing and order a videoscopic swallow eval if he/she thinks dysphagia is involved. This is a painless test; small bits of various food and drink types are swallowed while viewed through imaging which indicates whether food is being aspirated and going into the lungs or pocketed in the pouches of the mouth, or something else is going on.

If you have a PCP, ask for referral to a doctor, or speech pathologist, who can perform this study. It's the best way to determine what's happening when she's attempting to eat.

There are different levels of dysphagia, so she might benefit just from eating pureed food, and drinking thickened liquids.
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