Any tips to encourage swallowing in late stage feeding?

[Gigglemore]

I know failure to swallow is a common late stage problem so wondered if anyone has any advice about encouraging swallowing? Mum is in nursing home and many of the staff find it difficult to give her food/drink as she is now often "switched off" and just gazes into the mid-distance. I go most days and spend ages keeping her alert and focussed enough to eat soup, Fortisip and high calorie pureed desserts but am finding it harder to get her to understand "swallow". She knows I am asking her to do something but just doesn't seem to understand what.

The longer she holds fluids in her mouth the more risk of her aspirating as she may need to cough, burp etc. Today I gave up as I could feel myself getting agitated and didn't want her to sense this so went to the toilet, washed hands etc and returned - to find she still had the same mouthful of drink in her mouth.

I've tried a tip about stroking the neck to prompt the swallow reflex, but it didn't seem to help. Has anyone been given any tips, or found something that worked for their loved ones? Mum is not actively refusing nourishment (a choice I would try to respect), she is just failing to understand what to do.

 

[starryuk]

Good morning Gigglemore,

I am so sorry to hear about your mum . We went through the same thing...

I remember my mum saying: "I don't know how to do it any more" when I was trying to persuade her to swallow. She wanted to eat, but couldn't.

As for advice, it would be to get a speech and language therapist out to your mum if you haven't done so yet. I phoned a private therapist who specialised in working with people with dementia. She never actually came out to mum as other events intervened, but, bless her, she spent nearly an hour on the phone with me. If I remember rightly, the position of the head was important. Also, stimulating her other senses, eg smell and even unrelated stimuli etc to try and encourage the swallow reflex.

Ice cream was more successful than anything else for us as it melted slowly and seemed to slide down of its own accord.

It is so distressing isn't it. I am sorry.

Edit: I found this, which has some tips if you scroll through anything irrelevant to your mum.


http://www.rcpsych.ac.uk/pdf/Dementia Compromised_swallowing_guide_July_2010.pdf

 

[Gigglemore]

Many thanks for the reply, yes I had found that document when searching web for tips. I had really hoped to find something about feeding at this stage by Teepa Snow.

The nursing home has not done a referral to the NHS SALT, perhaps they have enough experience from past visits to other patients to go on until they think she needs thickened drinks. Your experience of speaking to a private therapist with dementia experience sounds helpful so I will have to do a bit of searching to find if there is one in this area.

I guess if no-one on TP worked out any cunning tricks I will just have to carry on the best I can for now, she's still over 6.5 stone.