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What would you do? Swallowing

Discussion in 'I care for a person with dementia' started by SerenaS, Sep 30, 2015.

  1. Sharaloui

    Sharaloui Registered User

    Jun 14, 2014
    1
    Swallowing

    My Mother has just recently passed away (7 wks ago) with Vascular Dementia (Aspiration Pneumonia)She had tried all consistencies and stages of food and drink types. Before her passing she was on a very soft stage diet with no lumps or bits in the food and drink at all. She went through stages of holding the food in her mouth for long periods of time. I found gentle encouragement and gently rubbing parts of her cheeks and neck often helped but with that I used to show her pictures and talk to her about them on a magazine or even on my mobile which also helped and distracted her somehow into swallowing. I used to buy very very small plastic teaspoons and feed her with those. I picked this idea up from the hospital where she went one time, as I noticed she was much better eating very small amounts at a time. The other idea I used was to alternate food and drink so I would give her one small teaspoon of puree and one small teaspoon of drink and so on and so fourth. I made sure before feeding we had everything we needed with little ideas here an their to encourage at meal times. I had to be calm and patient and loving like I had all the time in the world for her which I did and I wouldn't have had it any other way. I must have done something right as when I asked if she wanted me or the carer to feed her she said "you" this is from a lady who didn't speak for about a year and, only said the odd word every couple of weeks if I was lucky, and so it was always my privilege to be spending that special time with her at meal times.
     
  2. Enigma

    Enigma Registered User

    Sep 13, 2015
    6
    Bristol UK
    Swollowing

    My husband has vascular dementia and gradually his Swollowing has caused difficulties for him. I have been his sole carer for about six years, and giving him soft foods cut up really small. He started having trouble with fluids which caused a spate of coughing. Recently he got a chest infection which caused him to be immobile, and as a result I had to make the terrible decision to put him in a nursing home. The same evening the paramedics were called and after three weeks in hospital his Swollowing got a lot worse and he had to go onto puréed foods. He has now returned to the nursing home and he is bed bound as he cant walk. There he is on thickened fluids, which are sometimes given him on a spoon, or with a medicine plunger. He is constantly needing to be reminded to Swollowing, but retains the liquid in his mouth so long, he ends up with a lot of coughing. The hospital advised that he should be sat totally upright before eating and drinking. He seems to sleep all the time, and needs to be woken for drinks and food. It is extremely difficult to get him to Swollow or to open his mouth! I find that giving him just a tiny amount of food at a time helps, and even though it is puréed, he still chews and chews and chews. I have read other blogs and will now try plastic baby spoons. Sometimes he opens his lips, but his teeth are tightly shut. Of course, because he needs to be woken to eat, it seems he is just too tired to do anything, including Swollowing. In the hospital the SALT team came many times, and I have rung them since he has been back in the Nursing Home, and they will come next week again. I also found that thickening agent is best added to cup first, then the tea, or juice added and stirred, as that way there are less lumps.
     
  3. nitram

    nitram Registered User

    Apr 6, 2011
    19,140
    Male
    North Manchester
    "I have read other blogs and will now try plastic baby spoons."

    My wife had an extremely strong bite, whilst the use of spoons was still possible I was warned not to use plastic spoons as she could shatter them and swallow the debris. Metal spoons tilted but not fully inserted were advised.
     
  4. fremington6

    fremington6 Registered User

    Apr 30, 2013
    24
    Devon
    Swallowing

    Have just picked up on this thread. My husband (with VasDem) has been hvg trouble swallowing for a while. Dr sent him for endoscopy but nothing found so now I need to go,back again. He coughs a lot and recently had a chest infection as well but although it's more or less gone the swallowing hasn't improved. At no time has it been mentioned that it could be part of his illness. I can now mention this to dr myself. I get so much info from here seeing how other people deal with these issues ..... thank you.
     
  5. Aunttess

    Aunttess Registered User

    May 30, 2015
    9
    Swallowing

    The nurse came to check on Mom today. She said that Mom shouldn't be distracted during a meal. Up until now we kept the iPad on playing old movies. We've stopped that. The nurse said if she keeps food in her mouth to tap her hand and remind her to swallow. Also verbal reminders, "Mary, eat." She also said that lemon/cranberry juice triggers swallowing. I hope this helps.
     
  6. BR_ANA

    BR_ANA Registered User

    Jun 27, 2012
    1,082
    Brazil
    Last year my mom was 37 kg. she used to sleep while eating. I discovered that she wakes up with some smells ( vanilla and chocolate). She usually wakes up ready for food. Now she is 46 kg. She is in stage 7b.
     
  7. Aunttess

    Aunttess Registered User

    May 30, 2015
    9
    My Mom can't swallow pills. We crush her meds in a mortar and pestle and mix them in applesauce, ice cream, yogurt.
     
  8. jhind

    jhind Registered User

    Aug 15, 2012
    3
    swallowing problems

    problems
     
  9. jhind

    jhind Registered User

    Aug 15, 2012
    3
    swallowing problems

    My wife gradually developed swallowing problems (she has advanced vascular dem)
    We have been using a product called Thick and Easy, a white powder in a large tin.
    It has solved our problem with drinks, and her meals are well mashed to a paste consistency. We use 1.5 tsp per drink, well stirred. The product is available on prescript,
    and can also be bought online, about 7£ per tin. Do try it.
    John
     
  10. suze

    suze Registered User

    Oct 12, 2006
    62
    Sussex
    swallowing hints

    Hi
    When my Mum was reluctant to swallow, we would make a feather touch on her neck which reminded her to swallow. She was also only eating yohurts, porridge and ice cream near the end. Another idea is to take one of those pink sponge sticks to moisten mouths and gently squueze inside the corner of the mouth.
     
  11. Suzanna1969

    Suzanna1969 Registered User

    Mar 28, 2015
    346
    Essex
    After Mum's stroke last year the hospital advised that her swallow had been affected and that she needed to be on an 'E Diet' (which is basically fork mashable food). Up until then she and Dad had been preparing all their own meals themselves and also doing the shopping, with me ferrying them to and from the supermarket.

    The stroke put an end to all that but their independence is still very important to both of them. Mum's new diet demanded they totally change everything they ate and my Dad found it totally overwhelming at first, however we have adapted and now it works very well. Obviously she is not nearly as far advanced as the other posters' loved ones.

    Mum's swallow is actually quite strong, however it is often delayed, especially with liquids, which means there is a danger that they could go down her windpipe. At first we thickened her drinks with 'Thick and Easy' (I'm sure I went to school with a girl who had the same nickname ahem!) and then later we changed that to Resource as it doesn't taste of anything and leaves the liquid clear. Still it doesn't seem to help as much as having her drinks either very chilled or quite hot, the extremes of temperature seem to stimulate her swallow quite well (although she often forgets her hot drinks and leaves them to go cold). We found that lemonade is good too, the fizziness seems to stimulate her swallow, maybe the tingling reminds her a bit quicker?

    Mum and Dad's diet was always very plain, I was brought up on Meat'n'Two Veg! Pasta isn't seen as food in their house, spices were limited to white pepper and a bit of nutmeg in the rice pud. As joints of meat, sausage skins, leafy vegetables etc are now out I had to rethink their food but somehow accommodate Dad's hatred of 'foreign muck'!

    However, as some of the above posters have pointed out, sense of taste goes with age and spices not only add flavour to a bland dish but are actually good for stimulating swallow (for Mum) and keeping things 'regular' (for Dad) so I sneak in chilli powder, turmeric, paprika and others. It's still important to them that they are as independent as possible so once every few weeks I have a big cook-up and make big pan-fulls of the following:

    Meatballs in Tangy Tomato Sauce, Chicken Fricassee, Slo-Cooked Beef and Red Wine Casserole, Skinless Sausage and Butter Bean Bean Ragout (I skin the sausages and the beans before cooking), Shepherd's Pie, Stewed Steak with chopped Carrots, Turkey Breast Fillet Pieces with Julienne Courgettes etc etc.

    The I decant them into those very handy foil trays with the cardboard lids, write basic simple instructions on the top and fill up Mum and Dad's freezer. One big casserole of each dish can fill between 4 and 6 trays. Then they just take them out as needed, prepare their own vegetables (Mum can still peel a carrot and Dad supervises) and feel they are still looking after themselves. It means I don't have to be present for every meal, plus I know what they're eating. They couldn't follow supermarket ready meal instructions, one poor chilled cottage pie got microwaved for 14 minutes so it's better this way!

    Dad does sometimes notice the chilli because his lips tingle! Mum still enjoys her food and I know there are no mystery ingredients which could cause her to choke. Plus I know they are having a hot meal every day. For now it works.

    I quite enjoy doing it too, seeing the trays all neatly stacked up in the boot of the car makes me feel like I'm doing something practical. It's a small element of control in a situation where I essentially have very little.
     
  12. Aunttess

    Aunttess Registered User

    May 30, 2015
    9
    Crush mom's pills in a pill crusher or mortar and pestle and mix them in applesauce, yogurt, ice cream or whatever she likes.
     
  13. Aunttess

    Aunttess Registered User

    May 30, 2015
    9
    Yes, the nurse said to remind Mom to swallow. Rub her cheeks, touch her neck. I'm going to try the pink sponges. Thank you!
     
  14. penquins waddle

    penquins waddle Registered User

    Jul 22, 2013
    6
    Reply to an answer

    My husband has probs swallowing but had a speech and language person in and it was very interesting they watch how they swallow and listen they decided to put thickener in his drinks and only have mash food three spoons of food then three spoons of liquid this may seem that it isnt a drink but once it goes down it turns to liquid and he seems alot better their is foods he cannot have but you get advised on what he can and cannot have
     
  15. Aunttess

    Aunttess Registered User

    May 30, 2015
    9
    Thank you very much.
     
  16. Mollygoose

    Mollygoose Registered User

    Dec 19, 2014
    52
    Lincolnshire
    Swallowing

    Hi this is a difficult one ! Maybe stroking under his chin might just work ! Or pinching his nose ! Perhaps he could lick a ice lolly or ice cream ! It is such a serious thing to happen and very little one can do ! X
     
  17. karen1967

    karen1967 Registered User

    Oct 10, 2015
    20
    Blackpool
    I once looked after a lady who was so ill she couldn't swallow and we use to give her a drink with a syringe thinking we where helping but the doctor told us it wasn't the best idea due to the fluid going on her lungs, it was only a couple of mls but I understood once it was explained, but not sure if it is the same for food.
     
  18. hvml

    hvml Registered User

    Oct 10, 2015
    297
    North Cornwall
    These accounts are wonderful and full of ideas that I can use to help my Dad, who chews a lot and does tend to eat too fast and puts a lot in his mouth at once.It's a pleasure to see how much he enjoys his food.
     
  19. Spicer

    Spicer Registered User

    Oct 23, 2015
    3
    What does SALT stand for
     
  20. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,517
    Female
    England

    Speech and Language Therapy.
     
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