Swallowing Problem?

Bentley6

My mom is 95 and has been in nursing home for 3 years, she has dementia that has progressed since the start of Covid.  I think this has a lot to do with lack of stimulation from the nursing home and family visits due to Covid.

I noticed that my mom was pocketing food when she was sleepy, so I asked that since her behavior issues seemed to subside to remove the Seroquel.  She still seemed sleepy so I also asked them to stop the low dose morphine they were giving her.  This was prescribed because the aids were having a hard time dressing her without her being in pain.  She has been in a wheelchair since her arrival to the nursing home 3 years ago.  She just forgot how to walk.

I decided to have her food downgraded to purée because with the nursing homes being short staffed I worried about my mom being fed too fast and choking. She also starting coughing once while I was feeding her a McDonald’s hamburger and then threw up.  I did not think anything of this because after she coughed she sneezed 5 times in a row.  Thought it might be because she sneezed at the same time and has a reflex spasm.

Yesterday I gave her a milk shake and she had no problems drinking or coughing, but did start sneezing.  She does seem to have some post nasal drip as she has had this all her life from sinus issues.

Today Came in to see her and she was sleeping I woke her and she seemed confused and acted like she did not feel good.  Aid said she ate all her breakfast.  Gave her water and some hot chocolate and she seemed better.  Since I was there they asked if I would feed her lunch.  It was purée pasta and veggies.  I started with her drink snd gave her several spoonfuls of food, no problem. I also mixed spoons of yogurt too.  She was doing fine and then I gave her a drink and a few minutes later she coughed and began sneezing.  Then she started gagging and threw up.  I was so scared because I never seen her gag like that.  Then she stopped and said she was fine.  Nurse took her temp if was normal.  Although she seemed tired.

The nurse is telling me that it’s due to her swallowing but could it be her hiatal hernia acting up, GERD or post nasal drip?  I am going to ask for a swallow test.

M1

Bentley, sounds like you are doing the right thing to use thickened or pureed foods empirically.  I would suggest that a swallowing study would likely not show anything that you would do anything about.  Why put her through it?  What are you trying to achieve?  Is she on hospice care?  At 95, I would do everything for comfort but nothing invasive or difficult.  Just sayin.

Neverends

I agree with M1, pureed foods, Thickened liquids. No straw,small bites. Putting her thru a barium swallow test will be tough  on her or any test. Sometimes  doing everything  medically possible at this age would be so hard on her. Hope everything  is ok with your mom.

Michael Ellenbogen

Tell them to sop torturing here and let her go in peace. What do you gain by keeing her around longer . I know this is hard but we need to let then go. 

Bentley6

Hi Michael, thank you for your reply.  My mom is not being tortured in any way, this is a new symptom that we are trying to figure out if it’s a swallowing issue or related to  acid reflux.  If it’s a swallowing issue we just want to make sure that all precautions in feeding are being met and if it’s acid reflux then an antacid is given.  This is a horrible disease as you know and my mom has had it for a long time, but we still want to be sure that she is getting the best care.  It’s bad enough that the nursing homes are short handed then with Covid infections on the rise once again, it’s easy for care to fall short.

Bentley6

Thank you for your reply.  The swallowing test they do is non invasive, a therapist monitors how she is swallowing liquids and food.  My reasoning for the swallow test is she has had swallowing issues before dementia as she has a hiatal hernia and had GERD at one time.  I just want to make sure if it’s caused from anything other than the dementia it’s treated.

Michael Ellenbogen

I already have swallowing issues and also have reflux issues. I had swallowing test years ago and they were mild at that time.  I know what is ahead of me. I choke on things at least once a day or more. If it happened more frequently I would give up on life.

Bentley6

Hi Michael, I am sorry to hear.  I wish you all the best.  God Bless.

Bentley6

Hi Michael, I am sorry to hear. I wish you well.  God Bless