Mom is aspirating on solid food.

Graham Howes

Hello everyone, My Mom has been an ALZ patient for 5 years. Recently she has been choking on her food and aspirating. She has recently returned to her nursing home after being in the hospital for aspiration and pneumonia. The doctor has ordered her to be on a pureed food diet. The problem is that she hates the food and will not eat it. She is begging me do get her solid food and claims she is starving. I know she will be happier if she eats some solid food, but at this point she is miserable. I just don't know what to do for her.

jfkoc

This is certainly a problem.

When the time comes to eliminate solids you can go to pureed food which likey taste terrible. You can check this out for yourself.

You can make all kinds of healthy shakes for her. Sweet ones will probably go over better, I fed my husband a lot of sherbet/ icecream and milkshakes that had been laced with protein powder. But beware.....no straws!!!

Is your mother in the memory care section of the facility?

towhee

Pureed foods do tend to be incredibly bland; it might be the high water content. They do not look all that great either. In my LOs nursing home they did a good job of presentation, made the food look attractive, but it was often cold. Sometimes adding salt or a sweetener will help. I used to give my LO plain high fat fage yogurt mixed well with blueberry syrup or sweetened warm applesauce, but check with the dietician/speech therapist before you do that. In fact, check with the dietician/speech therapist anyway, they might have some ideas. The sweetened shakes and smoothies with protein powder as jfkoc suggested are good but check to see if liquids need to be thickened.

harshedbuzz

This is a difficult situation. I am sorry you find yourself in this position. How heartbreaking for you both-- food is a love language and one of the last pleasures a PWD can enjoy.

As it was explained to me, aspiration happens when a sluggish epiglottis doesn't close off in time to protect the airway. PWD dementia typically choke on unthickened liquids first, then solids with puree being safest. That said, one can also aspirate on saliva, pocketed food, reflux so keeping them safe is not 100% doable. Aspiration is generally a later stage symptom by which some PWD would not longer be very verbal to complain.

I would speak to the dietician, DON or feeding specialist SLP for ideas to make her diet more palatable. Before dad was diagnosed with aspiration, I made my dad a lot of pureed soups (mixed textures like cereal and mild weren't good)-- ham and bean, split pea, potato and leek. I also brought milk shakes, custards, pudding because he often didn't like the heart healthy offerings of the kitchen. This might work in your situation.

That said, dad aspirated silently for a time before the MCF ordered a swallow screening with an SLP. I was there while she tested him (I'd brought Chik-Fil-A which she used). It was decided that he would have his liquids thickened but not move on to pureed or mechanically processed (chopped) food in order to keep him eating. By the time his X-ray and blood tests came back, he'd passed from complications of aspiration pneumonia. I wasn't there when he actually passed, but I will say that in his case there didn't seem to be any distress on his part in the hours before. His breathing was rattly but that seemed to bother me more than him. We'd had a crazy conversation about a visit he'd had with my sister (she'd been death 25 years) between flirting with the SLP. I wasn't really surprised to get the call he was "unresponsive". For him it wasn't a bad end.

HB