Pocketing food - how do we get him to swallow the pureed food he holds on his tongue

HeyDforDaughter

Hi, Dad with dementia and on hospice just started pocketing food. Is fed food by spoon. Willing to open his mouth to accept the food but it lays on his tongue. Case Manager RN says it's part of the dementia/decline process. Otherwise, he can be alert to sit in wheelchair. Seems hungry, just doesn't seem to remember how to swallow or eat? Already painfully thin. Drinks water and juice fine. Any suggestions to help remember to swallow what is on his tongue? or physical stimulation under his chin? Puree starts to come out of his mouth and becomes sleepy. But still has a strong grip, just doesn't speak any more except for "no" and nodding to say yes. Is this one of the signs of nearing the end (I know this is probably a question for hospice but would like to hear from people who have experienced this first hand). Thank you!

terei

If you do not have hospice on board, I would suggest that that happen. Yes, this is part of the progression of the disease + IME soon he will be sleeping most of the time. When that happened, I gave instructions that my mom be left to sleep.(They had been waking her for ‘meals’ during which she would fall asleep again). She died about 10 days later

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HeyDforDaughter

Thank you.

harshedbuzz

My dad's swallowing issues began while he was still self-feeding, very verbal and quite ambulatory. His SLP and aides suggested verbal prompts to swallow/clear his throat which he would generally do when prompted. I wondered if there would be some throat message as one does when "pilling" a cat at some point. FWIW, despite eating pretty well and family bring calorie dense treats daily, dad was losing weight at a surprising rate which is a harbinger of end stages.

In his case, he passed from complications of aspiration pneumonia within about 2 weeks of us/his team noticing the pocketing of food. He may have aspirated some pocketed food or, TBH, it could have been saliva. We'll never know.

HB

HeyDforDaughter

Thank you for sharing your experiences. Yes, he is sleeping most of the time. But I am using his wakeful hours to offer pureed food and drink. This morning, he took a couple small spoonfuls of oatmeal and some sips of water before it started collecting in his mouth. I put him back in bed and let him sleep. Now he is awake and I will offer again. It is hard to see him waste away. I will inform my kids of what the pocketing could indicate so maybe they could visit more often. I am forever praying for a peaceful passing when the time comes.