Refusing to spit

Mamaof3Gigiof1

Hello all. I wanted to know if anyone is experiencing this and if you have found a remedy. My dear mother has moderate to severe Alzheimer's. She tends to hold saliva in her mouth and swish it around, refusing to spit it out. She's not rude, she will nod or say Mm hmm when I tell her to spit it out in the sink. Then she just continues to move the saliva in her mouth and hold onto it. She will also do this with toothpaste when I brush her teeth as well as mouthwash. I gave her a cup with paper towels so she could spit into it when she was ready. I looked up later and she had let it drip on her pants. Just wondering if anyone is experiencing the same thing. Have a great day💚

M1

does she have swallowing problems when she eats? This is a common problem in late stage disease and can lead to aspiration pneumonia as a common cause of death. There are scopolamine patches you could use to decrease the volume of saliva, but that can lead to other problems too. Maybe a swallowing evaluation is in order.

fmb

I wonder if this is related to "cheeking" or "chipmunking", when the PWD holds food in their mouth and doesn't swallow it. This is common in late stage ALZ. As for brushing, they make dental wipes that you can use to wipe the food debris off of her teeth. I would skip the mouthwash so she can't accidently swallow it. So far DH (stage 7) is able to cooperate when I brush his teeth, but I see the time coming when I'll have to switch to the wipes.

​fesk

Is it only when brushing teeth or at other times? If my mother is very tired, she may hold saliva in her mouth. There are also certain medications that may increase saliva contributing to the issue.

For brushing teeth, my mother also stopped spitting toothpaste and mouthwash. I use very little toothpaste when brushing her teeth. I believe they also make some that are safe to swallow. As for mouthwash, I use dental swabs to go over her teeth and squeeze out most of the mouthwash prior to using. Link below.

If you mother is holding saliva at other times, you may want to see if she will allow you to put the swab in her mouth. That may absorb the saliva. The excess saliva is an aspiration risk as M1 stated. If it happens when sleeping as well, I think she should sleep with her head raised a bit. I recommend discussing all with her doctor.

https://www.amazon.com/McKesson-Inch-Oral-Swabstick-Pink/dp/B00JEMY6EG/ref%3Dsr_1_3?crid=2N1QC1S35L4W&dib=eyJ2IjoiMSJ9.Fj_hqc1jjk4jh1iDKR416BHtdPzPtVhTAGfjJ4h6loaR0CK3YUPnq2Eqgxz5iS3YqAfD3IcS-osk8-FnxJ0KJ9-4FxiHNur3DkicoI7t8MvvTyNdAbuhDT6gw-bfXUJ9Dy_323vWfHcIXGPX6gFh88HGFtY_frn0iEAdOAgf-VkoiQTPP2O0rPAIYY_AST-SGX-jmU_Bu11q_9RS-YLruJE8ydsjMwcwqS5qZjblFIE.0_c0g6ZwUVfwV7rfMRD_gvN8K4CtHX2NsHwgX6xPff0&dib_tag=se&keywords=mckesson%2Bunscented%2Bdental%2Bswab&qid=1720383135&sprefix=mcesson%2Bunscdented%2Bdental%2Bswab%2Caps%2C61&sr=8-3&th=1