More about spitting…

Nowhere

It’s been a long time since I’ve checked in. My husband is still going strong physically and he’s on eighteen years since learning he had a diagnosis of MCI. Probably twenty five years if counting behavioral changes proceeding memory loss. He’s considered to be in advanced stages of loss of cognition, but I’m not convinced. Except it seems he’s forgetting he can swallow once he’s full or if he has a crumb or excess saliva in his mouth as he’s increasingly clearing his throat and spitting. The “achem” action of trying to bring it up irritates and inflames his throat, so it’s a cyclical problem. I sit with him and coach him to sip cool water, and thought that helped, but last night it just made him vomit. When I ask why he doesn’t swallow he says he doesn’t want to choke. But he can swallow fine when he is automatically holding a burger or something and is hungry. It’s as if he just forgets to swallow other times. I don’t know how to help him. I’m afraid aspirating is what will take him eventually. Infrequent spitting begun about 18 months ago and is now a regular thing after he eats.

This is my only real concern because long gone are delusions, paranoia, and confusing other residents are me as he can no longer think. He doesn’t know my name or relation, but he stands, smiles, laughs, and hugs! He always says he’s fine when I ask. Thank God for this!

Wishing all of you wonderful carers something in which to by thankful for on your journeys of this difficult path we share. ❤️🙏

trottingalong

My MIL did that exact same thing. My FIL was so worried about her choking that he switched to soft foods. Eventually she just didn’t know how to swallow any more. My father passed away 3 years ago from melanoma. At the end he would chew and chew and chew, but couldn’t figure out how to swallow. The cancer had spread to his brain.

SDianeL

It’s common for them to be able to swallow sometimes but not others. Is he under hospice care? Has a speech therapist done a swallow test? Is he home? The facility where my husband was did the swallow test and changed his diet to mechanical soft and then puréed. About 50% of people with dementia pass from aspiration pneumonia. My husband passed in August 2024 after I made the heart wrenching decision not to transport him to the ER to treat the aspiration pneumonia. It was the hardest decision I’ve ever made. So sorry you are at this point. You have been an excellent caregiver to your DH. He’s lucky to have you. Hugs. 💜

harshedbuzz

@Nowhere

I am sorry for where you are now.

Swallowing is a skill lost in stages. It's kind of counterintuitive, but the earliest issues will be with liquids the consistency of water. I wouldn't be surprised that he could still manage a hamburger.

You could ask for a swallow evaluation with an SLP who could devise a plan for safe feeding. This may or may not help as a PWD can just as easily aspirate saliva or reflux.

Aspiration pneumonia is a very common immediate cause of death for PWD. It was how my dad died. He seemed to pass quite peacefully.

HB