clearing mucus from the chest in late dementia

John Odell · October 23

Alzheimer's has taken my 83yo wife into its late stage, and she recently caught a cold or pneumonia. She improved in the hospital, appears not to have an infection now, but three weeks later at home she still has a wet cough, usually when lying in bed, which is most of her time. The cough interrupts her badly-needed sleep. I have followed medical advice on how to remove the mucus remaining in her chest: Elevate her head in bed, plenty of hydration, give guaifenesin to thin the mucus, inhale steam, encourage a deep breath, clap her on the back. All this seems to assume a patient who can cough it up. But she has been unable to bring it up to her mouth, evidently because of dementia. I have tried demonstrating how to cough-and-spit-or-swallow including visual cues. Have called the Association help line and found the library has nothing on this situation, which surely is not unheard-of. Have you had success with it? Thank you for any ideas.

SDianeL · October 24

welcome. So sorry about your wife. Is she under hospice care? If not I would have her evaluated. They help so much. In late stage dementia pneumonia can be caused by the inability to swallow. It’s called aspiration pneumonia. A speech therapist can check her for swallowing issues. Coughing is usually a sign of aspiration. I learned that when my step dad had a stroke. My husband who had Alzheimer’s passed away from aspiration pneumonia in 2024.

harshedbuzz · October 24

@John Odell

Hi and welcome. I am sorry for your reason to be here but pleased you found this place.

It's possible your wife has progressed to a point where the brain can no longer coordinate the parts of her body needed for swallowing and expectoration. This is likely what caused her pneumonia in the first place. It will likely happen again.

An SLP could do a swallow test and determine if she's aspirating and perhaps give you advice on safe feeding— only eating/drinking sitting upright, no straws, no mixed texture foods, thickened liquids, pureed foods, etc.

Both of my parents had issues with aspiration pneumonia. Mom's (no dementia) was related to the use of Fosamax and resulted in 6 hospitalizations in 5 months. She developed sepsis but was able to improve. With dad who was in late-stage dementia, his body could not overcome the pneumonia, and he passed fairly quickly. He died peacefully hours before we were to have a hospice evaluation. I regret not bringing hospice in sooner; mom and dad both could have benefited from the support.

HB

clearing mucus from the chest in late dementia

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