Was spitting food out, now vomiting

tonyac2 · April 2

Is anyone dealing with their LO vomiting after eating? Just a short while ago he was spitting food out. Now he throws up after a few bites. He’s losing roughly 4 lbs per week and sleeping 18+ hrs per day. Is he nearing the end? I have a video dr appt tomorrow to get a referral to hospice.
Any help or insight greatly appreciated.

jgreen · April 2

Dear @tonyac2

So sorry to read about DH. You can self-refer to hospice and they will come do an assessment. They might recommend a swallow test.

I think many physicians feel hospice is only for patients in their last weeks/days. It is different for dementia patients and can be a great resource for you. I encourage you to contact a hospice near you as soon as you can, and then let your doc know what transpired.

Prayers and hugs! You are one great spouse/caregiver!

🙏 💝

Sweetwater · April 2

This sounds familiar. You may want to have him checked for an abdominal obstruction.

SDianeL · April 3

Dementia-related spitting and vomiting often indicate advanced dysphagia (swallowing difficulties), where the brain struggles to coordinate mouth and throat muscles

These behaviors can stem from inability to process food texture, leading to pocketing food and vomiting. Safe management involves softer diets, upright posture, and professional assessment of swallowing by speech therapist.

Quilting brings calm · April 3

Losing weight is one of the things checked when evaluating for hospice. In my opinion, yes, you have reached the stage where hospice should be called in. They will provide you with extra help, support, a resource for questions and concerns.

Lethe · April 3

How did your appointment go? I’ve read vomiting can happen as digestive systems shut down in end stages. Swallowing difficulties can also lead to gagging and vomiting and aspiration. If he is not eating and loosing that much weight weekly it makes sense he is sleeping a lot. I hope you get some answers and I’m sorry you are going through this.

harshedbuzz · April 3

@tonyac2

The rate of weight loss is ominous; it should qualify him for hospice as failure to thrive. We didn't have the vomiting issue, but towards dad's digestive system wasn't working properly and food went right through him. His epiglottis became sluggish as well which led to aspiration and pneumonia.

HB

tonyac2 · April 4

Yesterday I had a video appt with his dr to get a hospice referral. I mentioned that my DH just finished a 7 day round of antibiotics to treat a UTI but his urine was still dark. She said he should be seen in the ER as he could become septic if the UTI wasn’t resolved. Most likely he is resistant to oral drugs and needs IV drugs. He was admitted to the hospital. I also asked the doc for a referral to a speech therapist to see if he’s having any issues like @SDianeL talked about.
These measures make me wonder if I’m ready for him to be on hospice as I doubt they would take the current path I’m taking with him. I can’t rationalize not treating something that’s treatable and just letting him die from it like I think hospice would do. Is that a form of euthanasia? Lots to figure out. Maybe my brain isn’t in the right place.

harshedbuzz · April 4

@tonyac2

I am sorry you are in this spot.

You said:

I can’t rationalize not treating something that’s treatable and just letting him die from it like I think hospice would do. Is that a form of euthanasia?

I feel it's more nuanced than that. In some situations, another potentially terminal event can be seen as an exit ramp that spares the PWD and their LOs the difficulties of stage 7. For my dad, it was aspiration pneumonia that offered him a peaceful passing before developed contracted muscles, bed sores and while he still knew us. In other situations, treating the treatable condition would be a painful or challenging way to spend their last months. A dear friend opted not to treat her mom's breast cancer when it was discovered fairly progressed when mom was in stage 6-ish. Hospice kept her mom comfortable and offered a lot of support to my friend around the emotional aspects and specific nursing tasks needed. For some (not all) PWD, being hospitalized is very traumatic and not a choice their LOs would make for the end of their life.

FWIW, antibiotics can be used in hospice care when the goal is comfort care and once on hospice. If your husband was on hospice and you wanted him transported to the ER, he would come off hospice automatically for the duration and you could decide on discharge if you wanted him to be re-evaluated for it or not.

HB

tonyac2 · 1:00AM

https://alzconnected.org/discussion/comment/269542#Comment_269542

I appreciate your perspective @harshedbuzz so much to think about. Like, is it me that can’t let go yet. I hate dementia and everything about it.

persevere · 2:10AM

Yeah so just to tag on to HB, Hospice's job is to ensure comfort. Their job is not curative in nature but for example, if there's a UTI which is causing discomfort they will treat with antibiotics. If the antibiotic cures it then so be it. But they would never pursue surgery or encourage feeding tubes. Regarding DH's current issue it could be he is severely backed up. When's the last time he had a good BM? Hospice monitors things like this to ensure they don't go too long. Sounds like now is the time to bring them in.

tonyac2 · 12:29PM

https://alzconnected.org/discussion/comment/269632#Comment_269632

He’s in the hospital getting IV fluids and antibiotics. He’s having bowel movements regularly, although I did ask for a CT scan of his abdomen to make sure he’s not blocked up. It’s crazy to me that you can have BM’s and a blockage at the same time.

Was spitting food out, now vomiting

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