Food options
My spouse has been on hospice for 4 weeks. Hasn't gotten out of hospital bed in our living room during that time. Still interested in eating for several hours a day. I put the head of bed up and he self feeds finger foods. Lots of coughing, but his lungs still sounds clear. Lots of food remaining in mouth after eating. Not sure where to go from here. It my heart, I know it would be best to feed him pureed foods and thickened liquids, which would require assistance. Are there other options? Will not do any type of feeding tube. What have others done? I will discuss with hospice nurse tomorrow
Comments
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Do you have a hospice nurse? When my wife was on hospice, her nurse was a great source of information. There was also a 24-hour phone number to call to get hold of an advice nurse.
(My wife was in the hospice due to her not eating when she was in the hospital. I didn't know they had hospice for non-terminal cases also. She got out of hospice about 6 months later.)
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@JDancer
Would hospice allow an SLP swallowing evaluation in your home with ideas to make feeding safer?
Dad's SLP suggested a number of strategies to feed him safely. We were encouraged to verbally prompt swallowing between bites. We were also given instructions on liquids that included a ban on straws and sports bottle spouts as liquid flooding the mouth with pocketed food is a recipe for aspiration as the epiglottis— which is controlled by a diseased brain— will not protect the windpipe quickly enough.
Liquids become a hazard to those with dementia before solids do. Thickening fluids or serving them separately might be safest.
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His nurse comes on Tuesdays, I plan to discuss with her
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I often have lunch in the dining room at the nursing home. Those with swallowing problems are on, as you said, pureed foods and thickened liquids. The aides that feed them have to say "swallow" when they put a spoonful of food in their mouth. Several residents have their wives come in to feed them their meals.
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Read the most recent studies on the subject. Thickened liquids are now being shown to not really help with Alzheimer’s patients. I think it makes us feel better to think we are doing something, but does not really give the results you expect
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Thickened liquids may also be more dangerous if choked on. Best to get the advice of a qualified speech therapist and research.
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This is such a tender and difficult place to be, and the fact that you are already thinking ahead about pureed foods and thickened liquids tells me you are paying very close attention to what his body is telling you even when it is hard to hear. The coughing and the food remaining in his mouth are signs that swallowing is becoming harder for him, and your instinct to move toward safer textures is a loving and protective one, not a step backward. Finger foods have been a wonderful way to honor his independence and his pleasure in eating for as long as that has worked, and that matters enormously. The hospice nurse will be your best guide tomorrow since they can assess his swallowing and suggest a speech therapist if needed, but in the meantime you are not failing him by wondering what comes next. Many families in this same place find that small, frequent offerings of soft or pureed foods, things that still taste good and feel familiar, can keep mealtimes feeling like a moment of connection rather than just a clinical task. You are doing this with so much care, and that love shows in every word you wrote.
I hope these references can help:
https://hopebridge.care/hospice-nutrition-and-feeding-beyond-the-feeding-tube/
https://en.wikipedia.org/wiki/Palliative_care
https://thegeriatricdietitian.com/embracing-hospice-end-of-life-nutrition/0 -
My husband died 4 days after I posted this
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You have my condolences.
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Commonly Used Abbreviations
DH = Dear Husband
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ES = Early Stage
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