The deterioration of the brain caused by Alzheimer’s and many other dementia-related diseases will eventually impair the nerves and muscles that control the ability to swallow. This is known as “dysphagia.”
As dementia patients’ swallowing reflex becomes marred, there are certain symptoms caregivers need to be aware of as their disease advances. Among these are:
• the improper inhalation of food and fluids, causing such particles to aspirate through the windpipe (trachea) and into the lungs: very dangerous.
• frequent choking
• hoarseness in voice
• heavy coughing
• drooling
It is important that we be aware of the condition of dysphagia as it often progresses into a severe case of pneumonia.
The logical thought might be that switching to thinner fluids would be best in this situation, but actually it’s the complete opposite. Thin fluid runs down patients’ throats too fast, not allowing stimulation of the swallowing reflex time to occur. This is a good time to invest in a good blender or even a food processor. Simply put, a thick milkshake may be easier for folks to drink. Try using their favorite ice-cream and a little milk for thickening purposes. If this isn’t effective, there are thankfully many products on the market created to help alleviate this, or other swallowing problems. One is appropriately named “Thick-it.”
At the onset of a swallowing problem, the doctor may order a swallowing test known as a barium X-ray. Here patients need to drink a barium solution that works to coat the sides of the esophagus, causing it to show up better on X-rays so that professionals can assess muscle activity.
There’s also the “Dynamic Swallowing Study.” This is the swallowing of foods of different consistencies coated with barium, making them visible while they travel through the mouth and down the throat.
Always have these loved ones sitting in a straight-up position while eating and for a good half hour afterwards. If their bodies become limp and they start sliding into a slumped position, try propping them up with pillows. Chairs with sturdy arm rests are always good to have for them at the dinner table.
If you notice any of these symptoms it is probably beyond the time where cutting their food into small, bite size pieces is the answer; instead use the food processor and consult their speech therapist as to what else to try. As far as drinking, they might have better luck using a straw or even a sippy cup, something that gives them more control of their intake and helps them keep their heads in a downward position.
Mealtimes should never be rushed. With my dad, I always found it best to actually sit down at the table and eat with him, as a family. Every time I tried to do errands while my father ate, I came back to an untouched plate.
If you notice any of these signs, please don’t hesitate to call a physician. The doctor may be able to prescribe an appetite stimulant, helping to keep them well nourished. Beware of dehydration. We have now reached this point in my mother’s care from vascular dementia. It’s beginning to become difficult to get her to finish her meals. Thank goodness for ice cream!
Enjoy the precious moments you have with your loved ones. I would be delighted to be able to cut up my father’s meal and sit down with him once again.