How does one forget to chew or swallow? It’s so counter intuitive, but that’s what happens with dementia patients. They forget to chew or swallow, or they’ll pocket food holding it in the sides of their mouths. Since my father died my mom goes through bouts of spitting out all food or saying she’s hungry but not chewing or swallowing. In fact, she doesn’t even need to chew as she’s on a puree diet, just swallow, but the food or drink simply runs out of her mouth without her even being aware of it. It’s one of those moments with this disease that really shows me who’s boss, who’s going to win in the end. The disease. It’s the realization that one of those next stages I’ve read about is starting, and no matter how prepared I think I am, the pain is biting and deep. Dementia robs so much dignity from the person. Mercifully, my mom has always been unaware of her condition, but many people are aware of their cognitive decline in the beginning and have moments of lucidity in the mid stages which is tortuous for them and their families.
My mother will repeat, repeat, repeat, that she’s hungry and that’s when I start the frantic parade of foods hoping something will be so yummy that her primordial reflex to swallow will somehow kick in. Soup, jello, applesauce, flan, pudding, cottage cheese, yogurt, ice cream—no luck.
Not even the favorite—CAKE.
So then what? She's angry, I'm overwhelmed. We're both frustrated. She keeps telling me she’s hungry, she’s HUNGRY, but all I can do is fluff her pillow, give her a kiss, turn off the light and hope she’ll fall asleep. I try to do the same, but it doesn’t work so well on nights like these...
Some tips I’ve received from speech therapists to make swallowing safer:
Cut food, preferably soft, into small pieces and feed them slowly.
Have meal time be stimulus free of t.v., noises or too much conversation.
Puree food in blender if necessary. I add secret ingredients like avocado, olive oil, tofu or beans that boost good fat, calories and make things creamy! Cottage cheese is a great high fat, caloric food but I puree it with apple sauce (she spits out anything with texture now) Love the Vita Mix
Don’t use straws which can cause choking. Use sippy cups
Thicken liquids like water, tea, juice with products like Thick-it.
Have them sit up straight and keep them upright for 30-40 minutes after eating.
Soft, thick foods like yogurt, custard, ice cream, applesauce are good choices.
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