First noticed pocketing a half year ago. It was occasional and a reminder seemed to do the trick. Yesterday there was an escalation. For what seemed like a long 2-5 minutes we couldn't get mom to swallow. Multiple reminders and prods failed to accomplish the task. Ultimately aid brought her to the bathroom and simply removed the food from her mouth herself. Already spoke to the geriatric doctor. We're going to feed her earlier in the day and see if giving her something yummy like chocolate pudding helps. I'm not looking to fix her but wondering how long a person can go on with sub-optimal nutrition. I plan to tell the aid that if she doesn't appear responsive to food not to force it and simply wait till the next meal to start again. Given the choice between skipping a meal and asphyxiation I'd prefer t skip the meal
I'm a dentist and most of my patients live with dementia, so I see pocketing often. A few mouth-side ideas that haven't come up here yet:
- Check her cheeks after every meal and before she lies down. Food tucked in the cheek can slip back later and be breathed in, so a gentle sweep with a damp gauze or soft swab is worth making routine.
- Keep her mouth clean even on days she eats very little. Mouth bacteria are what turn an aspirated bite into pneumonia, so a soft brush or swab twice a day protects her lungs too.
- Ask the care team or a dentist for a quick mouth check. A sore tooth, loose denture, or sore spot can make someone hold food instead of chewing it.
I'd also ask her doctor for a speech-language pathologist swallow evaluation. They can tell you which textures and liquid thicknesses are safest for her now. Her doctor is also the right person for the nutrition question, especially if her intake keeps dropping.
Another episode where she can't swallow or struggles to breathe, or a fever or wet, rattly cough, means same-day care.
Checking her cheeks and keeping her mouth clean after meals is real protection for her.
Everything should be minced, pureed, or soft (like pudding). And someone should be feeding her, or at least monitoring her while she eats.
My husband has dysphagia, and I make him 12 cups of thickened protein drinks every day. I use 4 Boost, 4 cups of milk, 2 cups of water, a thickening agent (Nestle Resource Thicken-Up) and I add some instant pudding and a juice to create different flavors. Orange juice and vanilla is really good; so is Strawberry Banana. Instant chocolate pudding makes a nice chocolate shake.
This makes a yummy, creamy shake which he can easily swallow. It provides all the protein, calories, carbohydrates, MCT's and vitamins he needs in a day.
I totally agree with you, as I'm sure most doctors would, that skipping a meal is not as important as swallowing safely. Please avoid giving her any liquids which are not thickened.
As her body winds down, she may stop eating all together. The body can no longer process food when the end is near.
You are right that she consistently did better earlier in the day for breakfast and lunch.
When all of these things come about, they are nearing the end. I see it a lot at my husband's memory care facility.
In 2024 you posted you thought Mom was in her 6th or 7th stage. That was 2 yrs ago. Not being able to swallow can be the body shutting down. Food nor water should be forced at that time. The body can no longer process it. It may be time for Hospice.