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Old 08-16-2012, 12:21 PM   #1
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Difficulty swallowing?

My MIL, who has been diagnosed with severe dementia (she's at later stage 5, early stage 6) lives at home with us. She has been complaining that she feels like she has a lump in her throat and can't swallow. She also says that it moves. Some days it's on one side of her throat, other days the middle or other side, higher, lower.. etc. It comes and goes, some days worse than others. We took her to see her primary care, who did an x-ray, which was clear. They're now ordering a CAT scan and a nasolaryngoscope. (I also noticed on the paperwork from today's appt that they have her listed as "mild cognitive impairment")
My question is, does this sound like dementia related difficulty swallowing to you experienced caretakers? I'm thinking we should try get her another referral for her neuro to evaluate her. She's convinced she has a giant tumor that's not showing up on the x-ray and doesn't want to go to the neuro. (Unfortunately, she's always been quite a hypochondriac).
Also, if it is dementia related dysphasia, is there anything they can do to help ease her discomfort?

 
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Old 08-16-2012, 02:04 PM   #2
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Re: Difficulty swallowing?

By the time my mother had difficulty swallowing, she was not able to verbally communicate. Her language had pretty much left her by that point.

I would think between all the tests you are having run, if there were a mass causing her trouble swallowing, it would show up on something.

 
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Old 08-16-2012, 04:56 PM   #3
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Re: Difficulty swallowing?

My FIL had also lost his ability to speak before he had difficulties swallowing so I have no idea what it felt like to him. This is usually the case

But one of the symptoms for those without cognitive decline is a feeling of something stuck in the throat which may be what your Mom is feeling. The nasolaryngoscope may give you some answers. Unless there is a tumor that the x-ray didn't pick up my bet is the CT scan will be clear. You may want to contact a speech therapist to do a swallow assessment. That is the simple non-invasive way find out what is going on. The speech therapist can also determine what food consistency will help.

To answer your question, yes it can be a result of the dementia and her food consistency may need to be adjusted to accommodate any problems she may be having. Her food may need to be "mechanical soft" which includes ground meats, soft veggies, and other foods that are easy to chew into softness. See if you can figure out what foods are giving her the most trouble since the level of difficulty seems to vary. Does she do better with a soup or ground meat than with a piece of chicken? If she is having problems with liquids, try "Thick-it", which can be purchased at your drug store, to thicken her liquids to the point they are easier to swallow. You may even need to puree her food so they are easier to swallow.

The other problem could be a GERD where the stomach contents back up into the esophagus. Again you will have to figure out the foods that cause the problem and avoid them. My husband has this problem and I know not to feed him dry breads or dry chicken (especially white meat).

There are lots of causes and hopefully the scope will give you the answer you need You might want the neurologist to update her diagnosis if she is further along than Mild Cognitive Impairment

You are doing all you can to get to the bottom of it and I do hope you find the answers you need soon.

Love, deb

 
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Old 08-16-2012, 08:46 PM   #4
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Re: Difficulty swallowing?

My late FIL had swallowing issue. Maybe it was due to Alzheimer's, he had this problem on and off. In the beginning since he chewed pills anyway, he liked softer food and etc. but he didn't use water to swallow the chewed pills. It happened in 2008/2009 when he began to cough on and off after he drank or ate. That was part of the Alzheimer's swallowing issue. It started but it was not life threatening. He still could eat regular food. Later in 2010, he began to eat soft food or baby food. Slowly he could still eat at that time. Yes there was one time he complained that his throat was itchy but we gave him benadryl to calm him down. (Benadryl is bad for the elderly with dementia but at that time he was sort of allergic as well so we just gave it to him once and he did wake up being confused talking about things with the wrong reference.)

In early 2011 the NH gave him pureed food since he choked on fish and some food and even water. He had had pureed food until July, 2012 before he died.
Actually he started having problem this April and needed to be fed first time. Really being fed. The last week he ate badly so he really died from stop eating as well as stop breathing from heart failure. His stop eating is not totally related to the talking. Actually he stopped talking around the time he stopped walking. He stopped talking last Sept and got more quiet in April. In fact, I think he really died after he literally stopped walking, talking and eating - 3 final steps.

For him, it had been a long toll for this swallowing problem. Your Mom may have started it but it does not mean the late stage eating issue yet.
You can calm her down telling her nothing is wrong. You can check it out to make sure nothing else is wrong. Don't focus too much on this or she would be upset. Give her Ensure or softer food for now.

Hugs,
Nina

Last edited by ninamarc; 08-16-2012 at 08:52 PM.

 
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Old 08-17-2012, 05:13 AM   #5
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Re: Difficulty swallowing?

I agree with what Nina is saying here. Also with other observations. My father passed away in 2010 from old age, if you want the truth. he was 95. He had severe dementia by then and couldn't swallow well. At least according to the folks taking care of him. They put thick-it in all his drinks, which turned them into rubbery tasteless gelatin. I wouldn't have bothered with it either. When properly monitored, he drank water just fine and very happily.

Dementia is not much fun for the loved one or the family. My father didn't know who we were in the end. He thought we were probably students he couldn't remember. (He was a teacher.)

I wish there was a better answer for dementia. A lot of people are doing research, and maybe one day we'll have a better answer.

I mean this in the most loving sense that I was happy that he was "tired" and never woke up again. He was incredibly intelligent, off the richter scales intelligent, and didn't need to be reduced to a few scrambled words.

I will always remember his intelligence and his impossibly big words. This is what brings me joy.

 
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