Is it true that Alzheimer's patients can stop swallowing or eating?

Here's something for you Lori. I'm not experienced with Alzheimers but plenty of people here are. Perhaps this will help a little.

Alzheimer's Disease at Age-Matters
Behavior of Alzheimer's Patients

Thanks to Beth Creason at about.com

The Seven Stages of Alzheimer's Symptoms

Do you know what to expect during the course of Alzheimer's disease? There are seven stages that describe each phase of this debilitating disease. Not everyone who has AD will have all of these symptoms, nor will they necessarily have the symptoms in the order I have listed, but, by using this guide, you can get an idea of the progressive decline of the patient's cognitive functions.

Alzheimer's disease usually lasts from three to 20 years. During this time, cognitive function steadily decreases. In many cases, patients do not die of Alzheimer's itself, but other complications, such as pneumonia, heart failure or infections.

Let's examine the seven stages:

Stage One: There are no symptoms at all. The patient has no memory impairment nor does he have any visible signs of other cognitive decline.

Stage Two: The patient will notice some mild memory loss. He or she will usually start by misplacing objects or forgetting names that are well known to them. He or she may wonder about the memory loss, but will usually blame it on aging.

Stage Three: The victim will notice an increase in memory impairment. They may make a trip to the store and forget how to get back home. Their work performance may suffer because the patient may forget important details while working on a project. They may start trying to think of what a particular object is called, and the frequency of forgetting names of people they should know well will probably increase. Reading may become a problem, as the patient cannot remember what he or she has just read. At this point, the patient may lose or misplace something valuable, not remembering where they put it. Concentration will become very difficult. Most victims will go into denial during this stage, and will tend to have problems with anxiety.

Stage Four: In this stage, some long term memory loss will be seen. When asked about news headlines or current events, they may have difficulty in recalling what is happening. Travel becomes difficult because of the anxiety it causes. The person may not be able to handle their finances any longer because of confusion. The victim will usually start to withdraw from anything that presents a challenge. Denial is still prominent.

Stage Five: The patient now has to have assistance with some activities of daily living. They usually need help in selecting the clothes they wear, as during this stage they tend to dress inappropriately. They can still feed themselves and use the restroom without assistance. They may have trouble remembering some family members names, especially grandchildren or siblings, but can usually tell you their own names or the names of their spouse or children. They have trouble recalling such things as their address, or phone number.

Stage Six: The victim may now start forgetting the name of their spouse or children. They usually cannot recall any recent events in their lives. They may be able to recall things that have happened in the past, but cannot go into detail about the events. They are disoriented to time and place. When asked to count from ten, they will usually not be able to do this. They may even have difficulty in counting from one to ten. They may become incontinent, and will require help with most activities of daily living, such as bathing, toileting, dressing and sometimes eating. Delusions and paranoia may be a problem. They may start having some difficult behavior problems. Anxiety, agitation or violent behavior may occur.

Stage Seven: Most communication skills are lost. Speech is non-existent. The patient is incontinent. They will need help with feeding and toileting. They will become unable to walk or control other motor functions. During this stage, the person usually becomes bedfast.

It's been my experience that many patients will stay in stage five or six for a long period of time. Some patients that I met several years ago that were in these stages are still in the same stage. Not every patient is the same, so the stages and length of time in each stage will vary.

You can help the patient by showing him or her a lot of love and patience. Learning the different stages and knowing what to expect, will help you, the caregiver.

They may aspirate food into their lungs. That took out a friend's mother. Mom has problems swallowing, probably due to dentures at this point.

A swallowing study can be done easily by a dietician in one nursing home my husband was in every new pt. even those for rehab had a simple swallowing study done by the dietician and if needed a more complex study can be done if a pt. can not swallow then a feeding tube has to be placed.

I really appreciate the information you all have given to these questions. I particularly appreciate the 7 stages Pamela mentioned. I recognize some of the stages my mother has moved from and into. I see her now in a combination of 3, 4, and 5. I think she may get frustrated trying to read, but she won't say so. One thing I read here too that made me feel a whole lot better, is that I may have to accept it when my mom refuses to take a shower. A co-worker said I must make her take a shower at least twice a week. I felt awful, because my mom is very stubburn! Anyway, thanks again!

Jodi,
My mom had the same problem with the shower. She was very good about it until all of a sudden she absolutely refused to go near the shower. We think she may have forgotten how to adjust the water temp at one point and it either got too hot or too cold. Too late we learned about this possibility from the Alzheimer's Association. They recommend starting the use of a bathtub chair and wand shower as soon as the Alzheimer's patient is willing to accept being bathed by a caregiver. The sooner this happens, the easier it is for her to adjust to the caregiver and to the new method of taking a shower. Once an Alzheimer's patient has a bad experience with something they instinctively stay away from it.

Has he been diagnosed with Alz or a certain form of dementia? There are actually several different types of dementia, and even though they all basically behave the same they have distinct differences. My gma has multi-infarct dementia, which means dementia from multiple strokes, and in theory she can have these strokes for the rest of her life. It is possible that she will have a stroke in the area of her brain that tells her she is hungry, and she will stop eating. Or it could hit the area that tells her heart to beat. There's no way of knowing. Check with your doc to see the specifics of his form of dementia, because it may behave differently from Alzheimer's. No matter which form he has, there's lots of hope and every day there's more research being done and more treatments available, so don't lose hope. Also, he might think he has already eaten, so he won't eat again-I've hit that wall a few times. I have a few tips on getting stubborn people to eat if you need them :)

Yes it is true...I experienced that my mom went from eating whole foods at the beginning, and as the muscles in the throat did not work properly, and his disease progressed, she finally ended up with having strained foods. I believe that the dietician can evaluate your mom's capability....so her meals can be prepared accordingly.Inasmuch as everyone with AD can react different...this may or may not be the case with you, and I would have a further evaluation.

Good luck~

Hap

Hi Jody,
Eating and dementia is often an eiither good or bad mix- it seems that you are now in the bad mix area. People with dementia are still with us so now you will have to try to figure out why mom doesn't want to eat.Knowing the stages of dementia is good, but most people travel within several stages daily. She may need food that is easy to eat such as finger food or she may no longer like what is being served. Give her two choices of meals that you can easily prepare.
Some people no matter what stage they are in may have swallowing problems. Have the doctor order a swallowing test. Sometimes a person may need to start again with pureed food and then gradually move back to table food.
What is going on when the meal is being served? A person with dementia might not remember what is in front of them. They may look to you for clues as to what to do. They may just need a gentle start from you. They may be confused as to which utencil to use. Place the fork or spoon in their hand. If needed- hand feed them.
Keep mealtime simple. Focus on eating. If you are hand feeding mom keep encouraging her and when the food is in her mouth rub your index finger on her cheek to encourage swallowing.
Hope this helps.

Lori--to follow up....It may be a good idea to contact the experts at the Alzheimer's Association as well----they have a 24 hour help line...or go online to alzheimer'sassociation.org, as they have an ongoing forum there as well.

The more you learn and know about this disease, the better you will be prepared. You seem to be off to a good start, by entering your question in this online forum.

Once again--Good luck :-)

Hap!

All this is very informative. Doesn't it make you think about prevention? When they find the cause, the real cause, then they can work on prevention.
An elderly person living with a younger person (daughter, son, caregiver etc.) should always be provided for> meals have to be served to them and bath/shower water started for them before they enter the bath. Clothes should be selected for them, and they should be groomed by the person caring for them. It was an absolute joy taking care of my husband during the last two years of his life. What I wouldn't give to have him back home here again.

Lorilori folks with Alzheimer's disease lose their skills as they learned them. They will forget how to chew and swallow. Choking is a big issue, make sure that his head is elevated when he eats or drinks. take care Jaye

Bob DeMarco of Alzheimer's Reading Room newsletter and website wrote about feeding tube decisions in today's post.
http://www.alzheimersreadingroom.com/2010/02/alzheimers-are-feeding-tubes-good.html

Thank you - that was the clearest concise descriptions I have found. I now see Mom is in stage 4. Her denial and ability to hide it so well have made it difficult and at times even I wonder......so I have had to be a bit of a detective and pay close attention. Knowing what is to come-I hope i can prepare for it.

I myself am not familiar with Alz and I keep reading about the different stages. Do these stages come fairly close together, or there a lot of time in between each stage, or does it vary with each person?

What was said by someone else, that a co-worker said that her Alz.
patient had to have a shower twice a week is not true. As long as you give her a good sponge bath each morning (when you aren't giving her the shower), once a week is fine. I give my m-i-l a good sponge bath every morning except her shower morning. Elderly people don't sweat as much because they are not as active as we younger people are.

To the person who said to hand-feed the elderly Alzheimer's patient, I wouldn't do it. If that person gets to the point where they continue not to eat by themselves, they need to go into a nursing home. I hand-fed my m-i-l last winter and she got used to it. I eventually kept Ensure in the house to feed her meals. Ensure is supposed to take the place of a meal but I limited the Ensure to once a day and pureed the other hot meal. I didn't have too much trouble with brkfst. After so long, she went into the hospital and then the nursing home for rehabilitation. She was eating whole food again within a week of her coming home from nh.

There is such a thing as a "swallow study" performed by ENT's and their staff (some). It can show how much food can be tolerated in one sitting, how food must be chopped, pureed, or mashed, but more importantly what kinds of food the elderly who have swallowing issues must consume.
What's in: mashed potatoes, puddings, applesauce, cranberry sauce, chopped veggies and chopped meat. What's Out: Pastries! bread with liquids ( the bread expands), peanutbutter, elbow macaroni or "ringed" macaroni, anything that expands.

my mama sometime whispers or either a hum sound...her pluse went sky high an ems was called,,,she acts as if she wants to talk so bad ..she will get a feeding tube thursday if she is physcial able ..what happens if she cant get the feedibg tube..thanks betty

my mom has alzheimers- speech about 90 % gone - falls alot- got motion detector for night time- baby monitor during the day- so i can see her when in anther room -used to hate showers- but same as child - hate water in the face- so got a shower with hose - sits on a chair in tub- washe body( also does not like even warm water says its hot- so she gets cold - bought a small propane heater to keep bathroom warm) tilt head back - no water in the face. she does not complain when it is shower time- now she takes one every other day - good luck

Hi Lorilori,
When a person such as your dad has dementia, over time they WILL forget how to chew and swallow. For some, they may regain these skills (my mom did after a hospitalization where my sister demanded a feeding tube- luckly for Mom it wasn't in her living will- which made it easier for me to deal with the doctor and NOT have a tube put in place). Mom then went on a diet of blended food and progressed to real food and did well for 10 more years. I say well because she was still with me and I had round the clock care in my home. Frankly, knowing my mother- the last thing she would have wanted was to spend down her childrens inheritence for her care- at this point in her life. The reason that I'm sharing this with you is that a person with dementia,now has a progressive, irreversable brain disorder and that over time, the body will naturally shut down. When that happens, it is a good goodbye. Over the years and working with different hospice agencies I had the opportunity to understand what tube feeding is and how it affects the body.- which is not alsways pleasent. Many nursing homes and ALF's use tube feedings to cut down on the time it takes to actually feed a person- it's for their convience and not in the patients best interest. Nobody HAS to have a feeding tube. Feeding tubes may prolong life for the person but may also prolong suffering. Feeding tubes are often a cultural or religious issue. I look at this as a quality of life issue. Food is love. When a person stops wanting to eat I often wonder if out of love, they are letting us know that it is time to let go.
I don't know where you live or your circumstance and beliefs. The best advice I can give you is to speak with your local hospice- they have clergy, social workers and RN's that work as a team and will best help guide you. G-d bless

my mama cant swallow she cant even hold her head up..i feel when god is ready he will get my mama but until then i will cont to get medical care for my mama...the alz.has really taken a quick tole on mama..if she is physical able today she will get a feeding tube...it is not us to decide when she will go home to god but to give her as much love an care as possible...i dont like a feeding tube but what do i do sit there an watch her suffer an starve to death....prsy for my family god bless you all ..betty

A note on the showering. My mom showers three times a week. A nurse at respite care told us that even once a week is fine. The older someone gets, the less natural oils they have on their skin. Showering washes those away. Apparently some nursing homes have moved to showers only once a week and the instances of sores, rashes, etc. on the skin have decreased.

My mom has been in stage 7 for the past year. Just this past week she started having trouble swallowing. She will push her food out with her tongue or pocket it in her cheek. She has a living will which states absolutely NO TUBE feeding. She was diagnosed 20 years ago and is now 83 years old. This is one of the cruelest diseases. You literally come full circle from baby and back again at the end. She always said death is a part of life and was never afraid of it. It's harder on the families. She is probably in a very happy place in her memories - at least that's what I like to think.

I would encourage you to try to remember the Mom you knew growing up. Yes I do agree that AD is cruel and unrelenting. take care and God bless...

It is good she has a living will I would encourage everyone to talk to their parents about that my Mom does not have it is writting but I know her feelings and it was such a comfort to have it in place last year when my husband was critical so I did not have to make tough decisions at that time. Declamber your Mom is probably at a good place and you know she is not afraid to die I hope that is a comfort to you.

my mother was in a nursing home and all of a sudden she kept her food in her mouth when I fed her she couldn't swallow, what happened? Did she have a stroke?

nanalove...is this still an ongoing condition that you are working with? You may have to go to protein shakes, drunk through a straw. Work with viscosity, does thin or thicker work better. I dilute Mom's protein/yogurt/fiber smoothies with coconut WATER,which is full of elecrolytes, more than Gatorade. good solution for mom for her leg cramps. very few any more. Anyway, if the shake is too thick, it's too stick for her to swallow. Also work with the diameter of the straw, really. the amount of sucking needed, bent is probably better. I got this down to a science currently, but her condition may change. I use the plastic cups and tops I get my iced latte in. Amt of fluid also in cup...like too much in cup and it's too heavy. also the temperature, mom does not like too cold, so luke warm. I will also put a wrapper around cup for insulation. I use old decorative socks like you'd wear at Halloween...good use for those we don;t use any more.

Alz or not, an elderly patients' food must be pureed. You have to know just when to introduce this type of food. You have to keep watch and you'll know when the time has come. Not all foods have to be pureed, but the condition known as Dysphagia can cause food to settle and not go down or to just get stuck in the long esophagus. Get out the blender. Good luck.

Use a stick blender...so much easier and more bettah than a tabletop jar blender. Haven't tried a regular puree device. Also, problems with dentures, food being stuck beneath them, adhesive oozing out. Finally, I got Mom to give them up...well, one day I just refused to give them to her. Too many agonizing hours fooling with them, choking. How many hours a day devoted to stuff like this. People don't realize. During one period, I think I spent two hours a day just on mom and her gloves. Dentures alone can take up hours...

Keep in mind that someone with Alzheimer's disease loses their skills as they learned them... We were not born eating. It can be very complicated to chew breath and swallow... Pureed foods are easier to swallow however don't always look very appetizing try to do hi protein shakes and cream soups and custard's and puddings...

My mother has had this disease for @ 20 years now. She was doing good with finger foods, but now all she wants to have are sandwiches. Depending on the sandwich, she will shove the quarter of sandwich into her mouth and forgets to chew or swallow. Now she can't figure out how to spit the food out. Being a diabetic all she wants is to eat sweets or candy. I deny her of these things because her sugars are doing good. She is 86 years old and lost her husband 2 years ago and they were married for 50 years. I really expected her to go about 6 months after he past, but this cruel disease is just holding her down. My father's dying wish was for me NOT to put her in a nursing home, I just don't break promises.
I do have providers that come in to assist with her care. But they are only there for a paycheck!!! I have my 25 year old daughter staying with my mother and she is at her wits end with all that is going on. Does anyone have any suggestions that I really could use?