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My husband keeps putting food in his mouth when he hasn't finished chewing what is already in it. He chews and chews it all, then spits it out in one big mound. Then he adds other things on his plate to the mound, pressing it all together. I do cut his meats and problem veggies into small pieces, but this doesn't seem to make any difference in this behavior.

I would sit with my Husband and as he was chewing I would prompt him to swallow and I would also rub his cheeks so that food would not get lodged between teeth and the cheeks. (this is called "pocketing")
I would then tell him to take a sip of whatever he was drinking.
It is possible that you might have to cut the food up smaller or begin to process it so it is between small dice and puree. Or just begin to puree the food.
This is one of the declines with dementia. He is "forgetting" how to eat and the steps that need to be taken to consume food.
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Reply to Grandma1954
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Has your husband been evaluated for dysphagia, a swallowing disorder? It can occur independent of dementia, as the body ages.

The pocketing you describe is one aspect of dysphagia.
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Reply to GardenArtist
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my mother is unable to eat alone for a similar issue. I sit with her for every meal and coach her if she starts to add food when she hasn’t finished eating. She always has a glass of water next to her plate and I remind her to drink in between bites when she starts to do this. If I don’t do this then she has choking issues. I too have to cut up all the food. If my mom was taking more than she could eat and playing with the food then I would take the plate away and offer her food at a later time. You could also offer the food as soft food. Like oatmeal or soups or purées in single items at a time. My grandmother used to care for dementia patients when I was young and she would simply offer small plates of food all day long as her patient would forget when she had eaten but would always take just small amounts.
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Reply to Isabeau
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Here is a link to a useful site for you to read:

https://www.asha.org/public/speech/swallowing/swallowing-disorders-in-adults/

Soft foods are best to serve; applesauce, cottage cheese, yoghurt, scrambled eggs. Your DH may also enjoy milkshakes prepared with extra protein powder, and fortified with a banana or other fruits pureed in the blender. Offer him small snack type meals more frequently rather than full sized meals 3x a day.

Alz.org is another good website which has a question forum like we do here at AgingCare. They also have an 800 number to call to speak to a live person about specific questions you have pertaining to AD or dementia.

Best of luck!
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Reply to lealonnie1
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My 100-yr old Aunt does the exact same thing and has been doing it for a few years now. In her case, she is missing her front lower teeth and one or 2 molars. She is given a muffin and coffee for breakfast every morning and doesn't seem to have a proble with that. She takes a handful of pills at that meal and manages to swallow them. Then for lunch she has chicken and stars soup with an egg in it, with a piece of cheese and a granola bar (and drink), and doesn't have a problem eating that, either. But at dinner, if she has any foods that are more firm (like meats), that's when she will pocket -- no matter how small we cut it up. It could maybe have to do with Sundowning, that at the end of the day she is mentally more tired and doesn't remember how to eat. At dinner one of her family sits next to her and monitors what's going in and out of her mouth, and reminds her to drink and swallow. It's a very regular pattern. Amazingly, she seems to be getting enough nutrition as she has no other health issues.

In your husband's case maybe see if eating softer foods helps?
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Reply to Geaton777
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Purée might work if he’s able to still swallow. My mom holds food in her mouth because her brain doesn’t tell her what to do with it. She will chew and chew liquids until they drip out of her mouth. This is dangerous as it chokes her. Sigh. I hate this disease.
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Reply to LoveLea
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Relentless chewing and then pocketing food is a sign that the damage to the brain has progressed. The network of nerves that coordinate using a utensil, biting onto food, chewing the food, and then swallowing it before putting more food or fluid in the mouth is breaking down.
The safest strategy is to ask for a swallowing evaluation from his medical doctor. Specialized speech therapists can figure out quite a bit of what is and is not working reliably. Even if he is not fully cooperative for the whole exam, it is important to get this information. Then the correct strategies for what to give him and how to cue and supervise his eating and drinking will be clearly explained to you, and in writing.
To avoid choking (feels so scary) and aspiration of food particles into the lungs (causes pneumonia), it is very important to give the right stuff in the right way.
All of the suggestions here are possible answers - but not for all patents or at all stages of the disease.
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Reply to Clairesmum
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Sounds like it's time to puree all his foods and thicken his drinks with Thick-It. That should help with the problem he's having as it sounds like he has a swallowing issue, which you can have him tested for, but is very common with folks with any of the dementias.
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Reply to funkygrandma59
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Ewashib1: Perhaps the bigger problem is that he is not receiving proper nutrition since he is spitting the chewed food onto his plate. Since most foods can be blenderized, maybe this is the way to go to ensure that he is receiving nutritional meals. However, please seek his physician's advice before proceeding in that direction. Perchance he should also undergo a swallow study.
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Reply to Llamalover47
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7772186/

Memory Care is probably the answer, but it's a big decision that you need to make, based on your coping skills and financial status.

Until then, you both may benefit from meeting with Geriatric Psychiatrist.
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Reply to ConnieCaretaker
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