My dad is forgetting to swallow his saliva, any advice?

Is your father on hospice care? If not, now may be a good time to get him evaluated. Late stage/end stage dementia often brings this inability to swallow along with it, which is fatal because other than a feeding tube, nothing can be done for dysphagia. A feeding tube is normally against a person's wishes for end of life care, especially when dementia is present. It's possible certain meds like a Scopolamine patch behind dad's ear may help dry up the saliva in his throat, I don't know. Ask his doctor about that.

I'm sorry you're dealing with such a thing and I hope you can get dad signed up with hospice asap.

I'm sorry, my mom had perhaps 3 months of this before succumbing to aspiration pneumonia. The difficulty with suctioning is that saliva is produced constantly, I was surprised to discover we can make over a litre every day, and feeding tubes don't stop people from aspirating their saliva! Medication to dry up secretions is problematic because it dries up every bodily fluid and I think it was worse than the alternative. Positioning him on his side while in bed can help drain the saliva out of his mouth onto the pillow, use a barrier cream on his face and an absorbent cloth on the pillow. Otherwise unless it is causing him distress my advice is to leave it alone. 🤗

I know you say that your dad is on a pureed diet, but are his drinks thickened as well with something like the product Thick It?
My late husband(who had vascular dementia)almost died from aspiration pneumonia in 2018 and had to have his food pureed and his drinks thickened until he died 2 years later.
The neurologist at the hospital said because my husband had dementia(like your dad has)that his brain was no longer telling his throat to close when he ate or drank thus allowing both to go into his lungs.
When eventually my husband was under hospice care they prescribed the Scopolamine patches to put behind each ear, and Atropine drops to put under his tongue to try and clear up the excess secretions.
I hope you realize how very serious this can be for your dad, and that most people do not survive aspiration pneumonia. My husband did initially survive it, but because he almost died, he developed sepsis and septic shock and was completely bedridden for the last 22 months of his life.

As a respiratory therapist, I would suggest that if you have catheters, change them to a Yankaur tube. The nose method may cause bleeding unless you are trained correctly. You also should use lube gel if you try. If he has no wheezes then stop nebulizer. So many are ordered out of the reason what the med does..asthma. You can stick that yankaur tube far down the throat because many people with swallow difficulty will not even gag. If you feel that there are still secretins are a
Iong way down it can be a crusty plug. Work on it for a while. If you cannot remove it, you see his breathing is labored and he is not on hospice, then your only recourse is the ER because an ENT appointment is too long. If he is on hospice, then check with the nurse for the next steps. He will need a visit.

I always suggest checking for an infection or identify stressors. My Mom had vascular dementia and would "forget" how to eat/swallow/chew if under stress or had an infection such as a UTI.
Apple cider vinegar will banish a UTI. One time of 1/4 or 1/3 cup acv in something super sweet, to hide it. Stress is a big one too. If we pushed her, or especially someone she didn't like, pushed my Mom to eat, she wouldn't eat. But set a plate in front of her and better yet eat with her like an enjoyable meal, she gobbled it up. We had a nurse determine my Mom had forgotten how to eat. My Mom was afraid of her. Without her, my Mom would eat just fine. Same with the hospital. The speech therapist determined a pureed diet when my Mom was still out if it from infection and a sedative. No one would eat at that point. When she could eat, it grossed my Mom out and she wasn't familiar with it so wouldn't eat. I begged them to let me feed her as she was begging for food after 3 days (and going quickly downhill from malnutrition). They finally did and watched in amazement, as she gobbled up all her favorites from me, chewing and swallowing with no problem. The therapist finally overrode the recommendations and told the nurse "give her whatever her daughter says". Familiarity, comfort, no stress, good food, but #1 infection. From my experience only. God bless!

Demntadaughter: Perhaps you should ask his hospice nurse to assist in your query.

Please ask for an evaluation by a speech therapist - a specialist in physical therapy. The therapist can evaluate his swallowing and make recommendations.