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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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My mother swallows her food and medication fine. She holds saliva in her mouth and refuse to spit it out. This started a few weeks ago. Why is saliva building up in her mouth? How can I get her to spit it out?
I'm sorry to see the news about your mother. I'm not sure about the answer to your question about saliva. My LO does that too, but, she didn't start doing it until she was in end stage dementia. I have read various reasons as to why this happens. I hope someone else can explain it. I think it has to do with the person forgetting how to use the muscles that cause swallowing, but, I'm not sure.
My Mom is my best friend. I Love her so much.Today I broke down and cried. My left hand started shaking uncontrollably.Thank you for the comforting words,information and suggestions.
Ririwoo, this is such an awful disease for everyone involved.
Hugs for all you do!
Please remember to take care of you during this difficult journey. The stress of watching a loved one slip away one brain cell at a time is greater than we think, it is so important to find a release for yourself, because if we don't leak we will blow. Your body is telling you something, listen.
"Remembering" to swallow is often a problem. Another problem arises when the body does not realize that swallowing a liquid, or anything for that matter the things that need to go to the stomach has to be diverted from the lungs. If the body/brain does not realize that it is a fluid or solid it may not divert and the food or liquid can end up being aspirated. This can lead to "Aspiration Pneumonia" and that can be fatal. There are medications that will decrease the saliva. Or you can use swabs designed for this purpose. It may also be the time that you need to start thickening fluids as well as chopping or pureeing solids. To confirm this the doctor could refer her for a swallow test.
You probably can not get her to swallow or spit as she will not remember when to do it. Start looking for "clothing protectors" (aka bibs, I don't like the terms bibs or diapers for adults)
Oral care is very important -- if bacteria build in her mouth she can aspirate it and the bacteria infects lungs turning into pneumonia. She may not be swallowing all her food and meds. She could be pocketing it in her mouth. I brushed my mom's teeth and used a portable water pic at a low setting to rinse..eventually she was not able to tolerate that so I resorted to mouthwash and oral swabs. If you do not clean her mouth at least a few times a day, she will get pneumonia.
It's called pouching. She may have difficulty swallowing. The saliva or other food backs up in her mouth. The more it backs up, the more difficult it is to swallow due to its size and her anxiety.
Pouching is usually a symptom of stroke patients and folks having swallowing difficulties. Ask your doctor for a referral for a swallowing evaluation - usually a special physical therapist who will evaluate you mom's ability to swallow different textures and thicknesses of liquids. and foods After the evaluation, you will know which foods and liquid thicknesses are safe for mom. The therapist can also let you know about thickening agents you can buy to thicken liquids to appropriate consistencies.
My mother does this too. She's in late stage dementia now and it's been going on for well over a year. I've found no real solution other than extreme patience.
She's been hospitalized for aspiration pneumonia once and she had a swallow test done then. Switched to a soft diet and nectar thickened liquids but she won't drink the thickened. Tried them again last month as she was doing more coughing during meals but she refused to drink so back to regular water, juice and milk. Hospice has been giving me guidance with these decisions.
I'm not really sure that it's strictly the swallow reflex that's causing my mom to pocket food, meds and not swallow saliva. I find she does it more often when she's tired usually at the end of a meal or in the case of saliva when she's drowsy right before nap time. It's almost like she doesn't know what it is in her mouth. And then she's too tired to get her brain to tell her how to spit it out.
Besides patience, I use clothing protectors (we call them aprons) and spit trays to try to contain the mess. What doesn't work for my mom is trying to remove food manually - she will bite, trying to get her to drink more to "wash it down" - she will hold it all and create a bigger mess, or massage her cheeks - staff tries this to no avail.
Yesterday I sat with her for two hours trying to coax her to spit out some saliva and Magic Cup. But she refused and fell asleep. So I tucked two napkins under her chin, alerted staff to the situation and went home for awhile. Came back at supper and of course she'd managed to spit/dribble it out on her shawl.
Like so much of this disease there's no rational explanation or solution. But I understand your frustration and concern.
It took 1-1/2 hours to feed mom a single meal. Her Alzheimer's got so bad she ended up with a PEG tube because I didn't want her to die slowly of dehydration. Worked out great and she lived quite a while and could have gone on for more years...until she went into liver failure; she had liver cancer. Feeding and hydration was easy after the peg tube and she never bothered it. she never had a single infection after it was put in; before the PEG tube she had chronic UTIs and lived off of antibiotics for months. That went away after the PEG tube.
Ririwoo, Thank you for your post. I am dealing with a similar situation. My mother's dementia truly manifested itself when she began to have difficulty swallowing liquid, not food. She had a couple of sessions with a speech therapist to assess her swallowing and yes, it does seem that she is beginning to forget how to swallow, and must be coached. I understand this is not uncommon in cognitive impairment. At first it was an easy fix, she took her pills with apple sauce and I gave her the mucous-thinner Guaifenesin (OTC), in combination with Benadryl, which curbed her compulsion to spit constantly. As her dementia progresses, all bets are off, and every day presents a new challenge or raises a new question. I wish you well. R27
She didn't forget to swallow. She has awareness of the quality of the food in her mouth. If she is afraid that she can't swallow it whole without taking some into her windpipe, she will hold back. It can be for a variety of reasons. My mom will spit out nuts or chocolate chunks in ice cream since she can't control them. My neighbor can't eat Rocky Road ice cream for the same reason. It is the same thing with pureed lasagna with large chunks of meat or with pureed stir fry vegetables. The meat can't be broken down or there are too many stringy food parts left after the puree. The solid food has to be like thick sauce to be eaten.
Usually you would swallow after eating/drinking something & that is hard wired from infant time so because she hasn't had anything cross her lips she may not realize the need to swallow - what happens if you offer her some liquid to drink?
I am humbled by so many of the posts about such difficult situations. My heart goes out to all of you dealing with these problems day in and day out. I hope you all also have a few moments each day of joy and peace.
If she is in a facility, ask for a swallow evaluation, usually done be a speech therapist. If she is safe for thin liquids, have a sports bottle around with water in it. Anyone coming on the room should offer her a sip anytime they come in her room. The idea is to encourage her to swallow. Oral care specifically tooth brushing goes a long way to reduce the chance of aspiration pneumonia.
My Mom would also squirrel pureed food in her jaws. When she had to go to the nursing facility for 24/7 care. The CNA's discovered it and told me so that when I fed her myself, which I did sometimes, I would be aware of it. They had to start thickening my Mom's water too after her 3rd year there. If you notice your Mom strangling, be sure to put in a request for a speech therapist to check her. Mom had one twice. Difficulty swallowing can sometimes come along with the dementia. Been there with Mom. Mom had to be x-rayed 3 times for aspiration and in her final days, she DID aspirate and passed away from pneumonia due to aspiration. It is on her death certificate. The nursing home said she didn't have pneumonia and I made them call EMS and take her to the hospital and they confirmed there that she did indeed have pneumonia and it was aspiration related. Anytime I was worried about her enough to make them take her to the ER, she had a UTI or something when they got her there. Stay behind them in that nursing facility. Some CNA's do not take enough time to properly feed them and give them the amount of water they need. Some would dispute this but Mom was in there 4 years and I was there on a regular basis. They did not like me much because I would jerk my Mom out & take her to a "real" doctor in a skinny minute if I suspected they were not checking her well enough. She needed the outside help every single time I did it too. Medicare/Medicaid had no problem paying for the trip and the hospital either because she was always diagnosed with needed medications and I would follow the transport van back to the nursing facility to get her settled back in with her all out of sorts and give them the prescription for the proper medications. It is not easy but I was the only one to see about her and I did the best I could. Just things to look out for and not to alarm you. Be aware, that's all. Good luck to you. God bless.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Hugs for all you do!
Please remember to take care of you during this difficult journey. The stress of watching a loved one slip away one brain cell at a time is greater than we think, it is so important to find a release for yourself, because if we don't leak we will blow. Your body is telling you something, listen.
Another problem arises when the body does not realize that swallowing a liquid, or anything for that matter the things that need to go to the stomach has to be diverted from the lungs. If the body/brain does not realize that it is a fluid or solid it may not divert and the food or liquid can end up being aspirated. This can lead to "Aspiration Pneumonia" and that can be fatal.
There are medications that will decrease the saliva. Or you can use swabs designed for this purpose.
It may also be the time that you need to start thickening fluids as well as chopping or pureeing solids.
To confirm this the doctor could refer her for a swallow test.
You probably can not get her to swallow or spit as she will not remember when to do it. Start looking for "clothing protectors" (aka bibs, I don't like the terms bibs or diapers for adults)
I did buy a portable suction device from Amazon.
There are suction devices for dementia.
She's been hospitalized for aspiration pneumonia once and she had a swallow test done then. Switched to a soft diet and nectar thickened liquids but she won't drink the thickened. Tried them again last month as she was doing more coughing during meals but she refused to drink so back to regular water, juice and milk. Hospice has been giving me guidance with these decisions.
I'm not really sure that it's strictly the swallow reflex that's causing my mom to pocket food, meds and not swallow saliva. I find she does it more often when she's tired usually at the end of a meal or in the case of saliva when she's drowsy right before nap time. It's almost like she doesn't know what it is in her mouth. And then she's too tired to get her brain to tell her how to spit it out.
Besides patience, I use clothing protectors (we call them aprons) and spit trays to try to contain the mess. What doesn't work for my mom is trying to remove food manually - she will bite, trying to get her to drink more to "wash it down" - she will hold it all and create a bigger mess, or massage her cheeks - staff tries this to no avail.
Yesterday I sat with her for two hours trying to coax her to spit out some saliva and Magic Cup. But she refused and fell asleep. So I tucked two napkins under her chin, alerted staff to the situation and went home for awhile.
Came back at supper and of course she'd managed to spit/dribble it out on her shawl.
Like so much of this disease there's no rational explanation or solution. But I understand your frustration and concern.
Thank you for your post. I am dealing with a similar situation.
My mother's dementia truly manifested itself when she began to have difficulty swallowing liquid, not food.
She had a couple of sessions with a speech therapist to assess her swallowing and yes, it does seem that she is beginning to forget how to swallow, and must be coached. I understand this is not uncommon in cognitive impairment.
At first it was an easy fix, she took her pills with apple sauce and I gave her
the mucous-thinner Guaifenesin (OTC), in combination with Benadryl, which curbed her compulsion to spit constantly.
As her dementia progresses, all bets are off, and every day presents a new challenge or raises a new question.
I wish you well.
R27