Inability to chew is Symptom of Late Stage dementia
It’s bad enough that Alzheimer’s disease robs the person of their sense of smell, which can certainly impact the appetite; but it also affects people’s ability to Chew, Swallow or recognize thirst.
There are many late stage Alzheimer’s dementia symptoms to cope with for the person who has Alzheimer’s and the Caregiver as well.
The person with dementia must be encouraged and reminded to drink plenty of liquids. Serving fruit and vegetable juices as well as water, soup, or yogurt at meal and snack times will certainly help. My Mom loved jello and it was a great way to keep her hydrated when she didn’t realize she was thirsty.
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As the person reaches later stages of Alzheimer’s disease, more issues arise regarding eating and swallowing their food. Often, in the final stages they may forget how to chew altogether and require tube feeding. Despite the fact that many people do remember how to chew and want to eat by themselves, there are still serious issues that can arise during the later stages of Alzheimer’s.
If the patient has difficulty chewing or swallowing, extra caution must be taken at mealtime. Agitation or rushing the patient while eating can cause them to breathe food or liquid into their airway and make them more susceptible to pneumonia.
If they aren’t chewing long enough or correctly, it will be easier for them to get choked on a large piece of food.
If the patient still wears dentures, be sure the dentures are checked periodically and realigned if needed. If they require dentures but refuse to wear them, they should only eat soft or pureed foods, along with liquid or cream soups.
My Mom needed a hearing aid because she was totally deaf, yet in the later stages of her disease she refused to wear the hearing aid
and depended entirely on lip-reading for any conversation.
The Best Setting for mealtime is:
- A simple table in a quiet area, with regular utensils that they are accustom to.
- Their concentration should be on feeding themselves–No television, loud music, conversation or a noisy room
- They should sit upright while eating, rather than reclining. That will aid in swallowing and chewing.
- They should remain seated and upright for a half hour or so after their meal to aid digestion.
As the patient’s disease progresses, mealtimes will last longer. It isn’t unusual for the person with Alzheimer’s to store or “pocket” food in their cheeks or under their tongue as they forget the need to swallow as they eat. Then they eat more and are pocketing more until they’re in a choking situation. They may need more encouragement and coaxing to chew and then swallow and they will tire more easily.
A little patience at mealtime will prevent frustration for the patient and the caregiver alike. If they are struggling to finish an entire meal at one setting, it may be advantageous to have smaller meals at closer intervals. Many caregivers prefer to change the feeding schedule during this later stage.
Often, the patient may be switched from 3 meals a day– to 5 smaller meals. And when they don’t remember to swallow, their diet is often changed to pureed food.
Caution must always be taken if they are hoarding food in their cheeks or under their tongue as this makes it much easier for them to get choked. Yet another good reason to switch to pureed or softer foods.
The caregiver might put more emphasis on easy-to-swallow, softer foods. The softer foods are easy to chew and swallow, such as pudding and mashed potatoes and decrease the fear of choking. Bite-size and finger foods, such as cubes of cheese with crackers, also work well. If the patient can no longer eat solid foods, try a food processor or blender. Many great tasting dishes are created with these gadgets. And with all the softer foods, you lower the risk of choking.
With good preventive measures, you should have no issues with choking. But–you never know when something might happen and– it’s better to stay prepared. Since late-stage Alzheimer’s often includes swallowing problems, coughing and choking are serious risks during meals. Learn how to do the Heimlich maneuver and be prepared for choking emergencies by having a phone nearby.
During the very last stages of Alzheimer’s your loved one may not be able to feed them self at all and have issues chewing their food. A last resort to furnish nutrition is to use a straw. Many have found that dipping the straw into pureed food, then hold your finger over the end until you put the straw into their mouth–then release your finger and the pureed food will slide into their mouth. The Alzheimer’s Speaks Blog offers a photo and instructions on this method of feeding.
Also, when they no longer want to eat or swallow, you may need to confer with their physician, he may suggest a speech or swallowing therapist. By watching the patient, they can tell if they are able to swallow and what would be the best way to feed them.
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My Mom is 89 and in a care facility. I go to see her every day and usually feed her one of her meals per day. She has been pocketing her food as well as chewing and chewing it and then spit it out. She rarely eats more than a third of her meals. She is on finely chopped meats and puréed fruits along with a soft mechanical diet. She has also started sleeping more of the day. Her memory is non existent for short term and seems to live when she was a child and constantly calls for her Mama and daddy. She frequently calls me apMama and thinks that I am her Mother. She has a difficult time finding and forming her words and has very little comprehension of what is said to her. I am assuming that she is in very late stages of Alzheimer’s Dementia. How long to you think it will be before she stops eating altogether?
You know, it really depends on the person.
My Mom never stopped eating but passed away with other issues. I have a sister-in-law who has been in a nursing home for many months. She can no longer talk or eat, but she’s still there. I think each individual is different. There is no knowing for sure.
Thank you for writing,
Sandy
It’s all so confusing. My mom is spoon fed (but not all the time) and ‘forgets’ to chew and the food dribbles out of her mouth. She’s mostly on pureed foods, but can eat softer foods. This points to end stage dementia. She’s been declining since 2009 and has been in memory care since Spring 2016. On the other hand, she always knows me and can always eat the cookies I bring for her. . .bites off a piece, chews and swallows. She is still mobile. Her short term and a lot of her long term memory is impaired. She still plays the piano and sings along to the visiting music groups.
Can someone with dementia be end-stage but still somewhat functional? I guess I always thought she would be nonverbal and bedridden during the end stages.
My mom is a stroke patient and she has diabetics for almost 20 years. And now she is resting in hospital for almost 3 months. Lately I notice that she seem can’t recognise me and I need to call out to her many times then she will respond. Is it a sign of dementia? Thanks to advise.
Mark
Hello Mark,
I’m very sorry for your situation at this time and hope your mother gets better very soon.
I’m not real sure that this would indicate dementia. After all she’s been through she may have signs of early dementia, but it does seem that her issues are from other things such as the stroke. In time, she might gradually respond better as she heals from the stroke.
If you share your feelings with her physician, I feel certain he would be able to explain her position better than me.
Best wishes Mark, for you and your Mom. We’ll be thinking of you.
Sandy
My Dad has been “pocketing” his food for about the last 6 months. He still has a lot of strength, but is very confused most of the time. He CAN remember things from long ago, though. He also becomes fixated and obsessed with things very easily. He never eats a full meal anymore, such that it is — usually 3 different foods on a small plate! I was wondering if the “pocketing” of the food is always a part of the late stage of Alzheimer’s, or if if can appear earlier?
Hello Anna,
You’re a wonderful daughter to be caring for your dad. Be sure and take care of yourself also.
There’s really no way to tell for sure what stage someone is in with Alzheimer’s or dementia. The later stages are always filled with confusion and lack of appetite but it can also occur in the earlier stages. My mom began losing weight early-on in her Alzheimer’s. She simply forgot to eat and wasn’t hungry later. So it might be earlier with your dad.
During the very late stage, they may forget how to swallow, but that’s a different issue than what you are seeing.
I’m glad you stopped by and wish you all the best with caring for your dad.
~Sandy