Posted 12/12/23
Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing? -Matt 6:25
I feel pretty confident I have discussed this in the past, but it lends itself to a repeat. Dementia is a pervasive illness (It affects everything about the sufferer in some way or another). Some may disagree with this assessment, but they have only seen a person with dementia on YouTube if so. (Sorry if that was a little pokey. 🙂 )
My point here is mush. I know, I know, you may find most of my points as mush, but what I am talking about is the most common cause of death in dementia: bronchopneumonia (38.4% of the time compared to 2.8% for seniors as a whole—LINK) So, I repeat, four in ten with dementia die because they develop pneumonia. How can this be?
Here is your first clue:
The NIH explains the 2 body challenges with eating for us all: “Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. ” Volitional activities are stuff you want to do (He voted for Batman instead of either candidate under his own volition). Reflexive is just what it implies: It is something you do without thinking about it. (He voted for INSERT PARTY across the board reflexively even though one of them had died and another was in jail)
Bottom line, stated awfully early in the article to already have a bottom line: Eating/swallowing is hard enough when you are well, but when you have dementia in its many forms (Alzheimer’s being the most common form of Dementia), this process begs for problems…and it finds them well. 🙁
Why so much Pneumonia? I can think if a few reasons:
- Weakened organ systems throughout
- Poor diet leading to being extremely tired
- Catching airborne illnesses in a nursing home faster than a politician catches a glimpse of a baby to kiss when the TV station camera comes out
- and the winner for the most common reason: they forget how to eat and/or their muscles don’t do it automatically any more…and they inhale their food/drink into their lungs.
Enter the mush:
You get the point. Here was an article from a few years ago about similar: LINK
In the spectrum of dying peacefully in their sleep while dreaming of Spring all the way to dying from a million fire ant bites while you watch C-Span on your phone while you are waiting in line at McDonalds only to find out at your last breath that the ice cream machine was broken anyway…… to me, dying of pneumonia is far too close to the latter for my happiness. I know we cannot control everything, but if we can fight this way of passing we are better off. (Note here: Hospice workers I know insist that it isn’t as bad it sounds like/seems…they often fall asleep, drift into a coma, and are gone. However, to me just getting pneumonia is terrible!)
So, is there anything we can do to try to push back at this pneumonia menace? Absolutely! Here are some ideas (Note: I have been feeding my mom many days a week for a few years now. Things are similar when they feed themselves in this area) :
- At first sign of eating issues, talk to your primary doc and ask for a referral to a specialist: They will most likely consider a dietitian, a Speech-language pathologist (SLPs), or a ENT (ear, nose, and throat) specialist, or otolaryngologist. I am NOT an expert…they are. They went to school forever to know what they know. I went to school forever because…uhhh….errr…I ask myself that often. (Sigh…considering my life story and evaluating my choices)
- Feed them slower
- Make the room smell good so they don’t fight eating
- Avoid distractions for the same reason
- Teeth/Denture trouble? If you have ever bit your tongue when listening to a political speech and then noticed the sore when you went out to eat at McDonald’s on the way back, hoping in vain for ice cream to soften the pain, you know how mouth pain makes you eat poorly. Trying to eat away from a sore is hard enough when all is well in your eating process…
- Puree as needed…The doctor/specialists will discuss this quickly
- Chase food with thickened drinks. Have drink options. (Thickening usually comes in 3 levels: nectar, honey, pudding thickness)
- Routine is good, even in eating. Same time and place. 🙂
- Let’em have that stinkin’ Twinkie! It is soft enough…and many with dementia love’m some sweets. As long as it is cut up well and perhaps a little soggy with chocolate milk (Don’t knock it until you have tried it!), it will be ok.
- Nausea makes eating hard. It may even cause insufficient or excessive chewing. Anything different from the norm can cause issues, so treat other symptoms too.
- Oh, and the meds used for treatment of said condition can also cause eating challenges. Wash down with flavored, thickened liquids.
- Choosing food that is moist/moistened with gravy is better than dry. Avoid super fibrous foods like pureed beads or meats unless they are ground up well. Sticky food is also bad. Same with hot food.
- Check for food that was chewed but not swallowed. My mom would leave food in her mouth after supper and the potential to lay down with it still in her mouth was always there. I always go heavy on the liquids at the end to prevent that.
- Posture, posture, posture… Just like momma said when we were kids. “Sit up straight when you eat and drink!” As best you can, make their upper torso as vertical as is safe.
- Be aware as best you can. You can usually sort of tell whether they are swallowing ok.
- Mom has her food pureed and her drinks are between honey and pudding thickness depending on the preparer. We watch as closely as we can and do most of the above tips as well as we can…and we still fail. Give yourself grace!
- There are plenty more tips (LINK for one good list).
Add eating to the long list of things we take for granted every single day! There are sooooo many things we take for granted. 22,000 times a day we breath and never say thanks to the breath-giver for that air we commandeered. Take some time and be thankful for the absolute multitude of things we are blessed with every day, even from and through our loved one with dementia. Life is better than we remember to be thankful for…
#EndALZ
Update: Mom was stable yesterday. She only ate about 1/3 of her food though. (See picture above). She normally likes her mush (pureed food) quite well, but the atmosphere was terrible. A couple a folks with the disease loudly stuttering the same thing, another asking loudly to be taken to the bathroom right in the middle of an understaffed staff trying to serve supper, and people coughing everywhere. Not exactly conducive to eating well. 🙁 It happens. They do their very best, but some days it is what it is… 🙁
Daily shill:
Could you buy a little ornament heart or star for my Winter Solstice tree? I would love to get rolling well this year by getting the first $200 knocked out by the Solstice event on 12/21 and we are $30 of the way there. 🙂
Here is the link:
https://act.alz.org/site/TR?pg=personal&px=14575499&fr_id=17194