Auntkiki Asked June 2014
Mom is spitting out her food. Any advice?
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My mom who has LBD and Parkinson started a new thing. When I feed her she will chew a few times then spit it out. I don't care what kind of food chewy or soft like pudding. The only thing I can get her to do is drink 3 Boost a day and she love Popsicle. I am at the point of thinking I guess if she gets the Boost maybe that will be enough. She has lived with me and hubby for 21/2 yrs and until the last month I could get her to eat, but I do have feed her and now this. Is this normal? Thanks and have a blessed day!
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Does she speak? Have you asked her why she spits out her food?
When you see a doctor, you might ask about seeing a speech therapist for a swallowing evaluation.
What about her teeth? Has she been to a dentist recently? If not, perhaps a visit might be in order to make sure that her teeth aren't the problem with chewing.
Or it could be that her taste buds are changing and for some reason solid food doesn't seem good to her.
You might want to try to supplement her diet with fruit juices such as apricot and pear; they're thickened and not watery like some of the other fruit juices.
GardenArtist, what kind of test does the speach therapist do?
The speech therapists in the SNF gave him thickened liquids and watched carefully to see if he could swallow without coughing or choking. They also used objects (I can't remember the specific name of them) that were like lollipop sticks with small sponges on the end.
Certain tastes, of which I believe lemon was one, stimulate swallowing reflexes. The "stims" were used to prod specific areas of his mouth to stimulate the reflex, then he was given thickened liquids and observed to see if he coughed or choked.
When he was discharged and had speech therapy at home, he was given a set of exercises to do. One was akin to sit-ups for the neck, lying flat in his hospital bed, raising his neck and holding for I think 30 seconds. Another was to strengthen his vocal chords by making gutteral sounds, consisting of emphasizing consonants together. The sounds were something like Russian words. Sounds were something like ungh, thnk, but unfortunately I can't remember the rest. We joked that these were his Caveman exercises because the sounds were so gutteral.
There was another exercise but I can't remember it now.
I probably should mention that initially I did the consonant exercises with him so he wouldn't feel awkward, but the speech therapist advised me not to as doing them could harm my healthy swallowing muscles.
The most revealing and definitive test though was a videoscopic swallowing test (dysphagia videofluorscopy) during which he drank some fluid with a substance (barium, I think) that illuminated various areas of his mouth, neck and check. He sat in a room similar to an x-ray room, drank little bits of fluid, and the technician observed to determine where the fluid went - i.e., eventually into his stomach or into his lungs.
When he could tolerate fluids, little bits of food were added to see if he could swallow them.
This is a good explanation of the study: http://www.asha.org/public/speech/swallowing/Videofluoroscopic-Swallowing-Study/
There might be some less complicated tests that have been developed since 2004, which is when we went through this process.
He was again evaluated a few years back while in the hospital, but whatever was done was performed there and I wasn't present.
The therapist at that time did caution that sometimes dysphagia can, even if resolved at one time, contribute to weakened swallowing muscles at the person ages. She said to be sure to "flush" food down with water, rather than drinking water at the end of the meal as some seniors do. She also said NEVER to add more food into the mouth until it's completely cleared of the previous bits.
We have noticed that crumby foods such as cookies, bread crumbs, crackers as well as nuts and sometimes chocolate will provoke coughing attacks.
Hope this helps.
Thanks everyone for your help.
It just occurred to me that she may have a sore throat, throat infection, or something going on in that area.
The sauce on BBQ and cheese on the potatoes might be too "tasty" or sharp for her if there is something wrong with her throat. Yogurt generally goes down much easier though.
If the neurologist suspects a swallowing issue, you could ask for a referral to a speech therapist. He can get an appointment much more quickly than if you called on your own.
Good luck - keep us updated.
But I mainly just wanted to give a 'thumbs up' to consulting a speech and language therapist. The job title is a misnomer - they should be called mouth throat and tongue wizards!
You mention the possibility of a sore throat - is your mother appearing to spit the food out on purpose, or is it sort of making its own way? If she is 'actively doing it' so to speak, the other possibility is that her palate has changed and a flavour she used to like has gone weird on her. My mother suddenly found coffee too bitter and sugar too sweet (?!) - I think that, again, these are tiny neurological glitches.
Calculated Risk vs Quality of Life. He chose not to have a feeding tube early on in his Living Will. I felt that I needed to honor that request.