Dementia – Alzheimer’s: A Clogged Throat Nightmare Continues

Thursday – Friday Sept 11 – 12, 2008

This has been a real nightmare for us this past three days at least. Actually it has been well over a week that these more serious choking episodes have occurred with Mr. Q our Alzheimer’s resident.

However, the past two days one of us have been running back and forth with Mr. Q between the table and the patio or the table and the bathroom sink.

That’s only half of it. The other half is from the bedroom to the bathroom. All these times and more, we had to catch him before he had a choking fit. Almost every time he eats or drinks something, anything, he eventually starts choking. Some times his mouth is full of food because he is not swallowing the food or not swallowing his drink.

The problem of him eating is getting worse. From my prospective it is already at a disaster point. We have to baby him and feed him by hand maybe 70% of the time. Apparently he either has forgotten how to eat or something else is the problem. I’ve been told by the owner/caretaker that he forgets how to eat and swallow. Part of the time he is falling asleep between spoonfuls, whether we are feeding him or he feeds himself (rarely).

Now, Mr. Q is already on antibiotics for an infection of the lungs. He had a shot for that last week. He is also taking (we have to do it, he is totally unable to do it himself) a spray for his infection, which sometimes we have a hard time administering when he won’t open his mouth.

The really trying part is when it is time to go to bed, without fail he starts choking after we give him his required medicine, and then it starts all over again. Back and forth we have to rush him between the bathroom and the bed, sometimes three times or more every night and each time it is a half hour or more trying to get him to spit the phlegm into the sink and not on the floor (yes he has spit on the bathroom floor).

Tonight it was three times, almost to the hour, each time, after he went to bed. It is usually quiet when he goes to bed and lately it is late so we can generally hear his grumbling of the throat when we pass his room as a signal he is having major problems with his mucus in his throat.

These problems occur in part due to his dementia/Alzheimer’s condition. Because he is rapidly losing his ability to do ordinary things it compounds the problem. With someone who does not have Alzheimer’s problems it is relatively simple to cough up the mucus and doing that along with the medicine will clear up the problem. However with Mr. Q that is not the case.

He does not remember how to cough and we have been unable to get him to cough up the phlegm. We have to get him to goggle and that in itself is a problem. Also it appears that when he is eating somehow some food or liquids are somehow getting into his lungs, which caused the problem in the first place. Since we don’t know how this is happening it is a real problem. Due to his extremely poor eating habits (he takes mini-bites, almost never opens his mouth wide enough to get any reasonable amount of food in it, he can only drink a super small baby sip of liquids, etc.) and other less serious eating behavior it is prolonging this infection problem.

Mr. Q is having so many eating problems it usually takes well over an hour to feed him each meal, sometimes two hours on a bad day. This coupled with running back and forth between choking and spitting interludes means it often requires three to five hours a day just getting him to eat meals. Sometimes it takes so long we have had to skip lunch since he just finished breakfast when lunch is ready for the other residents. Add the hours we spend everyday between meals and at and after bedtime, and you have a full day of managing his eating and spitting/choking problems.

Add all these things together for someone who does not do what you ask of him most of the time and you can see the frustration that could occur. Of course this set of problems are unique to Mr. Q. Others with Alzheimer’s disease could have similar problems but if they can talk, can follow directions, and help you when you have to assist them then the frustration level will be much lower and much more can be accomplished in much shorter time.

Mr. Q does not talk, does not cooperate most of the time with anything, and often will grab things when you are trying to help him, clean him, or ask him to do anything. Part of his problem is he apparently is /has forgetting/forgot how to do the simple daily things everyone else does automatically. Things like cough, blow his nose, put on or take off his clothes, how to sit in a chair properly, how to brush his teeth, how to go to the bathroom and take a leak without wetting his pants, the floor, and the toilet stool. There are a lot of other ordinary things I could mention, but you get the point. Mr. Q has some serious problems. This combined with the diminishing ability to learn and remember makes for a very difficult time on a very frequent basis.

Well it’s 1:15 am and I need to get to bed. Hope this nite is over for Mr. Q and he stays sleep ( I hope he is sleep).

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