When it happens
End-stage dementia
Why it happens
The physical coordination and control needed to chew and swallow is lost. The person may cough or choke when swallowing, or refuse to try to swallow. This is part of the end-stage Alzheimer's process of the body gradually shutting down.
What you can do
Don't automatically assume the person needs a feeding tube. It's the natural disease process that makes the inability to swallow part of the dying process, not starvation from lack of food. Someone can live for weeks or months while appearing to take in minimal nutrition. Feeding tubes don't necessarily prolong life, according to research.
Do consult the person's advance directives to see if preferences were made. Know that even with artificial nutrition, there's still a risk of aspiration (choking) on saliva.
Know that an increasingly popular option in these cases is to continue to gently hand-feed. Puree foods and offer a baby-spoonful.
Be patient; hand-feeding meals can take three or four times longer than self-fed meals.
Remind the person of each step: "Open your mouth. Here's the food. Now close your mouth. Now swallow."
Stop if the person becomes upset or chokes. Try again another time.
