After losing the ability to swallow, how long can my mom last?
My mom has lost the ability to swallow. She has a UTI and is only able to get down 4oz yogurt and 4oz of water. Once we're not able to get her to intake food and fluid, how long can she last in this stage?
This is a tough situation. It sounds like your mother has gotten pretty sick, and her appetite is poor. Sometimes, when people get an infection (like a UTI), they can get weak and confused. Her poor swallowing and lack of appetite may be related to the infection, and this problem can sometimes improve once the infection is treated. However, sometimes the swallowing problem is related more to an advancing dementia (forgetting how to swallow) or a stroke (losing the ability to swallow well). If this has happened in your mother's case, it is not something you can fix or change. What I would recommend:
1) See if she improves after the infection gets treated. Most people who lose their ability to swallow (from strokes or dementia) will not improve once the infection has cleared. Keep in mind that some people with swallowing problems cannot handle liquids. They will cough or choke when being fed. This can be dangerous, as they will often swallow things into their lungs, which can lead to a pnuemonia. If this has not been an issue, then I would see how it goes. I would also concentrate more on liquids then solids at this point, as dehydration is the biggest risk. If she doesn't drink well, dehydration can also cause lack of appetite and inability to eat, as it can make people confused. I would feed her slowly and gently, encouraging her to sip liquids throughout the day.
2) If the UTI has been treated now for a couple days, and you see no improvement in swallowing, I would have her swallowing professionally evaluated (like a speech language pathologist). You can get her referred to one by her health care provider. Speech pathologists evaluate swallowing ability and make recommendations about special foods or liquids that can help the person eat better.
Lastly, to address your question about how "long she can last in this stage". If your mother really has lost the ability to swallow, some people can live a couple of weeks or months if just drinking fluids. If she still eats some solid food, she could last months. If she cannot eat any food at all, she may live only for a few days to about one week.
My husband, who is a Parkinson's Disease patient, had aspiration pneumonia. A feeding tube was inserted and in a few months, he was able to swallow again. Food was re-introduced and he was able to resume eating regular food, but not fluids.
Three more years passed and his condition deteriorated. The next step was a switch to mechanical food. This continued for about a year and then he was switched to pureed food, more because he would forget what he was doing and we feared he would choke on his food.
A year of so later, he required another feeding tube to eat. This continued for about a year. During this time, I was allowed to give him "pleasure feedings," if I felt he was alert enough to swallow. After awhile, he lost his appetite and refused to eat anything. We continued the tube feedings and this kept him going for many more months. However, he was losing weight.
As his condition deteriorated, we eventually had to stop feeding him because his lungs were filling up with fluids from his food and any liquids he received. The decision was then made to stop all food and water and he passed away about 9 days later. This entire saga lasted more than four years.
I was glad to have him for four more years. It was difficult, but we adjusted and so it was worth it all. I am sorry to report that I lost him today.
I'm so sorry for you and your mom, but.....Time to call in Hospice. My mom couldn't swallow and if she did it went into her lungs, causing paemonia (sorry can't spell) we called Hospice, they are WONDERFUL!. She died Monday, 2 weeks was how long she lasted. You need to make her comfortable and Hospice will see to that and all her comforts. Hurry!
Last summer my 89 yr old mother had emergency gall bladder surgery.GB had calcified to her stomach(dr had to cut open her stomach to remove)she could not eat for a week and was on just IV's. She also had complications caused by anesthesia and pain meds and got ICU psychosis.Meds they used to counteract that made her catatonic for several weeks.All that time she was not able to eat so they fed her nourishment through a pic line.When she finally started to get lucid again she couldn't swallow failed several swallow test and dr wanted to put tube in her stomach.She was 5' & 115 lbs prior to illness and lost 35 lbs in hospital and rehab.The director was advising us to call in hospice when Mom refused the stomach tube.Miricles happen even though Mom was talking gibberish and refusing to even try her physical therapy to relearn to swallow almost overnight she came back to us said Dad(who died in 1973)was not ready for her & started eating and was home in 10 days.She spent a total of 2 months in hosp/rehab and has been home 5 months now she is eating all the time gained 25 lbs.She recently celebrated her 90th birthday, and now fighting newly diab breast cancer with tamoxifen but doing very well. My point is they can turn around when all looks bleak whether her recovery was her unwavering faith or it took that long for all narcotics and anti-psychotic drugs to get out of her system I don't know or as one friend said her stubborn mid west unbringing cured her.We are glad to have her for as long as possible. I wish you well and hope for fast and peacful result.
My uncle lived one week to the day. He chose not to have any tubes for food and water.
there is a product that helps people to swallow again. Find it on
I use to work for this company and this is a real good product.
It sounds to me that your mom may be septic from her UTI if her ability to swallow has been compromised. Your mom needs to be hospitalizede for this, if this is the case. If her problem with swallowing is from another cause she can have a gastric tube placed for long term needs. For shorter term she can hav a nasogastric tube placed which bypasses the need for swallowing and would empty the food,liquid or pureed, into the stomach. TPN is also another alternative,but only provides nutrients and vitamins needed to sustain the body with not alot of caloric value and does not keep the stomach in the digestion mode. I hope this helps, I am terribly sorry for your situation.
There are many reasons for inability to swallow and the outcome is related to the cause. As you've noted, her infection can compromise her swallowing function, surgery and drugs can be associated with swallowing dysfunction. As long as she is given water and this can be done intravenously, you will have time to determine if her swallowing problem is transient. If she has a neurodegenerative disease such as Alzheimer's, she may not recover her ability to swallow and if there is a physical obstruction in her swallowing organs, she won't recover the ability to swallow without medical intervention. If one of these is the case, then you would need to consider a feeding tube but for this, there are considerations about quality of life. The duration of life in the absence of nutritional intake is variable and depends somewhat on the overall health of the affected person prior to the onset of swallowing dysfunction.
My father-in-law lived with me for 8 years and had Parkinson's Disease. As his PD progressed, he had a harder time chewing and swallowing. To keep him hydrated towards the end, I made soft fruit sorbets using frozen bananas, frozen peaches, or blueberries and milk. Here is a link to a post I wrote that talks about my experience with feeding my father-in-law, including a list of soft/pureed foods we made for him. It took about an hour to feed him, with constant reminders to swallow, as well as checking to make sure nothing was left in his mouth. He passed away last year at the age of 92 and never went on a feeding tube.
I am a speech pathologist and work in an acute hospital with people with swallowing disorders on a daily basis. There are a number of reasons your mother could be experiencing difficulties swallowing. If a UTI is her only presenting issue (i.e. she has not had a stroke, does not have dementia, does not have any respiratory conditions or any degenerative neurological conditions such as parkison's disease, motor neurone disease etc) it could be due to confusion/poor medical condition beacuse of her UTI, in which case her swallowing should improve as the infection improves. I would strongly recommend you seek a referral to a speech pathologist (via her GP, her doctor/nurse if she is in hospital or a nurse if she is in a nursing home).
In the mean time, while your mother is unable to swallow it is important she is receiving hydration via other methods (most commonly IV fluids through a drip) otherwise she will soon dehydrate. Interim tube feeding can be used to supplement her nutrition via a nasogastric tube until her swallowing begins to improve. This will need to be in consulation with a doctor and a dietician. If her swallowing does not improve, it is not likely due to her UTI and longer term tube feding options may be explored.
I hope she recovers well
My father had Alzheimer's disease and when he couldn't swallow and refused first food and then liquids he lasted approximately a week. I would have been horrified if an IV was put in him to hydrate or a feeding tube was inserted for feeding. Dying is a natural process and sometimes with us interfering with this process we deny our loved ones their opportunity to pass. Keeping them comfortable and pain free and letting them tell you by refusing to eat or drink that it is their "time" is the kindest and most unselfish gift you could give them. Keeping them around because YOU are not ready or you want more time with them is all about you and not in their best interest. Subjecting them to painful and invasive life-saving measures is very cruel. My mother is in late stage Alzheimer's as well now and we will refuse any IV fluids or forced feeding in any form once she is unable to eat. Her life has little dignity left and to deny her the dignity to die when she is clearly ready would be unconscionable and selfish.
Hello, My name is Shanen. I am from NY. I have been reading all of these responses and some are very enlightening while others seem almost harsh and cold. I, for one, hope that she recovers, but if she doesn't retain the ability to swallow then I feel it is your duty as her child to do whatever it takes to make sure she has the best chance at living. My father is in the hospital as we speak. He has aspiration pneumonia. He had knee replacement surgery on December 11th and went to rehab on the 17th. He had a small cold and cough at that time, but they still sent him there. Well he was there for 4 days and on the fourth mourning, his nurse went to his room and found him unconscious While rushing him to the hospital he had a temperature of 104.5 and couldn't breathe on his own. His oxygen level was 72 which is dangerous. They stabilized him on the respirator and endotracheal tube. He was put on that the 21st. He was finally taken off of it on the 27th. From the time the tube came out he had to have liquids with corn starch in it to thicken it up to help him swallow it. After only 2 days he was eating solids, which I believed was too soon because they ordered up an evaluation on his swallowing. Well The tube came out the 27th, and he aspirated again yesterday, the 31st and again is back on the respirator and tube. They have told us that he may not be able to eat solids ever again and may need to have a feeding tube surgically placed with in his stomach. I have already spoken with 2 different dietitians and they both guaranteed me that a person can live for several quality years while receiving their food from the feeding tube. Some people may still be able to drink thicken liquids which can help to give them more nutrition. They can eat thicken soups and thicken oatmeal and other stuff. Nothing is a guarantee, but don't give up hope. Never give up hope 'mam'. The only people that would deny their mother or father a life saving IV is someone that is just tired of the stress that comes along with trips to the hospital and the ICU. How can we ever say that it is selfish to want our parents too live? If they are on full life support with no possibility of ever living without the machine, then that is a situation where we should make the right decision, but too just let them die when all they need is a feeding tube or an IV is ludicrousness. They would never do that to us if we needed those things as babies! ! ! So why would we do it to them as adults? The only reason would be because you can not handle the responsibility and don't want the hassle of having to help them eat for the rest of their lives. It is so selfish to deny your father or mother the right to live when they only need an IV to give them fluids. This is in response the response above mine. I can only pray that your not a nurse or any type of nursing home caregiver. I feel so sorry for your father and mother. .
When my 94 year old dialysis dependent father could no longer be cared for at home and was poorly tolerating the restrictions of the dialysis regimen, plans were made to have him admitted to a nursing home where he could be kept alive through dialysis, living his life in the sterile and lonely environment of a nursing home. He chose to stop dialysis and come home with us to await the inevitable. It would have been selfish to ask our father to live separated from his family when he needs us the most. Babies are starting their lives and we do all we can to support this start. Our very elderly parents are winding down their lives. Comparing them doesn't work. At present I have been caring for my Alzheimer's affected husband at home for the past 6 years. We cherish this time together because we have enough good moments to erase from my mind the slog of caregiving for me and the suffering experienced by my husband. It would be cruel to augment his suffering with tubes and other manipulations as his cognition continues to wane and my ability to reach him fades away. Please don't be sorry for my husband and I'll try not to be sorry for your mother and father.
Shanen, Im very sorry for what you are going through but with all due respect, you are completely wrong with your assumption that someone would deny an IV or feeding tube based on stress of the caregiver. My father has a rapid progressing form of Parkinson's. His body is naturally shutting down from the disease and therefore has lost his appetite. Thankfully as a family we made certain decisions before it got to that point, but he didn't want a feeding tube. He doesn't need a vent to stay alive. Is it cruel that we're allowing the dying process to proceed on a man who is bedridden but could be alive for who knows how long with artificial means I.e. feeding tube? Did you know that giving an IV to a dying person can be painful for them? The fluids build up in their lungs and its as if they are drowning. The only way it's not cruel and inhuman is if the PATIENT has expressed their wishes and NOT what the family wants. Every situation is unique. Making false assumptions just proves you have a lot more to learn about the dying process.
My mother has stage 4 cancer with bone mets. I have just placed her in a nursing home 2 weeks ago. She is having difficulty swallowing and coughs with all liquids. However when she was still alert she gave me strict orders for DNR she signed the papers herself. She also refused a vent and a feeding tube. She has a living will which is something everyone should have. I will respect my mothers wishes. She is dying, she has suffered for a long time .sometimes the greatest gift you can give a loved one is to let them go naturally. That's why we have hospice for palliative care. Keep in mind that every patient is different. And everyone's journey is different. You should respect that. And don't try to make people feel guilty when they are only trying to do the right thing. Sometimes you just have to say That's ENOUGH!!!
My Mom died late in the evening of May 2, 2013. She was surrounded by all six of her children, 4 son-in-laws and assorted grand-children. She has lived (valiantly) with Parkinson's, Diabetes II, Dementia (advancing), almost blindness, and 3 years ago the loss of her beloved husband of 63 years. Beginning Friday April 26 through Saturday she suffered many TIAs, a full-blown stroke Sunday. Mom knew she had the stroke, it was like she became "clear" for a while. Through the day on Wed. she knew everyone that came in to tell her how much she meant to them. She could even whisper words of love and encouragement to all of us. She also made it quite clear NO HOSPITAL. I am the Director of a Medical Clinic; and yes, it was the most difficult thing I have ever done to watch her fingers turn blue, know she was not eating nor drinking, give her morphine every hour; but this was my wonderful, beautiful, special Mother's wish, to go naturally on her journey to Daddy.
Most of these responses do not refer to the patient's health directive. It is imperative to abide by that if one exists. It is not "cold" to follow a person's directive or realize that nature must take over...it is exactly what they want even if it feels wrong to let them go by lack of food and hydration. Interventions can be the cruelest form of torture. Returning temporarily to extreme pain and confusion is not really living. It is risky to be put on a feeding tube. Be sure you know all the facts.
My mother who is 74 years old and been very healthy up to about 3 months ago. She to has lost the ability to swallow because of a very small stroke ( never showed up on cat scan). But Drs still have not been able to confirm this. My mom was put on pureed food and slowly the aspirating pneumonia returned. At the same time she was diagnosed with Breast cancer( not related to swallowing in any way) and underwent a lumpectomy. During her surgery the drs did damage to her throat and somehow the pnuemonia came back with a venegance and she was in the hospital for about 2 weeks fighting for her life. To let her throat heal "SHE" decided to have a tube in her abdomen to her stomach. She has made a full recovery and has regained all strength. The feeding liquids has nutrients and vitamins needed to survive a very long time. She is battling her cancer and so far winning. I think it should be totally up to the patient and this should be discussed with all family members to know ahead of time.
My mom said to me " I do not want to die" thats all she had to say. And she is winning. Keep the faith and know miracles happen. If you believe your mom wants to live and can survive. Do what ever it takes to make it happen. As for the previous post. It is not inhumane to keep a loved one alive "IF" that is their wish. Fave did not give information on her mothers health condition prior to her swallowing situation.
I wish you the best of luck Fave.
My husband of 42 yrs. was signed up w/hospice today. He was in the hospital early December with a leg wound. He is 91. He has dementia and well as cerebralvascular disease. About 2 weeks ago he had a TIA which left him without speech except for a whisper and then the speech was garbled. He has now reached the stage today that he does not want to eat or drink. I am able to hydrate by using the tooth sponges on a stick. It is not very much at a time but it keeps him from choking. I do not know how much longer the Lord will leave him with us but I am thankful for whatever it is. These last 2 months especially I have had time to say good-bye. Some people never get that blessing. No regrets as I look back I am so fortunate to have had whatever time I have.
My Dad just passed away 2 days ago. He had Lewy Body Dementia and Parkinson's Disease for about 7 years. About 4 months ago he was walking pretty well and we were able to go to restaurants and have some nice conversations. Then 2 months ago he started falling a lot, getting dizzy and didn't want to go out much anymore. A month ago he fell but said he was o.k. Two days later he was in such pain he couldn't get out of bed. The ambulance took him to the ER and they did hip replacement surgery. After the surgery, dad was mostly sleeping, hallucinating, had some moments of actual conversation but could not swallow so the hospital put a tube down his nose and of course he had the IV in his arm from the surgery. Dad physically fought against the nurses putting that tube down his nose--we weren't sure if it was a physical reaction or he really didn't want it.
After a few days, he was swallowing a tiny bit of pudding. He hated that tube in his nose (irritated his throat and itched him) so we took it out and we kept the IV in. He was only able to swallow a few tiny bites of pudding and then would begin coughing. They did a swallowing test and they said we had to be very careful and only feed him when his was 100% alert. He was not very alert and didn't really want to eat. One time I was trying to encourage him to eat a bite of pudding with crushed medicine in it and dad clearly said, "What's the point?"
We found Dad's written Advanced Health Care Directive he had done many years ago and in that it said he did not want any forms of hydration or nutritional assistance except for normal digestion; no IV nor feeding tube. We spoke to his long-time neurologist who said dad was not going to "learn" to swallow again and he would unlikely recover nor live more than a few months. We spoke to another doctor who confirmed this prognosis. It was agonizing but we followed his written directive and took out the IV. In another one of Dad's lucid moments when he was able to speak, he said, "13 years ago I gave you papers..." I assured him we read the papers and we were following the instructions. After the IV came out, he went to Hospice. He swallowed a few bites of apple sauce the first night in Hospice but then no more and was mostly asleep. He started very labored breathing the next day so we started morphine a little at a time. He lasted 9 days without aided hydration nor nutrition.
His quality of life had deteriorated even before the hip surgery. Dad would not have wanted to live if he was bed-ridden and couldn't eat. Two of his favorite hobbies were walking his beloved black lab, Lucy, and eating a good meal. As hard as it is to lose a father and to watch him die after we took out the tube in his nose and his IV, it was what he had specifically asked us to do years earlier when he was not yet diagnosed, and had also reconfirmed in writing about a year ago when he moved into assisted living. I have the same health care directive in place for myself and I would want my husband to consider my quality of life over his need to have me still with him.
My mother is 88 years old with advanced dementia. Until about two months ago, though requiring some assistance, she was independent. In fact, independent, fiercely loyal, and determined sum up her personality. She was diagnosed with Lewey Body Dementia about a year ago and the decline in just the past few months has been cruelly swift. At this point, my mother no longer recognizes me (her only child), her grandchildren, or other family members. A few weeks ago, she had "conversations" but now no longer speaks. Always a very healthy eater (a remnant of surviving the Korean War and the aftermath), she began refusing food about two weeks ago. Now, she cannot swallow because of the dementia and is unable to drink water. I have discussed artificial means with my mother's hospice nurses and doctor. It's a very hard decision, but we are making her as comfortable as possible to allow her to pass naturally. I have read the other posts, all of which were helpful. But at the end, it's a personal decision unique to every family member. My mother did not want any tubes. Even with a feeding tube and IVs (which present their own complications and risks), those efforts will do nothing to improve her quality of life. My mother's dementia has progressed to a point that prolonging her life will not help her recover or bring back the person she was. I struggle with this decision, but believe strongly that this is what she would want.
My father passed away in 2015 at age 87 he broke his hip at 84 and was in a hospital bed at home for 4 yrs they only put in half a hip coz of heart problems and he did well for 4 hrs at home enjoying the TV and having friends visit pneumonia and UTI developed he could not swallow a feeding tube in the nose helped him get nutrition however he was not getting better I made the desicion to take out the feeding tube he was home on hospice care for 4 days struggling to breath lungs filling up rushed back to the hospital and passed away in 6 hours surrounded by family and friends. I ask myself sometimes did I do enough did the doctors do enough and the answer is yes after reading these stories I see I am not alone and we all go through this each in a Lillie different way he was happy to spend his last few days at home