After Dad's stroke, he has suffered from aspiration. His nutrition is getting better - will the aspirations lessen, too?

Larissa michelle asked...

My dad has been in the hospital/rehab for the past year and has developed many new issues even though his stroke is going on 4 years ago. He has had a feeding tube in since last spring, which was often turned off because he couldn't tolerate it, etc. My dad aspirated on the tube feed several times and just recently this G tube was switched to a J tube. Since the switch, my dad has tolerated all food and has not aspirated. He was malnourished, but his albumin was tested the other day and the nourishment is slowly improving. However, there is still a major risk of him aspirating because of all the secretions in his lungs, which have now caused him to need suctioning, etc. The doctors think he would do best in an ltac now, which will be addressed soon. I want to know if it's possible that if my dad's nourishment continues to improve, could this cause the rest of his body to get stronger and control the secretions in his lungs? He had aspiration pneumonia numerous times in the past year and me and my mom are very fearful of him needing to be intubated, especially where he is so weak right now. Thank you.

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Very sorry to hear about this situation.

It sounds like all the right things are being done - feeding him through the J tube and avoiding any oral feedings. The aspiration of saliva is much more difficult to avoid, and requires frequent suctioning. I can't promise that this will improve as his nutrition improves, but it certainly can't hurt, either. Hopefully, as he feels stronger getting proper nutrition, he will feel more awake and have better ability to clear his own oral secretions. In the long run, this will hopefully lead to fewer aspiration pneumonias.

Good luck!