Is my mother's Alzheimer's causing her to have trouble swallowing and eating?

A fellow caregiver asked...

My mother,has been having trouble swallowing and can't eat much more then baby food and other foods of that consisity. Even those foods she has trouble with swallowing and even water bothers her and I hear her gurgleing after she drinks.She is getting weak and doctors after hearing she has alzheimers just dismiss everything. I think there is even more going on,but doctors do not listen when they find out she has this disease. Is this condition just from the alzheimers I don't know and am frustrated.

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

Unfortunately, with Alzheimer's disease, people slowly decline in all the normal mental functions, like talking, walking and eating. This is the progressive nature of the disease. Your mother has developed dysphagia, otherwise known as difficulty swallowing. Swallowing is actually a very complex multi-step process. In Alzheimer's disease, swallowing problems develop because the swallowing muscles literally forget how to do the swallowing sequence correctly. Because Alzheimer's disease is not reversible, this is not something that your mother can re-learn to do again or be trained to do again, simply because the muscles aren't working together to swallow.
When you speak with her doctors about her swallowing difficulties, this is why they cannot offer you any help. There is nothing they can do to change this process, as they cannot fix the muscles or make them work again.

I know you are frustrated. What I would recommend is asking her doctor for a consultation for your mother with a speech pathologist. Perhaps they can help you learn feeding techniques or change the consistency of her food to something that she can swallow better.

Until then, when you do feed her, make sure she is sitting upright, fully awake and alert, and spoonfeed her slowly. If she starts coughing, you should stop the feeding process. You can try to thicken her liquids, which makes them easier to swallow. You can buy thickener for her liquids and soups from a medical supplies store or drugstore, like Walgreen's (it is called Thickit). Add this into her beverages, and thicken it to the consistency of honey. I would even thicken her water at this point.

If you are trying to give her crushed pills, make sure that they are absolutely necessary, as there is a risk she could choke on these too. If the pills are really big, ask her doctor if they can be stopped. Also, please be aware that some medicines are not made to be crushed, so ask her pharmacist if you are not sure.

The last thing I would like to mention is poor swallowing is a risk for developing pneumonia in Alzheimer's patients. When your mother coughs, it is a sign that something went wrong with her swallowing. She could easily choke, or inhale the food into her lungs. When this happens, an aspiration pneumonia could develop. This is when food/ liquids go into the lungs (not her stomach), causing a nasty pneumonia that is very hard to treat. Signs of this are shortness of breath, cough, fever, and congested lungs. Let her doctor know right away if she develops these symptoms.

Good luck!