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SherylRob Asked January 2019

My mother's caregiver called me last Friday to tell me my mother is not chewing or swallowing. Any advice?

She wants me to decide what to do with her. I turn to the internet and I found this site. I want to know how other people handled this phase?

cwillie Jan 2019
As has already been stated, first you need to find out whether there is a simple, treatable reason someone can't chew/eat such as dental problems, dry mouth, difficulty swallowing certain textures (dysphagia)

Feeding tubes are a great option as a temporary measure until someone heals enough to have it removed - after a stroke for example. They are also life savers for people who have a chronic condition that prevents them from eating normally - like someone who has battled throat cancer. In my opinion (and numerous studies back me up) when someone shows no interest in eating due to a terminal illness - and remember that dementia IS a terminal illness - you are doing them no kindness by begging them to eat or forcing food in any way. This is an emotional issue because food is often associated with love and nurturing, but there comes a point where you may be doing more harm than good. They truly aren't hungry and they can't tell us any more obviously that they are transitioning to end of life.

BarbBrooklyn Jan 2019
She needs a swallow evaluation by a speech language pathologist. Call her doc asap to get that ordered.

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worriedinCali Jan 2019
Removing nutritional support isn’t “usually just done when the person is vegatative or comatose” and removing is NOT a form of euthanasia. It is also done when the body is shutting down and can no longer digest food. If you force feed a dying person through a feeding tube, you aren’t doing them any favors. Sometimes you are only prolonging the inevitable. If their body is shutting down, you are actually causing them great discomfort because their stomach is full of food they can’t digest! This happened to my MIL and everyobe thought she was just constipated. But before you make any decisions, unless she’s on hospice, you need to have her evaluated by her doctor at the very least! With her disease, the inability to swallow is not usual.

cwillie Jan 2019
There's a big leap between not chewing and swallowing and a feeding tube. What has she been eating up til now, has she had a modified diet at all - minced moist or pureed? And has she been evaluated by her doctor or a speech and language pathologist?

JoAnn29 Jan 2019
At your Moms age I would not allow a feeding tube.

This could be the start of Moms body shutting down. You could have her evaluated for her swallowing. But I suggest you call her doctor and run this by him. He may suggest its time for Hospice.

BobbingWren Jan 2019
My grandmother lost the ability to eat by mouth. First, we responded with a liquid nutrition option, lots of proteins and thick liquids, which fixed all hydration issues, too.

She progressed further in her disease, and after a family meeting, a nasogastric feeding tube was agreed on, as opposed to a tube surgically placed in her belly. When you say you don't want a feeding tube, do you mean any feeding assistance, or only a surgically placed tube?

She was far enough gone where she would not fight the nasogastric tube insertion. Using a syringe to add medicine via a feeding tube is not very scary, and caregivers can be trained to properly monitor or even insert a tube depending on their professional level. You can feed someone while they are sleeping.

There are nurses and nursing services who prefer nasogastric tubes to surgery, as well: https://www.acsh.org/news/2016/06/14/nursing-homes-forcing-surgery-on-the-ill-and-elderly

Removing nutritional support and letting someone die is a thing that is done, usually when someone is vegetative or comatose, though. If you think the caregiver is hinting at euthanasia through removal of nutrition, get clarity immediately. If that is an option for your family, you'll want to make plans with legal advice from someone who is versed in end of life issues to make sure any nutritional removal you engage in is done in accordance with law and palliative care standards (such as being paired with opiods to dull suffering and overseen by a hospice nurse.) End of life options are there, as well as medically more invasive options to prolong life.

SherylRob Jan 2019
I do not want to go to a feeding tube.

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