My mother with late stage Alzheimer’s is too weak/doesn’t understand how to spit excess phlegm. Anyone deal with this?

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SandyBW Asked March 2021

My mother with late stage Alzheimer’s is too weak/doesn’t understand how to spit excess phlegm. Anyone deal with this?

It seems post nasal drip accumulates in her throat and she doesn’t know what to do with it. I try coaching her to cough it up and spit it out, but she is weak and frail so that is challenging. She also doesn’t really understand what I’m asking her to do. Has anyone dealt with this and how did you manage?

Alzheimer's & Dementia Family Caregiver

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score 1 · Answer 1

A build up of secretions is common.
Hospice prescribed drops for my Husband that helped dry secretions.
You can use a swab to absorb some of the secretions.
Do not go back real far as that can cause choking or gagging.
You can turn mom on her side and excess secretions will flow out of the side of her mouth.
One of the problems with excess secretions is they can be aspirated just as any other fluid would so it is important to try to dry them, remove them or allow them to run out of the mouth.

I just saw your comment that mom is not yet on Hospice. I would call today and have her evaluated. The help that you will get is unbelievable. Help with supplies, equipment, education, support.

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score 1 · Answer 2

Rather than postnasal drip I think it may be saliva, did you know we produce 1 - 2 litres every day? If she is having any difficulty swallowing (perhaps coughing and sputtering) when she eats or drinks she could have dysphagia, a dysfunction in swallowing. Gagging in your own phlegm is usually something that happens at the end stage of life since it often leads to aspiration, which leads to pneumonia. Has she been evaluated recently?

The suctioning device may work but since secretions are produced constantly there is only so much suctioning you can do, KWIM?
I'd also be very careful with the scopolomine, it drys up Everything and may have many other side effects, it is definitely for short term use only 🤔

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Yes, coughing and sputtering describes her issues perfectly. She was evaluated only two weeks ago and this was not an issue then. Things are changing rapidly at this stage of her disease. Thank you for this insight. I will use your words when I call her dr. today.

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score 2 · Answer 3

My husband had trouble understanding how to spit excess phlegm as well. You can rent a machine that plugs in and you can suction the phlegm out whenever needed. It works great. My husband was under hospice care, so they supplied it for him, but I'm sure her Dr can order one for her. Best wishes.

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Thank you, my mother is not yet under hospice care. I wonder if she’ll allow me to use a suction machine.

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score 1 · Answer 4

Is your mother on Hospice? If she isn't, you might consider asking for a Hospice evaluation. It sounds as though she may be in danger of aspiration.

Hospice frequently uses scopolomine patches to dry up secretions at end of life. There are also succtioning devices, but those have always seemed extreme and unpleasant to me.

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Thank you, the patch is an interesting option as my mother would most likely reject the suction device. She is at the tail end of stage 6 and does not qualify for hospice yet.

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My mother with late stage Alzheimer’s is too weak/doesn’t understand how to spit excess phlegm. Anyone deal with this?

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