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[Dysphagia] Dementia Patient Feeding
Alzheimer dementia by itself alters the cortical phase of swallowing. The
patient simply does not recognise what is in the mouth. Anything that they
don't associate with food is like if you put send in the mouth. They will
softly spit it and try to put it away or leav it in the mouth.
There are 4 flavours: sweet, salt, acid and sour. The 2 first ones are less
and less tasted by those patients. This disease affects those 2 first
flavours first. For example, if you give them orange juice, they will taste
lemon juice. Tactile sensations also are altered probably. So rather than
avoiding anything stimulating, you have to put more sensorial stimulation if
they answer to that. The RD can put sweeter or saltier food but he or she
will be considering the rest of her nutritional status. When I have this
kind of specific oral dysphagia, my job is to deal with the family and the
MD to avoid any specific nutritional treatments. When I can, they only eat
sweet cause that's the only flavour they recognise. At the end of the
disease, they don't even recognise sweet. That's when there's an ethical
question about the nutritional treatment. Other dementias can include
neurological problems to explain the dysphagia. The RD you work with should
have known that.
There's a excellent book on dysphagia and dementia published in 2004. I
could give you the title tomorrow when I get back to work.
Michel Sanscartier RD MS
----- Original Message -----
From: <maddoglynz@aol.com>
To: <dysphagia@b9.com>
Sent: Thursday, December 01, 2005 9:46 AM
Subject: [Dysphagia] Dementia Patient Feeding
> Any advice on how to feed a low-functioning dementia patient who is
> holding food and liquid in her mouth for a very long time, to the point of
> choking? I don't believe the holding is intentional. I believe she is
> having difficulty triggering the swallow. We have tried alternating hot
> food items with ice cream and other cold food items in an attempt to
> increase sensation. The holding is intermittent, in other words, she does
> fairly well with some meals and with other meals she holds almost
> constantly. The patient is nonverbal and cannot follow directions.
> Thanks for any advice.
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> Dysphagia mailing list
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