[Dysphagia] Dementia Patient Feeding

[pressmah at sjhmc.org (pressmah@sjhmc.org)]

Presenting the next spoon is a very good idea.  With the Developmentally
Disabled we often find individuals who only swallow when the next spoon is
presented.  If we want a dry swallow we present a spoon that is essentially
empty  Hilda Pressman

-----Original Message-----
From: neurosp@aol.com [mailto:neurosp@aol.com]
Sent: Saturday, December 03, 2005 2:56 PM
To: Pressman, Hilda; maddoglynz@aol.com; dysphagia@b9.com
Subject: Re: [Dysphagia] Dementia Patient Feeding


If the patient responds to the visual stimulus of food about to enter her
oral cavity, try the following:  Make sure the person is looking at the food
which is about to be given to her (on a spoon,etc.), make sure you call her
attention to "what is coming", be sure she is looking at the food while you
give her the verbal cue to "look here", etc., hoping that the anticipatory
phase of swallowing is striggered.  For some people, the natural reaction
would be that she would swallow what is in her mouth in "anticipation" that
more food is being presented, and automatically open her mouth to accetpt
more.  It works for many of my dementia patients, but not all.  Give it a
try.  Also, be sure that temperature and tastes are clearly differentiated
by the patient.  Try cooling the oral cavity via oral hydration (swabbing
with cold water) before food presentation.  If giving a cool drink, be sure
it&n bsp;is cold.  If sweetening cereal, use a little extra sweetener ( if
diabetic use artificial sweetenter )....all of which is inteneded to
heighten sensory awareness.   Let me know if it works for you.
 
John   
 
-----Original Message-----
From: pressmah@sjhmc.org
To: maddoglynz@aol.com; dysphagia@b9.com
Sent: Fri, 2 Dec 2005 13:34:01 -0500 
Subject: RE: [Dysphagia] Dementia Patient Feeding


This type and level of difficulty is consistent with end stage dysphagia.

In addition to the things that you are trying I would suggest, with straw

drinking, that the feeder remove the straw from the person's mouth after

they sip.  I have found that patients often cannot coordinate sucking and

swallowing and will only swallow once the straw is withdrawn.  Hilda

Pressman



-----Original Message-----

From:  maddoglynz@aol.com <mailto:maddoglynz%40aol.com>  [
mailto:maddoglynz@aol.com <mailto:maddoglynz%40aol.com> ]

Sent: Thursday, December 01, 2005 9:46 AM

To:  dysphagia@b9.com <mailto:dysphagia%40b9.com> 

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.  

_______________________________________________

Dysphagia mailing list

Dysphagia@b9.com <mailto:Dysphagia%40b9.com> 

http://lists.b9.com/mailman/listinfo/dysphagia
<http://lists.b9.com/mailman/listinfo/dysphagia> 

_______________________________________________

Dysphagia mailing list

Dysphagia@b9.com <mailto:Dysphagia%40b9.com> 

http://lists.b9.com/mailman/listinfo/dysphagia
<http://lists.b9.com/mailman/listinfo/dysphagia>