[Dysphagia] reflux and feeding tubes

[malindam at samhealth.org (malindam@samhealth.org)]

Failure to initiate the swallow with solids, in spite of adequate chewing, IS a common presentation with folks with dementia but not the end of the story.  Many of these people do quite well with liquid diets, warms foods thinned with broth to soup texture and put in mugs or cold food turned into nutritious shakes and put into glasses.  BUT that's not the end of the story either.  Thanks to the constant prodding from Irene on this list serve, I've been even more deligent about checking medications and medication history with this group. I can't say that a single medication has been the culprit but in many cases a little detective work with the hospital pharmicist and other resources has been very productive when shared with the physician.  In a recent case, a facility chart review of meds and staff chart notes showed a possible correlation between this "typical dementia behavior" and the increase of dilantin.  Sure enough, when the dilantin was reduced the person with dementia resumed swallow initiation AND self-feeding.  (Thanks, Irene.)

Malinda 

-----Original Message-----
It's likely that this person may not take a PO diet as many
Alzheimer's pt's hold food in their mouth and never trigger a swallow.
 
Heidi 



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