Dad is 96, has end stage Dementia and Silent Aspiration. He was hospitalized in August 2016 due to double pneumonia. He had been in AL but was moved to a NH. He went from honey thickness pureed to pudding thickness. He "drinks" with a spoon his liquid is so thick. The muscles that propel the food to the back of the mouth for swallowing are weakened. Either he can't or he forgets to swallow and must be reminded to swallow. It takes a long time for him to swallow what is in his mouth. Now I notice that he drools occasionally. He also has coughing fits without eating. My thinking is that he is choking on saliva. Yesterday I heard it in his throat, as well as some wheezing. I had the nurse check his lungs. Fine she said. My suspicion is that it just isn't to the point where he becomes sick. They give him breathing treatments 2 or 3 times a day. Blood work came back good the last time. His pulse ox has been 90. I truly believe he is aspirating again. At my 3 month meeting with the NH last week I was asked about a feeding tube if necessary. I won't subject an almost 97 year old man with Dementia to that.This site has become my go to site.... We all know what doctors and nurses don't or too busy to care about.
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We have a family friend who had significant dementia. He broke a hip, went into rehab, developed aspiration pneumonia, was treated, improved, and within a week developed it again and passed away within a few days. It all happened pretty quickly.
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Then I noticed that Dad was coughing a lot while he was eating. I knew nothing about aspiration so I just figured he was eating too much too fast. And he would keep on eating.
The one day he was running a fever and was quite weak, so the facility called 911 and Dad spent a few days in the hospital where swallowing tests were done. The test showed he couldn't swallow correctly and food was going into his lungs, thus he had developed aspiration pneumonia. A few days later he was gone, he went that quickly.
Dad's Living Will stated no medical efforts to extend his life, thus no feeding tube which he wouldn't have liked anyway. He was ready to be with my Mom who had past a year earlier, and sure enough he went.