Holding food or medications inside the cheeks. This is called pocketing. Your loved one may not be aware that there is something in their mouth to swallow. You may need to tell them to swallow.
“Pocketing” is a common tendency: keeping some food in the cheeks or back of the mouth rather than swallowing fully. Keep an eye on this: even when it doesn't happen frequently, it can happen spontaneously, especially when tired or temporarily distracted.
The most common reason is simply lacking the sensory awareness and/or tongue coordination to fully chew and swallow certain foods. Instead, they chew or suck on the food, and pocket it. Some babies may accidentally pocket food, or the food moves to a place in the mouth where the baby can't quite get it back out.
A person with a dementia may have difficulty with some types of food and fluids. This can lead to them spitting out lumps or holding food in the mouth. Things that can help include: giving a soft, moist diet - avoid hard, dry or fibrous foods that need a lot of chewing like steak, bacon and wheaten bread.
Put simply, seniors with late-stage dementia “forget” how to swallow, lose weight and become increasingly frail.
While it is impossible to predict exactly how long someone can live without eating or drinking, having dysphagia can mark the beginning of end of life care . People living with a neurocognitive disorder may benefit from end of life care for days, weeks, months, or years.
As dementia progresses, swallowing difficulties (called dysphagia) become more common, although they will vary from person to person. Difficulties may include the person chewing continuously or holding food in their mouth.
The most common cause of death among Alzheimer's patients is aspiration pneumonia.
Oropharyngeal dysphagia is when there is difficulty forming and swallowing the bolus and moving it from the oral cavity into the pharynx. This mechanism is the most common in patients with Alzheimer-type dementia in which the patient has difficulty in recognizing food in the mouth and initiating a swallow.
Swallowing disorders may also include the development of a pocket outside the esophagus caused by weakness in the esophageal wall. This abnormal pocket traps some food being swallowed. While lying down or sleeping, someone with this problem may draw undigested food into the throat.
Tiredness and concentration – tiredness can cause people with dementia to not eat or give up partway through a meal. It can also lead to other difficulties such as problems with concentration or with co-ordination. People with dementia may have difficulties focusing on a meal all the way through.
A form of facial blindness, similar to prosopagnosia, is also known as facial agnosia. This is not necessary caused by cognitive loss of the dementia-related disease, but more by the damage that the disease has caused to the brain.
Signs of the final stages of dementia include some of the following: Being unable to move around on one's own. Being unable to speak or make oneself understood. Eating problems such as difficulty swallowing.
For example, a sudden deterioration or change may be a sign that an infection has led to delirium. Or it may suggest that someone has had a stroke. A stroke is particularly common in some kinds of vascular dementia and may cause the condition to get worse in a series of 'steps'.
Dysphagia can be classified into four categories, based on the location of the swallowing impairment: oropharyngeal, esophageal, esophagogastric, and paraesophageal (Figure 82.1).
Providing the person doesn't appear to be uncomfortable or distressed, then sleeping more during the day isn't normally a reason to be worried. However, if a person is lying down in bed and asleep for most of the time they will need to be looked after to make sure they don't develop any physical health problems.
Bathing can be a challenge because people living with Alzheimer's may be uncomfortable receiving assistance with such an intimate activity. They may also have depth perception problems that make it scary to step into water. They may not perceive a need to bathe or may find it a cold, uncomfortable experience.
Administration: The examiner reads a list of 5 words at a rate of one per second, giving the following instructions: “This is a memory test. I am going to read a list of words that you will have to remember now and later on. Listen carefully. When I am through, tell me as many words as you can remember.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
Creutzfeldt-Jakob disease causes a type of dementia that gets worse unusually fast. More common causes of dementia, such as Alzheimer's, dementia with Lewy bodies and frontotemporal dementia, typically progress more slowly.