Expert: Michalene Peticca - 6/11/2009

Question
My father is in the late stage. He has lost 20 pounds during the last 6 months and doesn't chew any more. His food is liquid and is thickened as much as possible. He quit talking about 4 years ago, and is incontinent. Once they lose the ability to chew, is the ability to swallow soon to follow? Thank you so much.

Answer
Hi Jean,

I am so sorry about your father.  I know this has been a long disease process for you and him.

You ask an excellent question and one that is very difficult to write about, as you are experiencing the ravages of the disease process with your father.

Generally, the answer is yes.  Our brain is like a control panel for our bodies.  When those connecting wires in the brain no longer are able to send a message to muscles in our bodies...the muscles do not "work" on their own.  Therefore, many times a Dementia individual will lose the ability to swallow and start to "aspirate" on foods.  At this point, you as a family member, are asked to make a decision about a feeding tube.

This is a big and ethical decision.  As i've said before, it is only one that your family can decide is best.  However, most people are now planning in advance and have their wishes conveyed about feeding tubes and other artifical nutrition devices.  So, i always remind families to make the decision based on what they know or believe their loved one would have wanted and what their own religious foundations would be supporting.

My sympathy to you Jean!

Best Regards,
Michalene Peticca, MA