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Alzheimer`s Disease/Swallowing Problems for Mom

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Question
My mom has moderate dementia and for the last 5 months she has gone from 123 lbs to 111 lbs. She has problems swallowing and I think that is the reason she doesn't eat much. I have been cutting her foods in small pieces. She seems to hide her foods lately. She had a swallowing test and it appeared to be normal. Is this part of her dementia and how long can this linger on before she loses more weight again? I am her daughter/caregiver 24/7 since August 2012.

Answer
Hello Susan:  I'm very sorry to hear of your mom's decline--I'm sure you're very worried about the weight loss since she's a small person to begin with.  That's a significant loss of weight for her to have had in only 5 months.  It's likely due to the progression of the dementia in her brain to where it's now affecting her ability to swallow.  Despite a "normal" swallowing test, I would have her evaluated by a speech/language pathologist in order to see just what consistency of foods or fluids she would tolerate best without choking.  It may be that you need to thicken her liquids to honey-like consistency, or serve only pureed foods at this point.  It's important to try to stop the weight loss, so serving her foods/fluids that she really likes will help.  Milk shakes jazzed up with protein powder, if she can tolerate them would be good.  Those nutrition supplement drinks, in her favorite flavor may help as well.  Any way you can get extra calories into her is good--think about putting butter/peanut butter/etc. on bread or toast instead of margarine.  Don't worry at this point about reducing fat or sugar content (unless she's diabetic) or what her cholesterol levels are. Sometimes an appetite enhancer such as Eldertonic, or Marinol can help.  Remeron has been shown to help as well, but would need to be prescribed like the Marinol.  
I wish you much luck Susan as you try to find ways to prevent her weight loss, but this is a common progression in dementia and there may be only so much you can accomplish.  Cindy

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner

Expertise

As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.

Experience

I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Organizations
Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Publications
Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Education/Credentials
Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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