Aspiration pnuemonia

Kitchendilemmas · 2021-08-30T08:17:49+00:00

DF has advanced Alzheimer's and has been hospitalised with aspiration pnuemonia. He was actually sent down because he fell and hit his head (CT scan clear), but the doctors picked up on a crackle in his chest and sent him for a lung xray. Does anyone have any experience of this? He seems to be losing the ability to swallow so the medics are struggling to get a feeding tube in. He's now not eaten properly since Thursday and we're becoming increasingly worried. I'm also not sure how the care home will cope once he is discharged.

DominicRaabsTravelAgent · 30/08/2021 12:34

So sorry Kitchen. No experience but just wanted to offer a handhold

Yummymummy2020 · 30/08/2021 12:59

Limited Experiencefrom a dementia end and a cancer end , didn’t want to ignore though. A family member had throat cancer and suffered from aspiration and subsequent infections as a result. Began with a speech and language therapist to aid in safe eating and had different grades of food on a chart, some allowed some not allowed. This wasn’t enough so ended up with a feeding tube but through the stomach. Was very effective initially as no swallowing was needed but sadly died from the cancer. Did avoid infections from this path, not sure if it’s available to dementia sufferers though. Volunteered in a stroke ward that also catered for dementia patients that could not swallow. There was a thickener used for the liquid foods my allocated people ate but none had feeding tubes. Some were allowed small amounts of mashed food. They were very elderly though and the speech and language therapist told me in some cases quality of life trumped the feeding tube (particularly if they were constantly pulled out and traumatic to get back in) so that’s why it was never used with these particular patients on the ward.)when there were infections, they just treated them as needed with antibiotics. The patients did ok for the most part, I was there two years and even some with awful swallowing ability faired out ok with the liquid diet and thickener once fed very slowly on a small spoon. I’m sorry if that’s not useful to you but it’s the bit of experience I had!

Original poster

Kitchendilemmas · 30/08/2021 19:59

Thank you both so much! He has been aspirated 4 times in the last 48 hours which doesn't seem positive, but the doctors are still talking as though he'll be discharged in the next couple of days. All v stressful!

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MistyFrequencies · 30/08/2021 20:10

Ask for a referral to a Speech and Language Therapist to assess his swallow. Get this before discharge so he can go home with really clear recommendations. The SLT may be able to give tips/ strategies to make his swallow safer. E g. Sometimes it's a sensory thing with people with dementia and giving them really cold liquids, or fizzy drink, or anything that will increase sensation can help trigger a safer swallow. Sometimes thicker fluids (milkshakes, smoothies) can be easier too. They will assess and tell you.
Keep his mouth really clean. If he is aspirating food/fluid (means it's going to his lungs) then best that there's no germs in his mouth as otherwise they will go to hus lungs too. You're something like 6x more likely to get aspiration pneumonia if your oral hygiene is poor.
Im sorry to say this too but there is the possibility with advanced dementia that this is the start of the end. Often people lose their hunger/thirst/desire to eat and swallow also deteriorates. If they're talking about him going home that may not be the case but I know from experience that it can be.
I'm sorry you and your dad are going through this.

Candleabra · 30/08/2021 20:20

Oh I'm so sorry. I also don't want to upset you, but feeding tubes are generally not recommended for people with advanced dementia even if swallowing is compromised. I think there will be a SALT referral who may recommend thickening food etc. But I think once this stage is reached the prognosis is very poor. Do you want your dad to have treatment?

(I'm also going through the same with my mum so I do understand how hard it is, and I hope you don't get upset about what I've written. It is the worst disease and terrible for the patient's loved ones)

Original poster

Kitchendilemmas · 30/08/2021 22:17

Thank you Misty and Candle. I've done quite a bit of reading up on this now and yes, sadly I'm aware this can indicate we are getting close to the end. He seems to have rallied today though, singing along to the Beatles and smiling at everyone, so we'll see what tomorrow brings.

With it being the Bank Holiday, we haven't been able to get a proper SALT assessment. That should be happening tomorrow, along with the dietician visit. Great point about the oral hygiene. I'm not sure the care home staff are entirely on top of that so will raise it with them.

It's very hard to know what to do for the best. Even if he manages to fight this infection off we're very aware it can recur and that at some stage palliative treatment will be required as opposed to medical treatment. Being an adult really does suck doesn't it.

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DominicRaabsTravelAgent · 30/08/2021 22:20

Being an adult really does suck doesn't it.

I don't think there are many things worse than watching a parent with Dementia or a parent seriously ill. You have both

Original poster

Kitchendilemmas · 30/08/2021 22:24

@DominicRaabsTravelAgent

Being an adult really does suck doesn't it.

I don't think there are many things worse than watching a parent with Dementia or a parent seriously ill. You have both

Thank you

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Candleabra · 30/08/2021 22:25

It sure does suck. I hate it. My mum is at the final stage of dementia. All functions gone now, apart from eating and drinking. I'm on edge all the time, just waiting for the next crisis. My mum is doing better now (strong antibiotics following persistent chest infection). But better....well what does that mean really? She'll never be better, she'll never properly be my mum again.
The small improvements are somehow worse than the overall decline as it brings hope alive.

Candleabra · 30/08/2021 22:29

I hope you have someone looking after you through this difficult time

LoveFall · 30/08/2021 22:34

I went through this with my Dad. He had a blood cancer and was declining already when he got the flu. He did not have any serious dementia. He started having swallowing and aspiration problems and was given the thickened food. He refused to eat.

I am sorry OP but it really was the beginning of the end for him. He died peacefully a week or so later. A feeding tube would have been torture for him.

I hope you are taking care of yourself. It is so important.

Original poster

Kitchendilemmas · 30/08/2021 22:34

@Candleabra

It sure does suck. I hate it. My mum is at the final stage of dementia. All functions gone now, apart from eating and drinking. I'm on edge all the time, just waiting for the next crisis. My mum is doing better now (strong antibiotics following persistent chest infection). But better....well what does that mean really? She'll never be better, she'll never properly be my mum again. The small improvements are somehow worse than the overall decline as it brings hope alive.

@Candleabra I understand exactly what you mean about the crises and the brief glimmers of hope. It is never ending. It's so unsettling for us so god alone knows how he is feeling. I'm so sorry you're on this awful journey too. I am lucky to have family around me who are very involved in Dad's care. I hope you are also being supported?

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Original poster

Kitchendilemmas · 30/08/2021 22:35

@LoveFall

I went through this with my Dad. He had a blood cancer and was declining already when he got the flu. He did not have any serious dementia. He started having swallowing and aspiration problems and was given the thickened food. He refused to eat.

I am sorry OP but it really was the beginning of the end for him. He died peacefully a week or so later. A feeding tube would have been torture for him.

I hope you are taking care of yourself. It is so important.

I'm so sorry for your loss but also so glad for your dad that he passed peacefully. I hope that when the time comes, it will be peaceful for my dad too.

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Gingerlovesbiscuits · 30/08/2021 22:40

I’m so sorry. My Dad had dementia and I remember all too well how awful it was. He also lost the ability to swallow. He had a SALT assessment and was placed on a soft diet - foods like soups, scrambled egg, mashed beans etc. That helped for a while. He was also give subcutaneous fluids . His swallowing and condition did eventually deteriorate further but he did manage quite well for a period beforehand. It’s a horrible disease. Sending love x 💐

Original poster

Kitchendilemmas · 31/08/2021 09:15

@Gingerlovesbiscuits

I’m so sorry. My Dad had dementia and I remember all too well how awful it was. He also lost the ability to swallow. He had a SALT assessment and was placed on a soft diet - foods like soups, scrambled egg, mashed beans etc. That helped for a while. He was also give subcutaneous fluids . His swallowing and condition did eventually deteriorate further but he did manage quite well for a period beforehand. It’s a horrible disease. Sending love x 💐

Thank you and I'm so sorry you've also been through this.

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Candleabra · 31/08/2021 15:16

@Kitchendilemmas how is your dad today?

LoveFall · 01/09/2021 22:14

Thank you for your kind words OP. My Dad died in hospital, but all of his children (4 of us) managed to be there, holding his hands and singing songs we sang as children around campfires. He couldn't speak at the end, but he did raise his eyebrows to let us know he heard.

It is so hard, I know. Watching your strong Dad slip away.

I hope it is peaceful for your Dad too. You can be an advocate for him and try to make certain he is kept comfortable. The nurses came in periodically to give him meds and reposition him but mostly left us with him.