April 1, 2017

Preventing aspiration pneumonia

Those with advanced and end-stage dementia are a lot more prone to pneumonia. However, this kind of pneumonia you cannot get a vaccine against.

In people with advanced dementia, the body does not reliably close off the esophagus to prevent inhalation of particles of food or drink. When this happens food or liquid can slip into the lungs instead of the stomach, and can lead to aspiration pneumonia.

Here are some ways to prevent aspiration pneumonia:

• Rest for 30 minutes beforehand
  People who are active before eating have more trouble swallowing.
• Sitting up to eat
  Make sure your loved one is sitting up at 90° and preferably sitting at the table.
• Calm, leisurely meals
  Those who are rushed eating are more likely to get food down the wrong pipe.
• Reduce distractions
  Present only one food at a time. Smile encouragingly, but try to minimize conversation. Talking can be distracting and it increases the risk of aspiration.
• Small bites and sips of water
  When cut into small pieces food goes down more easily, especially if alternated with sips of water.
• Tucked chin when swallowing
  Lowering the chin toward the chest tends to line up the throat in a favorable angle.
• Regular oral hygiene
  Brushing teeth twice a day will help to remove food particles and bacteria. Using nonalcohol mouthwash can also help.

Thickened liquids
Thickened juices tend to cause fewer swallowing problems, but most dislike the texture and as a result, they will reject fluids altogether. This can lead to dehydration, which brings on other problems like bladder infections. Instead of thickening, try high-liquid foods like jello, watermelon, and sorbet.