T:DIFFICULTY SWALLOWING AND HICCUPPING	Q:Hello,  It has been a while since I last posted. My dad is <age> and was diagnosed with Alzheimers about <time_period> ago. He is doing very well and can still live alone and do everything for himself except drive. I take care of him and go over to his house several times a day for about <time_period>. about <time_period> ago he started having problems swallowing food. He said it felt like the food was caught in his throat. It happened maybe once every <time_period> or so. The <professional_practitioner> said it was because he refused to get dentures and wasn't always chewing his food well. Recently it has gotten a lot worse. Now almost everytime he eats or takes his pills or even drinks a milkshake,  he will start hiccupping and then gagging and vomitting up saliva (not the food) just saliva. It is horrible to watch. Sometimes it lasts for <time_period>. He tells me it feels like the food (or pills) are stuck in his throat. Finally after <time_period> the food goes down his throat and he feels better. I have researched this on the internet and found other people complaining of the same thing,  but no one was able to tell them why it was happening. I know AD patients sometimes have swallowing problems especially in the late stages,  but dad has no real symptoms of AD except severe short term memory loss. I am at my witts end. I have had him on a liquid diet for about <time_period> but he still has this problem. It is not getting better. Does anyone have an idea what could be causing this? Thanks,  <name>	A:Hi therei too have dentures and so many times if alone i will eat certain foods w/o my dentures in i have not had troubles with this at all but that is meidk i personally think it requires more looking into but hey thats just my opinioni also hv a brother that for whatever reason wont wear dentures n he never has issues eating basically anythingi am sure or relatively so that food is not digested properly due tp ;ack of complete chewing but again ive never hearfd of thismaybe others havehoping you get better answersblessing <name>


A:His short term memory loss might be the reason that he doesn't chew his food well. I tried finding it online too but I couldn't find the why's either. It just says that in the end stage that AZ patients have a hard time swallowing (like you said). So maybe he is forgetting to chew well? Or maybe even on how to swallow? Swallowing is both a concious and nonconscious act. We swallow in our sleep because our body is telling us to do so and when we are awake,  we make a concious effort to swallow liquids and food. But please keep an eye on him because the problem with the unability to swallow properly causes aspiration which in turn can cause pneumonia.  


A:Great point <name> huggs <name> wasnt quite awake but no excuse


A:Thanks so much for the advice. I will keep an eye on him.  <name>


A:Hi <name>,  My DM was orinally dx w/ AD,  then another <professional_practitioner> dx her w/ 'Dementia'. She has a problem w/ short term memory sometimes,  but a big problem w/ swallowing. She choked on a peanut butter sandwich last yr. Thankfully,  my sister was w/ her at the time,  gave her the Heimlich (sp) and cleared the path. Scared all of us. She has had problems since then. She is in a rehab right now to recover from C-diff and pneumonia,  she is <age> yrs old. While there,  they had a speech <professional_practitioner> come in to observe her eat,  talk,  etc. The S/T sent her for a <diagnostic_test> at the <institution>. This is the <num> time she has had this done,  <num> time wasn't too bad,  this time she had more problems. She only wears the upper denture and she has Gastroparesis. They have taken to chopping her food very well. I've had the worse time trying to convince her to have her food this way at home. They have also added something called 'Thick-It' to ALL of her liquids,  including water. These have helped tremendously to keep her from choking. The S/T also made some suggestions to help my DM. Keep your head facing straight ahead,  and as you swallow,  dip your chin slightly. Each time you swallow food/drink/saliva - swallow twice. Take smaller sips,  bites. We have all noticed big improvements. It all comes down to being very 'mindful' of what you are doing. Focusing on all the steps of eating and drinking. I asked about the 'Thick-It',  do we need a rx or can we pick it up OTC at the drug store? You can get it at w/o a rx at the drug store. My DM didn't like the 'Thick-It' to begin w/ but now she is used to it and it doesn't bother her. My DH has a problem w/ hiccups,  he does not have AD. He eats very quickly,  it does tend to bring on the hiccups,  plus one food sets him off - Beef! I rarely cook beef anymore (I get sick just thinking of beef - long, weird story),  so it isn't often that he has it. When I do fix it for him,  he always ends up w/ the hiccups. Just wondering if there are certain foods that can trigger this for your father. I hope you both get some answers/help. I know it can be frightening for both of you. God bless. <name>.  


A:Hi <name>,  Thank you so much for responding. Your comments were very helpful and I am going to look into the Thick It. The suggestions about how to swallow sound like they will really help Dad. I am curious about what you said about your DM being diagnosed with AD and then another <professional_practitioner> said she only had dementia. I have strongly felt for some time that Dad does not have AD. It has been <time_period> and the only problem he has is with his short term memory and even then he can remember some short term events very clearly. When I asked the <professional_practitioner> about this he said everyone progresses differently. I agree with that statement,  but seriously,  in <time_period> he has no other signs of AD. Every one else I know who was diagnosed with AD deteriorated within <time_period>,  i.  e. not able to feed,  bathe or dress themselves,  not knowing their own children,  etc. Does your DM only have memory problems or does she have other AD related problems? Do you think she has AD? It would be a great relief to me to know Dad doesn't have AD.  Thanks for taking the time to respond.  <name>


A:Hi <name>,  I'm glad you found the suggestions helpful,  hopefully,  they will make things easier for the <num> of you. The <professional_practitioner> who originally dx my DM w/ AD wasn't her regular <professional_practitioner>. She was the one on call in the <institution> when my was rushed there one time. She didn't know her at all and was rather snippy w/ my mother. Not a good idea! She was later dx w/ dementia by a <professional_practitioner>. A lot of the symptoms are very similar. The <professional_practitioner> believes this started when my DM had a stroke,  which she had after coming home from the <institution> to have her <num> pacemaker put in. She has a hard time w/ her bladder control. She never had that before. She held off using Depends for a long time. She had her own little Sr house,  didn't want to live w/ anyone. about the time she had her <num> pacemaker,  she got extremely upset about living on her own. She does have Depression,  anxiety,  and no interest in meeting new ppl,  the family is as much as she has interest in. She can't follow the steps for cooking anymore,  would forget she had something in the oven or microwave,  the smoke detector would go off and the fire truck would come. She was mortified. She gets stubborn about taking a shower,  sometimes. My mother would read <num> newspapers a day,  now not interested. Loved crossword puzzles and playing cards,  now can't follow all the steps. She will repeat herself on occassions. She will tell you a story she told <time_period> ago,  not all the time,  she will even ask,  'Did I tell you that before?' She can't write for long,  she used to have such beautiful handwriting,  now very childlike. She hasn't been able to write cks or keep a ck book for awhile. She know all her children,  in laws,  grands and greats. She knows anniversaries and b/d for children,  my DH and the grands - all <num> of them. She always remembers my phone #,  I've had it for over <time_period> and I can't change it - for the simple reason,  it is the only # all my family can remember. lol I have a very dear friend (we were raised as cousins) her DM and my DM were BFF since grade school. This woman has been dx w/ AD and it is about <time_period> yrs w/ this dx. She is in worse shape than my mother. She is in her early <age>'s. She knows her children,  but not sure of her grands. My DM is on <medicine>,  <professional_practitioner> said either AD or vascular dementia would benefit from using this med. I know my mother was extremely upset to be told she has AD,  but handled the dx of dementia much better. She can be extremely sharp and like her old self. Then she has <time_period> where she gets confused,  not all day but for periods of a day. If you and your father aren't sure or comfortable w/ the dx,  maybe another evaluation would help to define what is going on w/ your father. Maybe another <professional_practitioner>,  <professional_practitioner> or such. I wish you luck w/ your father. He is lucky to have such a loving daughter in his corner. You are both in my thoughts and prayers. God bless. <name>.  


A:Hi <name>,  Thanks for taking the time to respond. It helps talking to someone who has been through the same things. Most people can't understand the stress we are under trying to care for a person with AD. There seems to be a new problem or crisis each day. They are always agitated or fixated about something,  but I am blessed Dad can still live alone. Thanks for the information and tips. My dad has tried some of your suggestions (smaller sips and tip the chin down) and it has really helped him. He is doing so much better! Your DM and my dad have a lot in common with burning the food in the oven. I disconnected the oven a couple of <time_period> ago becasue I was afraid he would burn the house down. He hasn't missed it too much. Thanks again, <name>
