The Last Cookie: Another Stage in Mom's Alzheimer's Care

Dorian Martin Health Guide
  • Another sad milestone has passed - I’ve baked my last cookie for Mom.

    Just to recap what’s been going on, about three weeks ago I took a bag of cookies to Mom to brighten her day. A few moments later, she was struggling with swallowing the bite of cookie as her eyes started tearing, her nose starting running, and she started coughing. The speech therapist at the nursing home already had noticed Mom’s issue and recommended that Mom be tested to find out what the problem was.

    On Thursday, Dad and I went with Mom as she took a modified barium swallow test. The good news is that Mom was in a really good mood that day. I’ve found that since she has been diagnosed with Alzheimer’s disease, she can really be difficult to handle when she’s out of her element (the nursing home). She’ll tend to lash out verbally or refuse to do what needs to happen, especially if it’s a doctor’s visit. So as we went to the clinic with some trepidation that she wouldn’t participate in the test since she would be confused by the strange surroundings. Fortunately, the nursing home speech therapist (who Mom remembers and really likes) was present for the test so - between the therapist, Dad and I - we were able to coax Mom through the morning’s activities.
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    In the modified barium swallow test test, Mom was asked to swallow a variety of foods with different consistencies that were laced with barium as she was scanned by an x-ray machine. Dad and I watched closely on a TV monitor which showed Mom swallowing the food as it happened. It was interesting to see some of the issues that she was experiencing, but couldn’t describe to us.

    The test showed that Mom has multiple challenges: lack of back molars to grind food, lack of tongue coordination, weakness in the throat, and the inability to hold her breath for one second (due to her chronic obstructive pulmonary disease) which would allow the entrance to her lungs to close so that the food could pass straight to the stomach. This combination of issues has resulted in her being unable to swallow solid food.

    After conferring with the hospital’s speech therapist and the nursing home’s speech therapist, we (my father and I) agreed to have Mom's diet be exclusively pureed foods. The hospital speech therapist indicated that Mom's condition with swallowing will be a progressive issue that may result at some point in a liquid diet and a feeding tube. Dad and I are already having discussions (along with my brother) about what our family’s stance will be concerning the feeding tube (if it comes to that). But at least we are forewarned as caregivers that this decision may need to be made in the future.

    So no more cookies for Mom. But I have other treats (approved by the speech therapist) up my sleeve – regular peach or banana/strawberry smoothies. That way, Mom still feels appreciated, she gets her sweet-tooth taken care of, and she gets additional nutritional benefits from the smoothies. I’ll miss making the cookies, but am glad I can still enjoy spending quality time with Mom and still have ways to spoil her during those visits.
Published On: April 09, 2007