Changing positions when eating

[Kim C]

With mom's problems keeping food/fluids from drooling back out of her mouth as quickly as we put them in, got a few ideas from our speech therapist here at work.

She suggested a high-back wheelchair that reclines a bit so we could be mom out of the "C" shape posture she usually eats in. Her neck muscles are weak so her head hangs forward, her abdominal muscles are weak so her spine goes into a "C" shape when we sits in her wheelchair. Her lip & bulbar muscles are weak so she drools and can't keep food in.

Do you think the change into a bit more reclining position would defy the gravity that is working against her when she tries to eat/drink?

Also the therapist suggested that the saliva gathering in mom's mouth might be aiding the food's exit back out the mouth and we might want to look into a med that could dry the saliva up a bit.

I also have a call in to the ALS clinic that saw mom. We're under hopsice now. As usual the ALS clinic hasn't called us back. don't know what i would do if I didn't have my co-workers to go to.

 

[dalvin]

I think you would need to be very careful with that . If she's having trouble swallowing and you tilt her back she could easily aspirate whatever you put in her mouth and if her diaphragm is weak she may not be able to cough it back out

 

[Kim C]

That's true. If we could just get her sitting a bit more upright it would help. She has a vacant look to her face now.

 

[lgelb]

Is it that she can't swallow either or just that her lips/jaw muscles are weak? If she can swallow OK if the food stays in, aspiration may be less of an issue. In a power chair, many people eat slightly tilted back and/or reclined for neck stability. Either way, sounds like she's at the point where smooth texture may be important -- does she do better w/ things like pudding? Quiche? Jello?
What kind of a w/c does she have now, that can't tilt? Doesn't she have a head rest? If not or with, maybe rig up a chest strap? You can tear/cut a strip of cloth from just about anything. If her head is truly unstable, you could also run a cloth strip or bungee cord around her forehead and attach to chair...

 

[GilWest]

I also have a call in to the ALS clinic that saw mom. We're under hopsice now. As usual the ALS clinic hasn't called us back. don't know what i would do if I didn't have my co-workers to go to.

Sounds like our ALS clinic. Our specialist seems to be "phoning it in" and jut basically says expect the worst with no advice for comfort. The clinic is the only resource I have and our local docs have little experience with ALS.