Mouth Care

[Blythe40]

I am a caregiver to my mom. My mom is using a feeding tube and no longer eats through her mouth due to choking. She has been on the feeding tube for 1.5 years. We continued to give her mouth care 3-4 times a day and give her Atropine drops to have less saliva, but we always have a challenge where she says she feels like there's a rubbery substance throughout her mouth. Lately, we have been dealing with an increase of this build up where it's all over her mouth and lips. You can actually see it dried up on her lips and all over her mouth. When we use the (what we call) sponge on a stick and swipe it throughout her mouth, it is all over the sponge. It feels very sticky and yellowish.

Hospice nurse is stumped on what we can do and my mom is afraid she will choke on it.

Any thoughts on how to get rid of this or lessen the issues?

 

[affected]

You give atropine drops to decrease saliva, so mouth care is important and this is probably a result of that in part.

Lots of fluids, how much water do you give her daily?

What does her clinic doctor say about it?

 

[carex]

Check the "thick secretions in the..." thread. Might be what's going on.
Bob

 

[Blythe40]

We give her 550 cc of water each day. Can't increase it because she will have it come up and she can choke.

 

[Blythe40]

Thank you. I'm new to this forum and hoping it can help me to help my mom. Thank you

 

[Atsugi]

My general advice about the PALS mouth is this: The tongue normally does a lot of work sweeping and scrubbing the mouth. Once the tongue is compromised by ALS, the CALS needs to inspect the mouth looking for left over food, hairs, and broken bits of pills. And you never know what might burn the mucosa.

So oral care is not about brushing the teeth, it's about inspecting and removing junk.

 

[lgelb]

Might try titrating down the atropine; is she on BiPAP/humidification?

 

[Ells]

Hi, sorry your mother's having this problem. You could try putting pineapple juice on the sponge as it can cut through mucus.

The small amount of water she's getting won't help her either. Dietitians here say an intake of 30mls water per kg of weight is for "normal hydration", but we tend not to swallow normal amounts of saliva, so may have a higher requirement. You say water given to her is limited (550mls is not a lot) as it can come back up; is she lying down? How quickly is the water being given and how soon after a peg feed? There is probably scope to safely up her water intake, which in turn, should help secretions.

 

[Gorby]

Could it be thrush?