In the elderly, swallowing problems are a very serious matter and must be treated tight away.
If you have a parent or other relative who has had a stroke or currently has severe Alzheimer’s disease, swallowing can become an activity fraught with tension and apprehension because of the difficulty in coordinating the muscular and neurological movements that are necessary when swallowing. Such a person may even lose the desire to eat because it just becomes too difficult.
If swallowing becomes difficult, older people can choke on their food, or food can go down the windpipe instead of the esophagus. Since they lack the strength necessary to cough up even a small piece of food, the food particle may stay in the windpipe for a time. When this happens, a form of pneumonia called aspiration pneumonia can result.
If swallowing is difficult for an elderly parent or relative, her physician might recommend a nasogastric tube to help with feeding. The tube is inserted into the nose through the esophagus and directly into the stomach. Although family members may find this suggestion disturbing and quite unpleasant, it really does help the patient. These tubes are uncomfortable, however, and can eventually cause the skin in the nose to break down, so this feeding method should be used for no more than three months.
If a more permanent method is needed, the nasogastric tube can be removed and a small tube known as a gastric tube, or GT, can be placed directly into the stomach by a gastroenterologist. This is called a PEG procedure. The tube is then hooked up to an automatic feeding pump.
Again, although even the thought of this procedure depresses most family members, I’ve seen patients whose health and spirits pick up rapidly because the GT provides balanced nutrition after many years of being malnourished. In fact, many patients who have a GT placed soon regain their appetite, begin to eat regular meals again, and ultimately have the tube removed.
Before a gastric tube is prescribed, however, the physician will probably call on a team of other specialists, such as a nutritionist, speech pathologist, and/or an ear, nose, and throat doctor, to see if anything can be done to keep the patient eating real food for a while longer.
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