So my grandma eats and drinks unnecessarily fast and basically just keeps shoving the food or drink in her mouth without really swallowing first. She ends up looking like a greedy chipmunk at every meal. I didn’t think much of it until last week when she actually choked on something and the caregiver had to do abdominal thrusts to save her. Traumatic (probably more for me than her honestly). So I've been watching more closely now and I’ve noticed her coughing like the liquid goes down the wrong pipe or she’s got too much food in her mouth she can’t even chew it. So at first I thought she just needs to be monitored and reminded while eating (I have to like stop her arm from stuffing more food and say “first, chew”). But then she nearly choked on a calcium tablet. Granted they are big, but she never had a problem before. I started breaking them in half the last two days. I’m very worried about aspiration, but she seems very far from the stages of dementia where that’s usually a concern. Ideas? Tips? I cut her food small and don’t give her huge glasses of liquids, but it doesn’t seem to help much.
Choking and coughing, as well as inadvertent "pouching" of food in the pockets outside the teeth can occur. As FF states, a videoscopic swallow study should be done to determine if this is the issue.
In our experience, my father's pulmonary doctor was the one who ordered swallow studies, as did a speech therapist at rehab and a speech pathologist at a hospital.
It's an easy test. The individual is given little bits of liquids to swallow and food to eat. The pathologist monitors the intake and path flow to determine if "frank" aspiration is occurring.
A modified diet is then prescribed, based on the level of dysphagia. As Inlaw mentions, modifications such as chin tucking, slower eating and more processing time before the next bite, and exercises can be recommended, depending on the severity of the condition.
Several of us here have been through that, pureeing foods for our dysphagic relative.
A search of other dysphagia posts here brought up a lot of hits, which you can read to familiarize yourself with the issues.
https://www.agingcare.com/search.aspx?searchterm=dysphagia
If dysphagia is diagnosed, then you move to the next step of acquiring a food processor or something similar to puree the food, buying Thik-it or other brand to thicken the liquids.
Be aware that if the condition is severe, a feeding tube might be recommended. Think seriously if it gets this far, as that would typically mean an NPO status - no foods or liquids by mouth. That's a drastic and emotionally challenging step.
My Dad use to cough when he ate, but it got worse as he aged. Test were run when he went to the hospital at the recommendation of Dad's aide at Assisted Living. Turned out Dad had aspiration pneumonia.