Maybe it's something else besides Alzheimer's dementia, I have read GERD causes this also. It only happens when she is eating, without fail. I have told the doctor about it. Doctor thinks it's not a big deal so long as nothing is being aspirated (inhaled). At what point should I be concerned?
My mom had no trouble swallowing until one day it stuck in her throat. I gave her a sip to flush the food down but that made it worse and then she had classic symptoms of a heart attack!
I called 911. By the time the EMTs came through the door, she was okay and flirting.
Long story short, by the third time it happened I had done a lot of research and confirmed what to do—actually do nothing except to comfort her until she could swallow. Terrifying. Turns out rice is one food that’s prone to clump. I never made any dish with rice again and ensured her meals had more liquid, like sauces. Thankfully she never had another issue.
Don’t hesitate to contact a doc for an evaluation.
Very early on my mom began having trouble with water, she choked and had it coming out her nose! The next stage was when she occasionally began to choke on meat, even things like hamburger patties - the food would get stuck partway down and it was scary as heck because although it didn't completely block her airway she could neither cough it up or get it down. For a long time she was fine as long as her meat was ground, her veggies were well cooked and moist and her water was nectar thick, but by the end of her life she did need purees and very thick fluids.
Idunno, you might want to read up on dysphagia before an appointment, especially for the videoscopic swallow study. It will help understand how food can be aspirated into the lungs, and potentially cause pneumonia.
I do understand that you're under a lot of pressure trying to work and care for your father. Do you have any medical time off? This is really worth the effort and time.
It was a real eye opener when we eventually realized what was happening and why my father was coughing and choking while eating. And it's something that a primary care physician should have addressed but didn't.
And dump the jerk who said it's "not a big deal so long as nothing is being aspirated (inhaled)". He can only guess; that's why videoscopic swallow studies are performed. If you ask to sit with the therapist when the swallow study is being performed, you can watch very carefully and see the food or liquid being aspirated.
I would be concerned on two aspects of this.
1. That she is aspirating some foods
2. The doctor does not seem to realize this.
You could request from the doctor orders for a swallow test OR you can take matters into your own hands as a "trial run" start pureeing her food and begin thickening liquids. You can try a small amount of the thickening product so it is what is called Nectar thick and it will progress from there.
Stop feeding "slippery" foods that have not been pureed. Things like peaches, nectarines, jello, bananas. See if that improves the coughing and choking.
Why wait for her to aspirate something where that can lead to hospitalization, pneumonia and possibly death.
Cwillie is spot on with what she's telling you in her post.
Good luck moving forward.
https://www.agingcare.com/articles/dysphagia-how-to-help-a-loved-one-eat-and-drink-safely-187010.htm
https://www.agingcare.com/articles/swallowing-disorders-tips-for-using-food-and-beverage-thickeners-208048.htm
My husband who had vascular dementia, developed aspiration pneumonia, and it almost killed him. He survived, but suffered the consequences of it for the last 22 months of his life. I was told at the time by his Dr that because he had dementia, his brain was no longer telling his throat to close, allowing the food and drink to go into his lungs. I had to at first keep him on pureed foods and later just soft foods until his death.
It's nothing to mess around with, so please take her for the swallowing test. Best wishes.
I would get a swallow study by a speech/language pathologist.
Of course, if her dementia is very advanced, you might not want to invest the time and energy in that because she might not be able to follow instructions given to her on how to better managing swallowing.
Have you asked for a hospice evaluation?
Anyway I had some education with my dad going through similar issues except he would not talk about a problem. So far she does talk and it gets annoying but if she is talking normally I know she is doing good. I may try some thickened food and beverages to see how she handles it. My dad had something like that, I didn't really know he was needing them or much about thickened beverages but now I am thinking this could help her. I will try to ask for a "swallowing test" Will see if I get anywhere. As stated on another comment I have a unique situation.