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My mother-in-law with advanced dementia, will shove more food into her mouth before she chews and swallows whats in there. I cut it up as small as I can without puréeing it, but she’ll shove it into her cheek and then sit there and chew and chew and chew, but not swallow before she goes for another bite. I realize this is a stage that they go through, but I am at wits end to try to help her without purée all her food. She is able to choose some and swallow. Should I give her smaller portions? Any help would be appreciated.

She needs a swallow study, called a video fluoroscopy, to determine exactly what’s happening as she chews and swallows food. This will be done with foods of varying consistency. You’ll then have a better understanding of what’s going on and what foods/prepared how are safe at this point. Her doctor can order this
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Reply to Daughterof1930
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I agree with a swallow study .
But also Only put enough cut up food on her plate for one small mouthful at a time . When she swallows you put another mouthful on her plate. A bowl may work better than a plate.
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Reply to waytomisery
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Hi Vpaule13. My Mom has been having swallowing issues for about a year. Some days she can swallow a particular food and other days she cannot swallow the same food. I have a small blender and puree food for her on the days she chews and chews but cannot swallow. I add a liquid to the food until it’s mashed potato consistency. Works every time. My Mom is not having choking episodes. Just can’t swallow chewed food some days. I hope this helps. Best of luck.
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Reply to lmh1973
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So sorry. But yes, in latter stages of dementia this sort of thing, just as you so well describe it, is very common. It's important to now avoid choking so I would see to it A) that she is fed if that's possible (if she will allow it) and B) that the diet is what they call "mechanical soft" meaning there is no food like a huge chunk of broccoli and a big steak, that can be shoved in. That means ground meats, and chopped veggies, etc. You can easily look this diet up (tho this is not overall easily dealt with and may, no matter WHAT you do, result in choking.)

I am so very sorry. File this under "just one more thing!"
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Reply to AlvaDeer
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Why are you waiting to pureed all of your MIL's foods? That is what needs to be done now, before she gets aspiration pneumonia because her food is going into her lungs.
What she is doing now is called "pocketing" and yes it's very common with folks with dementia, thus why you need to start pureeing her foods today, and probably also need to be the one feeding her.
And make sure that you're thickening her drinks as well. I used the product Thick It for my late husband and it worked great.
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Reply to funkygrandma59
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I think you need practical tips and a strategy to get you through until an evaluation - yes to smaller portions, try using a smaller plate so it doesn't look empty
- instead of three squares a day try dividing her calories into smaller, snack sized meals served more often
- try having her take a sip of water often throughout the meal
- Do pay special attention to any meats you serve, it needs to be minced and served moist and loose meat style because even a hamburger patty can cause choking (as I unfortunately learned)
- things like thick soups and stews are often already an appropriate texture that are easier to swallow and are less apt to be pocketed
- smoothies are another good way to add calories
- think about planning meals that include foods that are already a soft/pureed texture, it's not necessary to serve a plate of mush. Over the years I've compiled a list
SOFT and PUREE FOOD DIET IDEAS
breakfast
scrambled eggs
oatmeal, cream of wheat, cornmeal mush, congee*
yogurt
pureed fruit

lunch/dinner
creamed soups
mashed potatoes, squash, rutabaga, sweet potato
finely chopped/ground meat in sauce or gravy*
pasta sauce over polenta or very tender pasta*
savoury custards/crustless quiche
refried beans
dahl
hummus
cottage cheese*
avocado and guacamole
fish pie
grits*

snacks/desserts
custard
milk pudding
yogurt
smoothies
applesauce and other variations
silken tofu puddings


(* these items may not be suitable for some levels of dysphagia)
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Reply to cwillie
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Those tiny pastas are nice. One is little stars the other is orzo. Maybe time for MIL to be spoon fed?
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Reply to JoAnn29
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