My mom has Dementia and Parkinson's and has started holding food in her mouth and not swallowing. Her caretaker feeds her, but eventually has to pull food out of mom's mouth. When dad feeds mom, if she holds food, he just quits feeding her and he says she "eventually" will swallow. I have discussed this with my mom's hospice nurse and she has told my dad and I that we need to start pureeing her food. Dad unfortunately is not wanting to do that yet, he says she will eventually swallow. I am afraid of my mom choking on her food, I am stuck between a rock and a hard place. My dad is still very much "in charge" when it comes to making decisions for my mom and is starting to create tension between he and the sitter, even to the point where she has mentioned leaving, which in my mind, is NOT an option.
Since there is so much good info here already, I tend to expand on what daughterof said: your dad is apparently having his own age-related decline, and perhaps you can gently say this one time to him, timed just right. It will make him sad and embarrassed, which I know you don’t want, but may help make some progress. That only someone in a more feeble mental state would cross what educated and experienced nurses are saying. He is under terrible stress, and/but you might need to use a chink in his armor.
Try to make a more special connection with the caregiver, that this is when you need her most, maybe even increase the pay a small bit?
God bless you both, and your mom. 💐
Getting information online (hopefully a brief description will be enough, as if it's too lengthy, he may choose not to read it) or even better a video demonstration you can show to him might help.
Give props to the caretaker. Make sure the person isn't feeling pressured by dad - if she's feeding mom, keep dad occupied and out of her hair!
Found one youtube that shows both normal and aspiration (note the first, normal swallow, is only has about 40 seconds of video, not 1 1/2 min, but it's enough. The second, aspiration, is closer to 1 min, not 8 min (the rest of both is just black screen!)
https://dysphagiadiagnostex.com/pages/mbss-video-examples
I just keep having to remind him to chew and swallow and have milk or juice for him to drink to help.
It takes him about an hour to eat.
Also, he doesn't eat food you have to chew alot like meat, ect.
He does better with softer food like oatmeal, applesauce, yogurt, eggs, pancakes, soups, muffins, mashed potatoes, sift beans and cornbread, ect.
For his meat I buy Vienna sauges.
Also, he loves ice cream.
I noticed his problems are when he has food that requires a lot of chewing before swallowing, I think he just forgets that he's suppose to swallow and thinks he will choke.
At 96 chewing can be tiresome.
Is there a speech pathologist involved who could somewhat more forcefully advise your father that his actions are potentially causing harm to your mother?
Mother made the transition to soft foods and a bottle of Ensure and he was a lot less anxious. Choking and not having the ability to 'cough up' what's stuck is horrible and scary.
Honestly, as much as dad enjoyed a good meal, I don't recall him ever complaining about the diet change.
My mom started pocketing her food in her cheeks and dad would have to pull the food out of her mouth also. Once she started to continuously do this, dad started pureeing her food so she wouldn't have to chew for so long and wouldn't hold it in her cheeks. He hated that she couldn't eat solid foods but he was more afraid of her choking or getting pneumonia that it didn't take much to convince him to do this. Google information on what could happen to your mom and read it to him. Sometimes this scares them into doing the right thing.
My only suggestion would be to try to arrange meals that include things that are already more or less the proper texture - oatmeal and cream of wheat for breakfast, soups for lunch (these may need to be thickened but the caregiver can do that at the table), mashed potatoes and well done veggies that can be fork mashed for dinner. Lots of custards, yogourt, puddings. Smoothies for snacks. And supplements like boost and ensure can help keep up the calorie intake.
Unfortunately at some point even that will be more than your mom can handle and she may aspirate anyway, you mention hospice so that time may be already here 🤗