My dad’s a goldfish – swallowing and spitting

The Goldfish started to have problems swallowing. I did some research and found some good articles, which I printed out for me and Wee-sis to study. I also asked the GP to for a referral to the speech and language specialist. She phoned to make an appointment to see the Goldfish and came to visit within days of the referral.

The Goldfish smiled at her when she arrived and promptly went to sleep so she couldn’t check what happens when he eats or drinks. It was a good meeting and she said pretty much what we’d read. The main difference, really, is the assumption that there is loss of appetite, which is not the case with the Goldfish who continues to enjoy his food – when he can swallow it.

Apart from our worries about food or liquid going into his lungs and setting up pneumonia, it must be really scary for the Goldfish. I tried not swallowing to see how it feels and it’s impossible for me not to swallow reflexively. The trouble is his swallow reflex is no longer working as it should. It’s as if he has forgotten how to swallow.

If he has taken a bite of toast or sandwich and we see it hasn’t gone down after an appropriate length of time, it is so tempting to suggest he takes a sip of juice or water to help it. That doesn’t work as the liquid joins the food in his mouth so he starts to acquire the appearance of a hamster. His eyes look panicked, though, and of course he can’t speak.

I keep a little jar – it once had a very nice creamy dessert – near us at meal time and refer to it as his spittoon. Holding it up, I ask if he wants to “spit it out”. Frantic nodding, and sometimes he succeeds in spitting out what’s in his mouth. Very often, though, nothing emerges and I have to take action and try to hook it out with my fingers – so grateful, he’s not a biter. Once, I removed almost an entire pancake with butter and jam. If it’s liquid, there’s nothing else for it but to put a straw between his lips and suck; then I spit.

At other times the Goldfish spits. I don’t mean when he can’t swallow – he just spits. I sincerely hope it’s not an indication of what he thinks of my cooking.

My Dad’s a Goldfish – Transient ischemic attacks (TIAs)

The Goldfish when a young lad with his brother and sister

The Goldfish when a young lad with his brother and sister

Transient ischemic attacks are fairly common in people with dementia. The signs and symptoms are very similar to those of a stroke: slurred or garbled speech, difficulty understanding others. On their own those aren’t particularly unusual in people with advanced dementia but there’s also weakness or paralysis in face, arm or leg, usually on side of the body and loss of co-ordination and balance.
When the Goldfish first showed symptoms of having a TIA it was pretty scary and, as with almost everything else with dementia we were always one step behind in our knowledge and understanding.
He slept for most of the day and although he woke up in the early evening he seemed more than usually ‘out of it’. I suggested a game of Snakes and Ladders, which he usually enjoyed – especially if he was beating the DH and seeing him slide down the snake. I noticed he couldn’t hold the shaker for the dice and he seemed to leaning over to one side, unable to bring himself upright. His eyes were unfocussed.
The DH called NHS 24 – the out-of-hours service. He’s much better at doing this kind of thing than I am. I just get cross at all the questions when I just want them to send a doctor AT ONCE! The DH is patient and somehow manages to make them understand the seriousness of the situation.
They did say a doctor would come out to see the Goldfish and he arrived in less than half an hour. As I ushered him into the living room the Goldfish looked up, gave the man a huge beaming smile and said: “Hello, how are you? Nice to see you.” The clue, I guess, is in the word transient.
The doctor and seemed not in the least put out that the patient he’d probably expected to find at death’s door was bubbling with good humour and bonhomie at having a visitor. He checked the Goldfish thoroughly and confirmed what we had begun to suspect that he had had a TIA.
Many more were to follow – sometimes while he slept, sometimes during the day – and we learned to manage but each one meant the Goldfish slipped a little further down the dementia slope.