This is from 2 years experience caring for a PSP patient, which
is similiar to end stage PD:
Difficult swallowing now is related to being "off" meds.
We get 12+ hours of a frozen sleeply state.
AVOID CAUSES: Being "off" meds, lack of mouth exercise
* c/l-dopa dose spaced no farther than 4-6 hours apart
* Chew gum often
* Do Silverman-type voice exercise:
= say "ah-h" loud and long
= low to hi sounds: "eh-e-ei-eii"
= common phrases: "Good morning"...
SOFT FOODS: * Most recommend crushing pills in apple sauce
Often that's drooly.
* BANANAS seem better at her stage to stimulate
mouth to chew and swallow pills.
BRUTE FORCE: * Sometimes, after she's had a long rest (12 hours),
I can manually open her mouth with my hands.
Somtimes I pry it open with a flat plastic comb
handle or tablespoon. Push them in flat, turn,
and pull out. Then, by experience, banana or grapes
work best to stimulate chewing. Once she swallows
I get a few pill in and more fruit.
* If she stops chewing and swallowing, I pry the
mouth open with a tablespoon and scoop out the pills
to give later. She goes back to bed.
* Interestingly, she will urinate on the commode and
follow verbal commands to move limbs while in a
non-swallowing half-frozen state.
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