Caregiver Tips: Confused elderly man is spitting all the time

Elderly Spitting

Elder is being ostracized because of spitting.

I received a call from Larry’s nurse saying they have had an ongoing problem with Larry “spitting.” The staff is having a problem because no one wants to sit with Larry and especially have him at their table during meals. Spitting is a particularly difficult problem and caregivers find the habit revolting and something the elderly are doing on purpose. Very seldom is this purposeful behavior.

Possible causes of excessive saliva and spitting:

• Elder no longer able to swallow saliva.
• Side effect of medication.
• Possible dental problem – inflammation.
• Problem with gastric reflux.
• Possible food allergy causing sinus problems.
• Behavior associated with Alzheimer’s disease.

In meeting Larry for the first time, I noted that he holds his head so far forward that his chin is almost resting on his chest. The staff says that when they are feeding him he doesn’t spit and swallows fine. We agree to have Larry seen by the dentist as well as the speech therapist to see if there are any dental or swallowing issues.

From the position that Larry is holding his head – it doesn’t appear that he can swallow his saliva, so as it accumulates he spits it out. We will be following up with evaluations by the physical therapist as well as the occupational therapist to see if we can provide strengthening exercises for his neck and shoulder area. Providing Larry with a higher backrest for his wheelchair will also support his head in a more normal position, as well as give us the option in the future of additional positioning devices.

Virginia Garberding R.N.
Director of Education, The Wealshire
Author: Please Get To Know Me – Aging with Dignity and Relevance
With Cecil Murphey
(For related information see also other blogs in this category)

Comments

  1. Thanks for that info. My grandmother is 93 and over the past year has developed this condition. The staff at her facility says that she is spitting on purpose but I really think there is more to it.

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