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My Father has really bad COPD, and his dr. put him on a liquid thickener, to help keep him from choking on his water.
But if I put the thickener in his water, he won't drink it. It sits all day... Then when I leave for the day, my mother won't continue to put it in his water, because she is scared by him not drinking anything, he is going to become dehydrated (Which I know is true).
How do I manage this situation?
Any ideas?

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I had the same problem with my mom while she was in the memory care home. Oh did she get angry when she demanded water. I believe the answer was they then made it not that thick.
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I would try more natural food thickeners. Bananas and applesauce are great or even try different "butters" like apple butter or some other flavor. My mom wont drink her ensure if i add protein powder in it b/c she says its "gritty". I take follow the protein powder directions, mix it with either milk or water, add in frozen berries or bananas put it in a blender and then divide into silicone muffin cups or ice cube trays. I freeze the mix and then add that to her ensure in a 16 oz glass. it thickens the drink and adds extra protein for her. Supervision w/ choking hazards is key.
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Truth be told, seniors can choke on liquid thickener and the body cannot expel it like the body can with regular water through coughing. Liquid thickener can be choked and it will settle in lungs.
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BurntCaregiver Oct 2020
You're right about choking on the thickened liquids too. Just let him have regular drinks and make sure someone supervises him while he's drinking. To make sure he's taking small sips and not choking on it.
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Imho, juice with pulp is better than no liquid at all.
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Try smoothies with greek yogurt, silken tofu. I freeze ripened bananas then add frozen strawberries and blueberries. Even a fresh squeezed orange. I also add chia seeds. The yogurt or tofu and the frozen ingredients will thicken the smoothie.
For a water or juice thickener I use Simply Thick. It's completely tasteless and you can easily adjust the thickness.
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Maybe a straw like mentioned below. Lots of "foods" count as a liquid like jello, pudding, ensure, smoothies, applesauce, soup and sherbet. Try to work with what he likes. My dad's last days he lived off orange sherbet and strawberry applesauce. Baby foods.
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My dad has to have thickened liquid as well. For almost 2 yrs, I bought big barrels of thickening. Until, I realized that natural foods could be used instead. Everyday I make him shakes. See my profile for suggestions. He loves them. No side effects of constipation, waste, nastiness, etc. Apples, bananas, oatmeal can thicken foods.
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Please add "flavors" to his water. Mio is a flavoring that you add drops to water. It comes in different flavors. Also, talk to mom about dad possibly choking to death on unthickened fluids. I hope that concern will override her fear of dehydration.
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Msharleyb Oct 2020
Aspiration pneumonia is a danger also. My husband has the same problem due to scar tissue from radiation treatments. He really enjoys the smoothies I make for him!
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can he drink thru a straw, if so, maybe that would work.  I don't know much about thickeners and if it would be too thick to go up the straw.  Does he like juice, if so, you might be able to water it down just a little and then add thickener to see if that works.  I hope others have better suggestions, and wishing you luck.
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Liquid of any kind will be ok to keep from becoming dehydrated. That includes soups which might hide the thickener, juices with pulp
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Hi, my Mom refused the thickener so we got her a variety of juice with pulp. We got in at the grocery store in the organics isle. Worked great.
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Along as he drinks plenty of other fluids he won't become dehydrated. Coffee, Tea, Milk, Juice.

Have him use a straw to drink water and see if that helps.
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Mix with the Apple & Eve no sugar added cranberry juice....!!!!good luck
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Give him ice cream with thickener...always worked for my mom....
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BAllen, if you can't get a list of dysphagia foods, there are lists online.   I don't recall right now if it's a Dysphagia Assn. that publishes the lists, or some other entity.  You will need to know his level of Dysphagia though.   There are minor but significant differences between what's allowable at each level.

Earlybird's practice of pureeing fruits is a good option, as some such as pears have more fluids.

Depending on his dysphagia level, he might be able to have fruit juices, such as pear and if I remember correctly, apricot.    They're thicker than water.  
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I would try other drinks. My mother has been on thickened liquids since last year. She does not like plain thickened water alone. I do Glucerna homemade vanilla flavor shakes and thicken them up with avocado and banana. I put thick up in fruit drinks with no sugar added. I give her coffee on occasion and thicken it up with thick up. She will drink these beverages. When she eats I give her a spoonful of the thickened water after each bite of food. She will consume her water that way. It took her a few months to get used to it but does well now. I myself dislike the taste of thickened water but I tried the shakes and fruit drinks which taste better. Apple sauce with strawberries, soups such as pumpkin soup, carrot soup with cream, chowder, Chili, oatmeal, cream of wheat made with 1/2 water and 1/2 milk. I puree fresh pears, banana and pears, blueberries, yogurt mixed with berries. I would google pureed foods and beverages to get more ideas. I was told never to use a straw by her speech therapist because drinking fluids too fast could cause aspiration. I spoon feed my mother her liquids and pureed foods. Barnes & Noble has some cook books on pureed foods and beverages. Good luck.
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My husband had to use Thick It in all of his drinks after he had aspiration pneumonia. I made it in the honey consistency, and it never bothered him. He drank Powerade and water every day, with the Thick it in it.

I myself don't like drinking water, so I have to put the flavored waterdrops in mine, so perhaps just either flavoring his water or giving Powerade, or Gatorade with the Thick It in it, might work better for you and him. And of course with the Powerade or Gatorade he will also get important electrolytes that he needs as well. Good luck.
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Have you tasted/ tried water with a thickener in it?
Sort of nasty. Not the taste because it has no real taste but the combination of the thickness and the texture of the thickened water is a bit off-putting.
Thicken other fluids that you would normally expect to be a bit thicker. Fruit juices, yes a bit more sugar than water but it is fluid.
Thicken broths.
Thicken coffee, tea or flavor the water. You can use fruit juices or any of the water flavors that are out there (Mio is one that comes to mind) Even Crystal Light, Kool-Aid will flavor the water. I am not a fan of the artificial sweeteners but if the object is to get him to drink more if it works, great.
And your fluids do not have to come from just drinking.
Salads, fruit, soup, all have high moisture contents so you are getting fluid into him. And soup and stew can be thickened with mashed potatoes, beans or other vegetables. Oatmeal, Cream of Wheat, Grits will all get more fluid into him.
Dairy like cottage cheese, yogurt are also good options.
Jell-O or gelatin is not good because as it is eaten it becomes a fluid and may be aspirated.
Same with Ice cream.
Pudding is a good option.
Watch slippery fruits like peaches and nectarines as they can slide down the wrong way very easily (learned that from a frightening episode) Oranges are to juicy they are a problem.
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Try to get liquids into his other foods:  soup, watermelon, applesauce, etc.  It's not a complete solution but it will help.

Ice cream wasn't allowed in my father's dysphagia diet b/c it melts and becomes liquid, so I gave him a few tablespoons at a time; it was swallowed before it had a chance to melt.

One of his speech therapists suggested putting applesauce on foods to add more moisture to them.

Ballen, did his speech therapist give you a list of foods for each of the dysphagia levels?    Sometimes you can find in those lists foods which can be watered down, to increase the fluid intake.
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Ballen1012 Oct 2020
I will see if I can find that list.
Applesauce on the food sounds like a great idea!
Thank you for the advice!
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How thick does he need it to be? If he needs minimal (nectar) thickening then he may do better with regular beverages that are normally a little bit thicker like tomato and vegetable juice or fruit smoothies. Thickened coffee is weird, thickened hot chocolate not as much. And using a straw helps too.
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Ballen1012 Oct 2020
He definitely uses a straw. I never thought about the hot coco, I will have to try that...
Thank you so much for the advice
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Have you by any chance taken your favorite beverage and put this in it. I NEVER in all my years of nursing found someone who could abide their liquids turned to sludge. I wish you luck. This is going to have to be something he could understand the reason for, understand the need for hydration, and agree to do despite how awful it is. Does Dad by any chance love a shot of anything? Because a few drops of Alcoholic flavoring was one way we got it down; it seemed to give odor more than anything else, of something they liked. Wouldn't want to suggest this for anyone who has history of alcoholism or anything, but it can work for someone who loved to have a highball at 5 p.m. And because you are administering basically drops, it might work. Check with doctor before doing this.
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Ballen1012 Oct 2020
Thank you so much. I will try and discuss with him and his doctor as well. I appreciate the advice.
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