Hello and thanks for your enquiry,

I am sorry to hear about your concerns for your mum.

You should contact your mum's GP surgery or her palliative care / community nursing team (if she is under the care of one), as soon as possible. Because her swallowing has changed, she needs an urgent review. Ask specifically for a referral to a Speech and Language Therapist (SLT) and a community dietitian. The SLT can safely assess what she can manage, and the dietitian can help ensure she gets maximum calories from what she is able to take in.

Prolonged steroid use can cause muscle weakness, skin thinning, increased infection risk, and confusion (which might link to the slight confusion you've noticed). However, in palliative care, doctors often maintain a low dose long-term if the benefits to her comfort and ability to swallow outweigh these side effects. It is appropriate to ask her GP or community palliative care team if her steroid prescription can be reviewed or restarted to help her comfort.

You can try to and ask her GP for prescribed nutritional drinks (like Fortisip or Ensure). Smooth, high-fat yoghurts, drinkable yoghurts, kefir, or smooth milkshakes may be tolerated well.

Sometimes, slightly thicker fluids are actually safer to swallow than thin liquids. A Speech and Language Therapist or dietician can provide specific thickening powders if needed.

If she is coughing after trying pureed food, then stop and seek further advice before restarting these.

I hope that this helps,

Best wishes,

Vanda