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It's worse than that. What you are describing can definitely cause dementia and cause other kids of dementia to get worse (loss of O2 to the brain).
You apparently already know she has to sleep on her side or make her head almost vertical to her body, "but she won't do it", so you have to wake her to do it when she starts "choking."
Her doctor will know what to do and when she sees the sleep specialist ask them to prioritize something to prevent her from rolling over on her back over machines.
watching his swallowing while eating and drinking very carefully.
Warm tea is relaxing and my mom is 98 years young. The "Vicks" Vaporub is also a little relaxing and provides aroma therapy. Finally I burn a scented candle in the bathroom which permeates throughout the 2nd floor. That also helps her to relax. She's been sleeping better for the last to weeks and coughing and gagging a lot less. Be blessed and encouraged.
I changed to this kind of bed about six months before the death of my fiance, and I honestly think it was one of the best things I could have done to make him more comfortable, especially when he deteriorated to the point that he needed supplemental oxygen.
At least check it out. Almost every mattress store sells these frames and the more-flexible mattresses that go with them—and they are the ONLY kind that some companies such as Mattress Firm now sell. Box springs are not required.
Have heart issues or stroke been ruled out? I don't mean to alarm but these can cause problems. I have seen sudden choking (someone with both issues). Saliva going down the wrong due to swallowing difficulties? Build up of fluid in lungs? I am not trained to know. Sitting more upright does seem to help though.
Strange your wife won't...but then, maybe she feels dizzy when upright?
The getting up & down so often could be obsessive thinking? Then again, symptoms of an UTI may be causing increased urge/frequency?
Are you wanting to start the merry-go-round of doctors, tests & specialist appointments towards treatment & cure?
Or are you more looking to provide relief of this symptom for her?
I think getting a good night's sleep should be moved up the priority list. For both of you. I hope you can find some advice that works.
Your wife might be having similar spasms. It's worth having her checked out to determine what's going on.
This happened to one of our pets and the dramamine really helped her with her balance.
Not comparing her to an animal but, the ears are very similar and when we lose those bones that are for our balance we walk like we have had to much to drink. So did my dog. It helped her readjust and she walked fine for 5 more years.
Just a thought.
Otherwise, I second the idea of a hospital or "profiling" bed - useful for both this situation and future reference.
Here you go - basic but clear leaflet for patients at https://www.hey.nhs.uk/patient-leaflet/globus-sensation/
Hope you can access it okay.
Swallowing problems do occur in the very elderly for a variety of reasons. Besides altering her food, physical therapy might be an option depending on the diagnosis and if recommended by her doctor...and she is cooperative.
Is she in a Hospital bed? If so try raising the head of the bed. That will gently raise the torso rather than an actual seated position.
Does she have problems with thin fluids? It is possible that fluids need to be thickened. If fluids are going down the trachea rather than the esophagus they can end up in the lungs and this can lead to what is called Aspiration Pneumonia and it can be fatal.
This should be evaluated.