How to Ensure Adequate Hydration for Elderly with Swallowing Challenges

Question
My mother in law is 85 years old. For a while now I have noticed that she is having difficulty swallowing liquids-she sips. When she sips, its  very awkward. The nursing home have liquids beside her chair to drink, but getting her to drink is difficult. They say she is not dehydrated but a lot of the liquid she is given is tea or coffee. I have heard that stroke victims can have a difficulty with swallowing. But she also can't eat tomatoes-which I have been told is a way to see if she has had some small strokes as well. She has gotten herself dehydrated about twice a year. I just want to make sure that she is getting adequate liquids. I know this can affect her memory?

Answer
Stroke (CVA) often leads to dysarthria and dysphagia or difficulty with swallowing which can lead to a higher risk of aspiration pneumonia (where food and/or fluids get sucked down the windpipe in stead of going down the esophagus).  Best to have the local doctors do a food swallowing study (radiological study) to make sure she can eat/drink safely before you allow free feeding.  Alternatives to keep hydrated and fed are feeding tubes (PEG or G-Tubes) that bypass the mouth/stomach.