Hi and thank you so much for this query. I am so sorry to hear about this stroke and the excessive saliva that flows to the throat. Also, sorry to hear about the pain he experiences when you try to suction him. I am sure it must be a very difficult moment seeing a loved one in such a situation. From all the information you have provided, i think his swallowing reflex is not very much intact seen his age and the stroke. this prevents him from being able to swallow the saliva leading to accumulation in the mouth. When it gets to the back of his throat, it can easily choke him. Proper evaluation and maybe feeding modifications would also be required. The best way to tackle this problem is to put him in a position that favors drainage of saliva out of the mouth. You would need to consult a medical personnel to personally teach you this. This will help prevent this problem. Also, you may want to suction more often than before it accumulates in volume that can overflow to the back of his throat. Check the suctioning device you have and make sure that the tip is supple enough not to cause any bruises or wounds when you try suctioning. If it is not the case, buy a more patient friendly one. The above measures should help. However, if you still continue having a similar problem, then consider getting him consulted. I wish you well as you take care of him. Thanks. Dr. Ditah, MD