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I myself would not attempt to prolong the life of someone with vascular dementia who doesn't wish to eat. I would supply food, or see to it that food is supplied. Whether or not a person wishes to eat should, to me, in all circumstances, be their own wish or not.
I encourage the POA or guardian to discuss with MD.
When my mother with advanced dementia got to the end of her life, she cut WAY down on her food intake and was also vomiting a lot. I had her start taking more Prilosec for GERD which did help with the vomiting, but didn't help with her appetite, which naturally decreases as death approaches.
You don't say how old grandma is, or what other health issues she's suffering from. It sounds to me like a hospice evaluation is in order, after you call her PCP to get advice about the vomiting after drinking Ensure. Try offering her a real milkshake made with ice cream and whole milk. Ensure tastes like chalk, imo. If she doesn't want to keep her dentures in her mouth, you won't be able to force that issue either. In reality, there is very little you CAN force with dementia at play.
It may just be time to leave grandma alone and to make her comfortable instead of forcing her to adhere to your wishes. There comes a time when dementia gets SO bad, that it takes the elder's life. I watched it with my mother, and hospice was a huge blessing in the final 2 months of her life.
I'm sorry you are going through such a difficult time with grandma. Sending you a hug and a prayer for acceptance.
I'd suggest seeking medical advice into the stomach upsets.
Have you tried processing other foods so that she can eat/drink those rather than relying on packaged product.
NOW...
I would contact Hospice. It sounds like she would qualify and they can provide some guidance and information.
If she is getting to the point where she is refusing to eat or drink it may well be that her body is not processing food. When you reach a certain point you do not require the nutrition/calories that you did previously. To try to make or force someone to eat can do more harm than good.
(Please do not entertain the idea of a feeding tube)
As to the dentures with weight loss it is very possible that they do not fit and are painful. Fixing them does not make them less painful. And if she is not wearing them all the time the shape of the mouth changes so they may not fit due to that.
I think at this point it would not be worth putting her through getting another pair. Just puree food for her so that she does not have to chew.
One more thing.
If she is coughing when she tries to eat or drink it is possible that the food or water is entering her trachea rather than the esophagus. If this is the case any food or liquid entering the lungs can cause Aspiration Pneumonia and that can be fatal.
Has she had a swallow test? Has she had her mouth checked for sores?
Have you tried soft foods like mashed potatoes and gravy, yogurt, ice cream, soups?
There are many reasons why a senior stops eating. Only her health care professional can really help you.
Dementia is a very difficult journey and a constant battle to stay ahead of the broken brain.
Best of luck getting to the bottom of this issue.
I turned a whole chicken casserole into soup - thick and delicious, where just the day before my dad (also VasDem) wouldn't touch the plated dinner with its constituent parts presented before him.
Eating gets to be hard slog (and I'm sure dentures don't help either) and the 'joy' of chomping dimisinishes as the sensory feedback fades.
Real, made from scratch soft foods are usually tolerated.
I'd also get a swallow specialist involved.
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