How should I handle Mom's dwindling appetite?
She eats so little I do not know how she keeps going. My mother's appetite has gone down considerably within the past 1 1/2 months. She had been on Remeron and that is known to make you eat and put on weight. She was not overeating but her appetite was good, Now however she could care less about eating since the Remeron has been removed.
We have tried numerous different foods to entice her but she does not care. She wants a cup of coffee and may say she cannot hold another bite of food but she will eat a couple cookies in lieu of food. I let her eat anything she wants, just to get food into her but this is concerning me. When we say anything to her about eating she becomes upset and yells, "Leave me alone. Maybe I'll die and get out of everyone's hair!"
I have noticed that when she eats, she seems to breathe harder almost like she is out of breath. She also pushes her elastic waist pants down a bit like she swelling.
She had gall bladder surgery in September of 2013. Previous to the surgery she had cut way back on eating due to discomfort and we did not realize it was her gall bladder so we began to give her Megace to increase her appetite. After realizing we had a gall bladder problem, we stopped but now I don't know if I should try the Megace again or what because I do not want to cause her any additional discomfort. I do know that as we age our eating declines but I just am unsure how to handle this. She only weights about 97 pounds.
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However, what she ate the most was Ice Cream. She was a naturally lean woman, but I became worried about her as she aged even more. I spoke to my own doctor about her. He was in his late 70's and had been my GP for about 35 years. He worked until he was 84. Then he passed away. He was a Great Old Fashioned Doctor. When I told him about my friend he told me that her diet was all right for such an elderly person. He encouraged me to encourage her to eat more Ice Cream....Quality Ice Cream with high fat content.....because it had a lot of food value for her. Now there are Liquid Food Supplements like Ensure etc. I probably would have tried those for her....if they had been "invented" way back then.
My friend did not pass away until she was 99 years 10 months old. She died in her sleep on Christmas Eve. The Nurses and Aides told me she had been Very Cheerful and Talkative the day before and went to sleep Very Happy. They said that happens with the Very Elderly. So my friend had a life she loved.....and she ate what she wanted....and she lived and loved for almost a century. Mostly eating Ice Cream for the last 8 years.
However, what she ate the most was Ice Cream. She was a naturally lean woman, but I became worried about her as she aged even more. I spoke to my own doctor about her. He was in his late 70's and had been my GP for about 35 years. He worked until he was 84. Then he passed away. He was a Great Old Fashioned Doctor. When I told him about my friend he told me that her diet was all right for such an elderly person. He encouraged me to encourage her to eat more Ice Cream....Quality Ice Cream with high fat content.....because it had a lot of food value for her. Now there are Liquid Food Supplements like Ensure etc. I probably would have tried those for her....if they had been "invented" way back then.
My friend did not pass away until she was 99 years 10 months old. She died in her sleep on Christmas Eve. The Nurses and Aides told me she had been Very Cheerful and Talkative the day before and went to sleep Very Happy. They said that happens with the Very Elderly. So my friend had a life she loved.....and she ate what she wanted....and she lived and loved for almost a century. Mostly eating Ice Cream for the last 8 years.
We are making it an everyday occurrence to eat lunch outside together. She only eats 1/4 of a sandwich, but I make sure she has potato salad or fruit maybe a couple chips or yogurt and a cup of milk. It seems like if we are looking at the nature and talking, she forgets what she is doing and she eats. When we sat at the dining room table or I was in a hurry trying to get multiple things done at once, she would lose interest and not eat.
I am trying to clean off the patio and get an umbrella and see if perhaps we could eat dinner out there periodically as well before it gets too hot.
I know logically that as we age our appetite diminishes and yes it is caused by a lack of exercise, medications, boredom and maybe even the lack of will to continue to live. I guess I just have to accept the fact that I am doing what I can, the best I can and if or when she passes away i will at least know that I did what I could while she was here. As a care giver I have to try and control most all situations but in the end we really have no control over life and death, it is just realizing this and accepting it that can be hard.
And I do sometimes have to have the "eat or you'll die" discussion with her. She doesn't have a great memory but I think it kinds of sinks in and I do it both in a nice way and also repetitively. While my mom has a bad memory, there are actually things that sink-in. If I ask her, she doesn't really remember how to answer me, but she'll remember to do it. It's hard to explain, but it's not as simple as a yes/no remember/not-remember kind of thing with her (and lots of other people, either).
She's determined she be allowed to sleep in and be served breakfast when she wakes up, whenever that might be. Unfortunately she's been a narcissist with delusions of grandeur her whole life. She has no sense of smell and hasn't for a very long time. She's given a protein drink at least once a day but mostly refuses to drink it. Even if I ran down there twice a day she'd still refuse to eat or drink but, loving the attention, she'd keep the behaviour up, probably escalating that behaviour to see just how far she could push everyone. You can take a horse to water but ...
Physical issues we can deal with. The nursing home staff and RNs have been there, done that, with those who are mentally ill (Dementia/ALZ) a thousand times but for us mere mortals there's no dealing with mental illness when all reasoning has gone out the window.
I would not push eating in the dining room for lunch and dinner because the smell of traditional meals may put her off eating.
She is clearly declining but probably has not come to the shutting down stage yet although another stroke would likely push her in that direction.
try and accept things the way they are now,at least she is still interested in eating and cookies and chocolate are easy to chew. If she would drink Boost or carnation Instant breakfast that would help too. Personally I hate Ensure but some of the other non dairy "milks are pretty good. Chocolate Almond milk is very pleasant. haven'y tried any of the others yet. They are too expensive to make a poor choice.
Try and just take things one day at a time you will know when she is truly shutting down.
She's had Parkinsons and numerous strokes over the last 17 years plus she has dementia. I go between feeling that, as she spends all her time in bed or her wheelchair, her body doesn't need a lot and thinking that maybe she's just starting to shut down.
Daughter took pictures of the new perm which did look nice - on an almost dead woman
Glad to hear your Mom enjoyed eating outside :)
I am trying to put into practice what Elena has said and add in other things. I told Elena that I was going back to the store to buy some of those small umbrellas that go into drinks and put one in her shakes. Plus I bought some small almost finger type food, which seems to make a difference.
We get so tired we are just wiped out and we cook a meal and put it on the table so everyone can eat, we can clean it up and then hopefully in a while go to bed. Those meals are mostly hurried and pretty basic rather that being fun. I am going to try to be more "fun!"
I remember when my cousin had to feed her mom (my mom's sister) with dementia (in the nursing home) because even with the meal in front of her, she'd forget to eat. At the time, I thought, "Geez, Mother Nature is telling you it's time for your mom to go...let Nature take its course." Of course now that it's happening to my mom, it's SO HARD to watch it and not try to intervene in some way. My mom says all of the time she's ready to go. She's not trying to limit her calories, she just isn't hungry. She says she's not doing anything, so doesn't need to eat much.
So I feel your pain...but don't have any real answer. I think with my mom, it's Mother Nature taking its natural course. And that's really hard on me, the caregiver. I want to "fix" it and I know I can't.
There are many times when I have seen the same question asked numerous times, if I am tired of answering that question I move on to another one, or if I have seen maybe, PStegman or JeanneGibbs or Igloo answer a question the way I would or I can add nothing to what they have offered, I move on or mark "Helpful Answer." I try not to write anything nasty to anyone as I know that we are all dealing with horribly stressful situations and just seeking advice.
Thank you for your apology....I appreciate it!
My remarks about it not being a big deal were directed to the forum and the world in general when so many people insist on major measures when their loved ones are reaching the end of their time on earth. This is not necessarily the case with your mother and of course you should continue to tempt her with tasty treats. The point I was trying to get across was that few people deliberately starve themselves to death but that is the way things appear to their loved ones.
Again please accept my appologies.
Get your Mom larger pants to wear, even larger underpants, and see if that makes a difference. I know it worked for myself. Let's hope it is something this simple.
My older sister brings home these cookies because she knows my Mom likes to eat them, so I am constantly fighting this and she brings home about 5 gallons of ice cream at a time as well.
I had also read that the brain of an Alzheimer's patient craves sugar is why they go for it. I do have to say that I cook some very good meals but she just refuses to eat or fakes a stomach ache. I thought when we gave her yogurt the other day to eat in place of her meal, she was going to throw a huge fit, but it was a rather small one instead.
geo123: My Moms memory lasts for about 10-15 minutes if that, so having a talk with her doctor is of no value to Mom. By the time we get home from his office, she doesn't even remember ever having been there.
She says she isn't hungry but it is more like, "I don't want to eat that!" I will ask her if there is a special meal that she would like me to fix for her and her answer is always "no nothing." Her main stays are a cup of coffee, cookies and ice cream. She might eat some salad as she does like that but I cannot get meat into her any more. I cook her one egg and she eats half. If I make toast or hash brown potatoes then she will eat less of the egg and a couple bites of the potatoes and bread. It is frustrating and I have turned into one of those people who are allowing her to eat anything if she will PLEASE JUST EAT!
She also will not eat lunch because she is still full breakfast and her 2 tablespoons of food and if she does eat, then she won't eat dinner because she is still full from lunch.
We have locked up all her medications to keep her from accidentally getting into them and overdosing herself but now I almost wonder if the lack of eating is a way to end her life as well. I have seen this before with my aunt and my father in their last year of life, we practically stood on our heads to cook for them to eat. It didn't work.
But as for the outbursts, I wouldn't necessarily put too much stock in it. My mom has outbursts when I try to get her to do a lot of things. Partly, she feels less control over her life now that I'm her caretaker and she doesn't like that loss of control. Partly, her ability to properly express herself is diminishing, as her memory is causing her to have a hard time coming up with the simplest words and especially so when she's upset (usually with me!! ;-) ).
There is a difference between not being hungry and not eating, though. My mother has no appetite but will eat when I put it on the table because she knows she needs the nutrients. Have your mother's doctor have a talk with her about it. If the only problem is a lack of appetite, she might be induced to eat. But if there's some other problem, she might be having a hard time figuring out how to explain what's wrong -- it's she's too bloated to eat, for example, she might not know how to tell you that, or even that it's important.
I also do not bother asking my residents if they want to eat. I usually put it on front of them. Yes, it should be served appealing. I NEVER use plastic silverware and paper plates in my house. Use attractive china.... Yes, ice-cream tastes better if served with an old silver spoon and in a favorite cup! Fry slice of any fruit to top that ice-cream and compliment it when make presentation: "Oh, mom, look what I made for you! Oh, it looks yummy and tastes delicious! Can I have a spoon too?"
It also helps to "take a bite" on front of your mother.... bring those apple slices and share it with her. I bet she will not resist....
I also top all salads with fresh fruits and berries. Who said you can't serve lettuces with pears, strawberries and blueberries? Little drizzle of balsamic vinegar will make it complete.
You might also talk to the doctor about her meds. Most come with side affects, and declining appetite is one of them.
Good luck!