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Reply with quote  #1 

I am posing this question concerning elders who all at once decide that they do not want to eat hardly at all. How much do you do in the line of trying to get them to eat? You cannot force them, for one thing it is considered elder abuse and if it was legal, forcing some people to eat, it would take an army to do it. There are, as I said things like Equate, Ensure and they pack in calories and nutrition, but what if the elder only will not drink enough to get the daily calories needed to survive? What do you do, keep after them to drink and eat and let them go til they are to weak to move and are bedridden? There are meds that may spur an apetite, but what if they don't work? I know there are food tubes, but that will not be an option as many Drs. and families feel this is prolonging a life when it is not fair to the person receiving the food tube. The quality of life over quantity scenario comes into play. So what are your thoughts? 

Reply with quote  #2 
JAH, my heart goes out to you.  Mom had a little spell of not wanting to eat or drink last night and it scared the beejeebers out of me.  I was not with her and the CG on duty called to say she was concerned.  Mom has never skipped her ice cream before.  I had MY hospital comfort bag repacked and ready to go (clean undies, tooth brush, blankey, important papers, book).    She was better this AM, no emergency. 

What would I have done?  A trip to the ER would determine if there was an infection, if she was dehydrated, maybe something else, but at 94?  No, I would not allow a feeding tube, another pill.   She would get treatment for infections, dehydration, but I would not put her through hoops to force her to eat, I might beg, conive, bargain (if you eat this, you can have the whole quart of ice cream).

It is a viscious cycle about eating.   They might be offended by the "drinks".  So much affects appitite.  If they are dehydrated, if electrolytes aare out of whack, they don't feel hunger or thirst, the same if they are depressed (well it is all depressing). 

At this stage for my mother, I will not look beyond the basics for a solution.  But you bet your sweet butt I will let the Drs have a look see.  If you are the "responsible party" you can be charged with neglect for making a decision without "on record" medical input.   

Hang in there,

Reply with quote  #3 

In a very real way, we are pioneers in uncharted territory.  A generation ago, these choices and resposibilities simply did not exist.   Yet we may be help responsible for these choices in court.  I am ready to throw up and go off my feed myself.

Reply with quote  #4 

Isn't it force the elderly to eat and bathe, is abusive, but to leave them alone and to allow them to have their way, is called neglect.

Reply with quote  #5 
It is difficult. Before I became his fulltime carer, Dad was not eating enough, and he said it was because he got terrible stomach upsets.
I persuaded him that in order to remain at home, as was his wish, he would have to be mobile enough so that I could reasonable care for him - that pretty much did the trick in his case. I carefully worked out an eating plan, giving hima good breakfast, a small morning tea, light lunch, vitamin pills, a cup of soup late afternoon, and then a light snack before he goes to bed.He get some stomach trouble, wind I guess, but I got him charcoal tablets for that and he is more comfortable.
I guess the crux of the matter was that he was so desperate to stay in his home he readily agreed to eat a bit more. What he really likes is the novelty cereal packs I buy that contain tiny mini-boxes of different cereals so he can have something different every day.
I suppose though with some oldsters they may just not be well enough to eat much anymore, then I think they should be given only some nourishing liquids and whatever little they will accept, I don't believe in pushing it.
Reply with quote  #6 

We contacted moms cancer Dr and he prescribed something that he feels will stimulate her apetite, we are to try it for a week to see if it does anything to help her to want to eat. We are hoping it will work.

trish (ttsd)
Reply with quote  #7 
My mom lost her appetite thsi May when she first got sick and it was very scary since it was so unusual. She was having alot of nausea for which she was prescribed haldon every six hours. She was also prescribed Remeron which did increase her appetite and she snapped out of it. She is eating fine now and has put on some weight. She was down to 95. I saw my mother nag my father incessantly when he wouldn't eat and i will never do that to her. I would also never put her on a feeding tube as I believe in her condition, CHF, incurable loss of appetite would be a sign of the end.
Good luck with your mom.
Reply with quote  #8 
My 83 year old mother with Alzheimer Disease stopped eating and dropped quite a bit of weight in her NH.
She is now on Remeron and she eats well. 
JAH, I suggest you give the appetite stimulant a try----if one type doesn't work, ask the doctor for a different one.  Remeron is successful for my mother, who wouldn't even drink anything before!!
Reply with quote  #9 

JAH,  When my dad was in a NH he didnt always eat. When his time was nearing he quit eating altogether mom wanted a feeding tube, but dad had stated never to be tubed to be kept alive. They had tried a tube but he had kept pulling it out. They called mom and asked her what to do I was here at the time and I told her that she knew dad didnt want any tubes he had made it clear to her and to me. My dad and I were watching MASH one night and they had a scene where they had tubed someone to keep them alive the guy kept pulling it out and dad had said if you ever let them do that to me I will come back and haunt you. I reminded mom of that and how he had made it clear he didnt want to prolong life. I am glad my dad and did talk about it because it made it easy to accept. Good luck with your mom. Have a happy thanksgiving.

Farm Gal
Reply with quote  #10 
JAH, I've been sorting of mulling this over since you posted it yesterday.  It's a tough one.  If an aged person decides she truly doesn't want to eat (no medical problem preventing it), I have to wonder if that's not a decision we have to respect.  She has her own reasons, even if she can't articulate them.  I've been thinking about what I would do if it was my mother.
We have discussed the whole "extreme measures to prolong life" issue, and my Mom comes down firmly on the Don't Do It side.  She gave me medical poa years ago to insure that nobody starts doing things to her that she has told me she wouldn't want. 
As it is right now, Mom barely eats enough to keep a bird alive (at meals, anyway - snacking is whole 'nuther issue!) and she's losing weight like crazy.  But if she decides at some future time that she really isn't interested in eating, I think I would get her to the doctor to make sure there isn't some physical reason for her aversion to food.  If there wasn't, I would have to respect her decision.  I feel strongly that people should be able to decide for themselves when they are finished struggling with this life.  Nobody else has the right to say they are wrong. 
Just my thoughts. 
Reply with quote  #11 
I went through this with DM back in the spring when  she was still living alone and she ended up in the hospital for one week due to kidney failure because she would not drink anything.  Now that she is a SNF she still has her days of not wanting to eat or drink, but they now have her on Megace to stimulate her appetite.  It is a tough road to hoe when our elderly parent will not eat or drink enough, but all we can do is encourage them and let the Dr. do the rest of the work.  Feeding tubes, I am not sure how I feel about this issue.

Reply with quote  #12 
JAH, when I first answered this post, it was from the perspective of my current situation, and I meant it (for someone 94).  But looking back, there are/were things done.   Dad had Megace prescribed along with his chemo (he was 86 then).   Liquid meals, pureed foods, baby foods were all depressing to him, but after he "lost" his "teeth", and was too weak for a new fitting, what else was there to do?  

For Mom, I have done somethings different and made some notes.  She still has some teeth of her own (dentures would be nice, but she refuses).  I make lots of meals that are easy to eat, look like "real" food, can be frozen in individual servings, and she will eat over and over (sometimes a little short term memory loss can be used to your advantage). 

I can share a list, but foods they like depend on their background, sooo..

A real biggy for Mom is to have company while she eats, and not JUST company, but some one who eats with her, and best if they are eating the same thing.   I must mention that a meal may take an hour or more.

 I know you have always talked about your Mother's independent, loner spirit, but things do change.   We are all less secure in a new environment, so sharing a meal might help.  Also, if they get in the calories, what does it matter if it is a "meal".  Farm Gal mentioned the snacks.   Keep them at hand for her.  Try to choose the better nutritional values, but anything she likes to eat should be close at hand.   Many of our elders are no longer on a 3 meals /day + snacks  internal clock.   

Company at meals has become a major issue for Mom.
Reply with quote  #13 
I agree that company during meals is important.  I try to get to the SNF at dinner time when I go so I can sit with her while she eats.  I notice that if I say "oh that looks good", she will usually eat it all gone.  DM is on a soft mechanical diet due to swallowing issues, but she has adjusted to the soft foods, knowing she will choke on the other type foods. 

Farm Gal
Reply with quote  #14 
BC makes a very good point about companionship during meals!  Eating is a very social thing.  When I worked in the in-home care business, we found that families who had the aide prepare the food AND sit down and eat with the client tended to have much better results than the families who maintained "We're not feeding the employee!"  It makes people uncomfortable to eat in front of somebody who is not eating.  And elders who are all alone often just seem to forget to eat.
Reply with quote  #15 
We had this problem with my mom (83). For the last few years she has been gradually losing weight. She said that she was tired of preparing and cooking. That it made her to tired to stand there in the kitchen to fix it and when it was done, did not feel like eating it then.  We tried to tell her about prepared foods that were very good and all she had to do was put them into the microwave, but that was change and see is very resistant to change.

While we were traveling a couple of months ago, I called her and she was very sick. Said she had a bad virus that was going around. She said she had been to the doctor and that is what he told her.  When we came back, she was in very bad shape.  I had her make a dr appt and I went with her.  She weighted 77 lbs, was dehydrated, malnurished, low blood pressure and signs of kidney problems, but never did have a virus.  We started working with her to get her to drink and eat.  Everytime we took her out to eat, she ate very well, but still did not drink much.  After breaking her pelvis and being in the hospital for a month, she gained about 9-10 lbs. She was eating most everything on her plate. 

The reason was that someone else was preparing it and all that she had to do was eat it.  Now that she is in AL, she eats very well during her meals and I got her a small refrigerator for her room for snacks and drinks. At least we got past this one issue.  I hope that you are successful with your parent in getting them to eat.

Now if I just could get her to stop wanting to drive her car that I am keeping from her. Thats a killer for us.

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