Decreased eating is a common concern for caregivers of the elderly population. Diminished caloric intake may, or may not result in malnutrition. Many seniors who are relatively inactive do not need as many calories as those who are physically active.
Many factors contribute to the decreased eating we observe in the aged. Being aware of them and determining which apply to our care receiver’s situation, is a good place to begin. They include:
- Disease processes affecting appetite; ability to feed self, chew, swallow, or absorb nutrients; impaired elimination; and distressing symptoms such as nausea, vomiting, diarrhea, and constipation
- Dementia, especially Alzheimer’s
- Dietary restrictions imposed by medical conditions or use of certain prescription medications
- Need for supplemental enzymes as we age, and probiotics (beneficial intestinal bacteria) to assist digestion
- Allergies or food intolerances
- Unrelieved pain
- Missing or no teeth; poor-fitting dentures; mouth sores
- Diminished senses–especially seeing, smelling and taste
- Limited mobility to shop and prepare meals
- Low income
- Decreased socialization or isolation that results in routinely eating alone
- Emotional states such as loneliness, depression, grief, or anxiety
- Mental health disorders
A recent example is a discussion I had with a cousin, whose 87 year-old mother came home from the hospital after having a heart attack (myocardial infarction), congestive heart failure (CHF), and coronary artery bypass graft surgery (CABG). Aunt Rose (not her real name) is petite and small-boned; I never remember her weighing more than 120 pounds. She did lose weight during her week in the hospital. Consequently, her daughter (who is a new caregiver and lives in another state) is worried and is pushing her to eat more.
Aunt Rose lives alone in her rural farmhouse; she sees no reason for that to change. She has always shopped and prepared her own meals. Now she has new dietary restrictions: 2 grams of sodium per day and low fat. Seemingly every food product in the house is now suddenly on the “banned” list. She also needs to weigh herself daily, to detect a sudden weight gain of two or more pounds, which would mean that she would need to take a diuretic for her CHF. So there are some challenges to be addressed, especially since her daughter is leaving in a couple more days. Perhaps Rose will benefit from drinking one or more nutritional supplements per day.
Another relative of mine, who I’ll call Mary (not her real name), is also an 87 year-old woman. She, too, has decreased eating, but her situation is entirely different–she has dementia. She offers more resistance to eating now, except for sweets. When it’s mealtime, Mary often says (with an attitude) to her caregiver husband, ”I’m not hungry!” She has lost about five pounds in as many months. Two foods that Mary always loved are fresh garden salads and dark chocolate; fortunately, she still gets pleasure from eating them both.
Mary usually refuses to go out to eat, which would be a nice break for her husband and provide some variety and socialization for both of them. Part of her reluctance to go out is the dementia, but also because of her history of irritable bowel syndrome (IBS). She still remembers having problems with diarrhea and is afraid that it will happen again without warning. Her GI symptoms have been managed nicely the past few months, with use of daily enzymes, a multi-omega supplement containing perilla seed oil (reduces inflammatory response), and probiotics. They are an established part of her routine; so for now, she accepts them.
What is your care receiver’s story about decreased eating? What issues and successes have you had?
I am new to this group, and I am at my wits end for solutions to keeping my mother at home with me. I do not think she is yet ready to be admitted to a nursing facility, but she does need some extra help during the day while I am at work. I have been searching for solutions, and have turned to groups and communities for support. Have any of you ever had any experience with personal medical alert or alarm systems? I have been checking into ResponseLINK Medical Alarm. They seem to have everything that I need and want for security for my mother’s wellbeing while I am at work. They offer 24 hour voice to voice response, meal and prescription reminders, along with wellness checks. Since she is not a good one at remembering to eat, this is a good way to remind her while I am gone all day. I make her food the day before, they remind her to eat, I am satisfied. It is working out for us well.
Kristiann,
Thanks for your comment and question. Does your mother have a memory disorder that impacts her eating, or does she just get distracted doing something that she enjoys (e.g., reading, watching TV, scrapbooking, etc.) like my mother does?
If your mother is independent enough to be left alone in the house for hours at a time, it sounds like the approach you mentioned may be very helpful. I am not familiar with the specific personal emergency response system (PERS) you mentioned, but it has lots of good features to consider and compare when deciding on a such a system.
Rose, the aunt I mentioned in this blog, recently got a PERS from a local healthcare system. Her family decided on it because of 24 hour local monitoring/staffing. They thought it was important for her to hear voices with similar accents rather than using a similar product whose monitoring company was staffed in another part of the country. For many people, that wouldn’t be an important factor.
I encourage you to involve other people from the community in visiting with your mother, if appropriate for her condition. Often faith communities and various service agencies have screened, trained volunteers who could probably join her occasionally for lunch or just provide some companionship.
Perhaps there is an elder day care program in your area that she can attend. If you have access to a PACE program, I recommend exploring their services and determining her eligibility for participation. She may not meet the criteria yet, but it could be helpful in the future.
http://www.cms.hhs.gov/PACE/
Keep reaching out as you are. Remember to take good care of yourself as well. What support do you need? Caregiving is challenging but very rewarding.
Perhaps other readers have suggestions or helpful experiences to share.
Pam
Thanks for this. I am currently taking care of an elderly patient with dementia. Sometimes I get frustrated when she doesn’t eat but I have learned to be patient.
Thanks again,
-Stefanie
Chicago,IL
Hi Stefanie,
It is most challenging trying to get a person with dementia to eat! Patience is important, as you state. I have learned to not take refusal to eat personally. Mary, who I referred to in my post, still skips supper about 2-3 nights a week. It does help to have a routine; sit down and eat with her. She has always loved salads, so putting out the ingredients on the kitchen counter and engaging her in assembling her salad (like at a salad bar), sometimes works. We try to talk about other things and listen to music she likes, as well. She tends to snack on candy throughout the day, even though we attempt to minimize her stashes. She stays in bed until at least noon, so that is another factor limiting her intake. Her husband puts out orange juice and a half banana in the morning, so when she gets up to the bathroom, she sees them. Sometimes it is successful. When I am there visiting, I also mist Young Living’s Citrus Fresh in the air about 30 minutes before mealtime. This therapeutic-grade essential oil blend can help perk up an appetite (and mood), plus the room just smells clean and fresh. If you want to learn more about using essential oils and caregiving, please feel free to contact me. Do any other readers have additional suggestions?
Peace & Blessings,
Pam