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
Wonderful suggestions. It helped me so much when Moms’ geriatric specialist explained that as we age our brain actually messages us that we are NOT hungry or thirsty. I never ask mom IF she is hungry or IF she would like lunch now. I prepare a healthy meal with smaller portions , present it , and she then eats most of it. She WILL drink Boost etc and her doctor says it is a wonderful meal replacement. This process I have learned is just part of the final phase of life.
Hi! Im very frustrated. My 87 year old mother in law lives with us and is set up nicely in the lower level part of our house. She has a caregiver with her 7 days a week from 8am until the time she goes to bed. She never was a great eater but as of 9 months ago she would start putting her food in her kleenex and then throw it out… when she feels we aren’t looking. She has lost about 30 pounds and we are giving her the best food possible. If she doesn’t eat what we give her my husband will go out and buy one or two more dinners just so that she will have some caloric intake. She doesn’t and won’t drink any meal supplements such as Boost. My husband and I are constantly fighting over this situation as she looks beyond bony. She said that she is eating when she most definately isn’t. My solution would be to remove the kleenex and her little garbage so that she can’t throw away the food anymore and whatever she doesn’t eat just stays on her plate so that way we can show her that the food isn’t been eaten. My husband tried this once and she freaked out wanting the kleenex back! Its heart breaking letting her starve herself in front of us! we have a little 5 year old who always says good morning and spends as much time with her as possible so it’s totally unfair that this is happening because I feel she is shortening her life by starving herself and we will all be devestated 😦 Do you think that by removing the kleenex for good may be a good solution since we are just aiding her in throwing out her food? I’m beyond upset and now my husband is realizing just how serious this problem is. I don’t want her to die so she needs to eat! What else can we do? My husband thinks she may have a bit of dementia… we are all so frustrated and sad… lately she has been complaining that she’s not feeling good…
Hi Jill,
You and your husband have done a great deal to try and turn this situation around. It is very hard to witness, and even more difficult to accept such decline. I encourage you to consult her health care provider, if you have not done so recently. Also, there may be a multi-disciplinary memory disorder clinic in your area where she can be evaluated. This team is used to working with caregivers and can help you sort through options. You will also be able to get the support you need to cope with this emotionally charged situation. It’s important, at this point, that your focus also include taking care of yourself and the rest of your familiy. Calling 211, using a landline in your area, can help you find local resources. Regardless of whether her life is short or prolonged, quality of life matters. Perhaps other readers have other ideas.
Peace & Blessings,
Pam
Hi. I am a caregiver for an 85 yo woman who has dementia and over the last year and a half as lost 45 lbs, and gradually quit eating. Nothing tastes good to her. She says its terrible. I have actually fixed as many as 5 different meals at one time for her and still nothing. Her favorite foods she is ignoring and insists to her family that we are not feeding her. They know we are and we are all at our wits end as to what to do next. I spend a fortune on food for the house just to see if she might eat something else. So after reading all of this I guess we will just go with the flow and keep putting her favorite foods in front of her and hope for the best. I don’t want her to starve to death but she insists she is not hungry. She used to drink a boost shake every day but they taste bad now. I have been trying to get some probioatics in her but she doesn’t like the citrus taste in her shakes (tangy flavor) Good luck with getting the script from the doctor, this little lady will say he didn’t write it and she isn’t going to do it. We have a good relationship but when she decides she’s not going to do something she won’t do it. So we will continue to take good care of her and love her and maybe one day in the near future she will start eating again. Judy H
Hi Judy,
A big challenge! It’s hard to know when to just accept things as they are. The love comes through, no matter what else is understood. A couple of thoughts came to my mind as I read your note. I know from experience with a loved one, that making eating a social event and not focusing on the food or what someone is/isn’t eating, tends to breed more success than trying to persuade someone to eat several times a day alone. You might consider diffusing therapeutic grade essential oils that improve appetite in her environment for 30-60 minutes before a meal. Some examples of oils to consider are: ginger, orange, spearmint, or Young Living’s Citrus Fresh or Christmas Spirit blends [https://www.youngliving.org/pschro]. Another product that might be worth a try is Mamimum Living Nutrition Bites. They are more like a candy in taste and size, so often preferred by folks with dementia. They contain soy protein, essential fatty acids, and are sweetened with natural honey and brown rice syrup. They were used by the US Army in Afghanistan and Iraq. Perhaps our readers have other suggestions.
My 81 year old grandmother who lives with my mother recently had her gall bladder removed. Since being home from the hospital for about two weeks, she has lost about 12 lbs. and has no desire to eat despite appetite-stimulants prescribed by her doctor. As a result of limited mobility because of arthritis and her recent surgery, she has developed two bed sores on her right buttock. We have done as much as humanly possible to encourage her to eat more and to sleep in necessary positions to allow her bed sores to heal. Her home-health nurses have stated the next step would be to insert a feeding tube and hospitalization to treat her bed sores.
Hi Patricia,
A difficult situation, to be sure! I’m glad that you have home health support. I’m wondering if your grandmother has any other co-existing conditions which may also be affecting her appetite and/or ability to heal. For example, depression can be a significant factor. If present, it needs to be agressively addressed. Is she alert and able to talk about what’s going? If so, her thoughts and words may be revealing. If she has not been evaluated by a doctor since being home from the hospital, that might be a useful, especially before deciding about use of a feeding tube. It is important to know the pros/cons of any treatment approach. Her doctor can help you sort that out, and put it in the context of her particular situation. I hope you and your mom are taking a few breaks to take care of your own needs while you are caregiving. Best wishes for a positive outcome.
Pam
I can relate to all of these frustrations of trying to get an elderly person to eat, I to have taken care of an Uncle (now 82) for the past 10 years who suffers from dementia, loss of hearing and also blindness, he is incapable of feeding or doing anything else for himself. Recently (within the last two weeks it has been a litteral battle to get him to eat or drink, I put it in, he spits it out, I do realize that I am dealing with end of life issues but I have a hard time because of not wanting to face the inevitable, love has a strong pull! May God bless all who deal with this.
Cheryl J
Pat Rossell
I can relate to all of the above. My mother is 93 and has Alzheimer’s and Parkinson’s. For over a month she has been saying the food and drinks we offer her taste awful. She will take one mouthful then spit it out and say her stomach doesn’t feel good. We feel like she is going to waste away from not getting nourishment and become dehydrated from not drinking liquids and we don’t want to see that happen to her. How do you know when it’s end of life issues and to stop offering food and drinks or it’s just the Alzheimer’s and you need to keep offering her more. My family and I are so concerned for her well being and stressed that she isn’t eating.
Pat R
Hi Pat,
A challenge, to be sure! If your mother hasn’t seen a healthcare provider, I would suggest that first. It’s possible to have thrush in the mouth or throat, for example, so things don’t taste right and the person’s mouth may also be sore or irritated. As to potential end-of-life concerns, has you mom had a recent hospice evaluation? It can be ordered by her healthcare provider and done in the home. If she meets hospice criteria for dementia, not only she, you you all can get a lot more personalized assistance and support in caring for her. Even when people are dying, giving sips of liquids are desirable, provided the individual is conscious and able to swallow safely. Of course providing good oral care however it can be accomplished (swabbing mouth with toothettes if a brush can’t be used, applying lip balm, etc.) is essential. Pat, I hope that a few of these thoughts will be useful. If any other readers have suggestions, please feel free to contribute.
Best wishes for a positive outcome,
Pam
Hi Pat,
My mother is 88 year , was admitted to a Hospice. She stop eating and drinking about threee days ago. no IV nothing since she requested. they just givin her morphine to keep her confortable.
I know tha she is going slowly. But my questions is, for how long she can be like that?
Hi Brunnie,
I’m glad you and your mom have hospice support to navigate end of life. Most people don’t have the same experience of hunger and thirst at this stage. The best guidelines is what they want. The mouth and lips always need to be kept moist and lubricated for comfort. If your mom wants something to eat or drink, as long as she’s conscious and can safely swallow, that’s great. It should be an enjoyable experience, not a have-to. Spending quality time together is a precious opportunity. Blessings to you and your loved ones!
Pam
These experiences are very enlightening. There is something in each one that is similar to what I’m dealing with with my 83 year old mother. Thank you for this site. Now I know I’ not alone.
I have stumbled across this site as I am looking for reasons my mother (age 100) says the food I make for her tastes terrible and even foods she used to love are now barely tasted before being rejected …she also for the past 2 weeks has become increasingly stubborn about taking her medications … she falls asleep eating the one or two spoonfuls she will sometimes eat …however she will drink milk and I add all the extra powdered supplements to it however she has lost a lot of weight … she has slight dementia but she is aware of where and who she is … she has lived with my family in her own part of our house for 28 years and has always been stubbornly independant… however over the past 3 years she has become totally dependant on me for everything and just sleeps all day … I realise that this is a natural progression but for some reason I keep thinking I should be able to make it better … it has been of comfort to me also to read the stories on here and that this is a part of aging and that I am not alone in feeling like this … Edye N
Hi Edye,
I’m glad these shared experiences are of comfort to you. It is really hard to see someone we love reject nourishment that we know is life-sustaining. Since it sounds like there has been a change in the past 2 weeks, I’m wondering if you have consulted her health care provider. Would be good to see if anything major has changed that might be reversible. In the event that there are no meaningful changes suggested, at least you would have a forum for discussing the situation and getting a little more support for yourself. It also might be valuable to discuss end-of-life scenarios. Does your mother have an advance directive? Is a do-not-resuscitate order from her physician appropriate at this point? A natural death at home can be a satisfying, albeit emotional experience for you and your family.
Peace & Blessings,
Pam
My mother who is 87 has been refusing food for the past three days. She has bed sores which are being treated by a wound nurse. Her legs are contracted and she’s arthritic. She suffers with parkinsons, diabetes, and high blood pressure. She has lost a great deal of weight and I want to make her comfortable and not have a feeding tube given to her. All she wants to do is sleep and I let her. I believe hospice should be my next step, do you agree?
Barbara,
I would want to make sure that your mother has appropriate pain management; bedsores and dressing changes can be very painful and could certainly contribute to loss of interest in eating. Feeding tubes in the elderly are rarely the best option. If her providers feel she can quickly heal from the bedsores with improved nutrition, it is a consideration. Most of the time, when people refuse food and a feeding tube is inserted, they just pull out the tube. Facing a decision about when to remove a feeding tube once it’s in place is another hurdle to address.
I would agree that a hospice evaluation is appropriate, if you haven’t already done so. Your mother’s physician can faciliate it, or you can find local providers and place a call yourself. The National Hospice & Palliative Care Organization is a resource[http://www.caringinfo.org/i4a/pages/index.cfm?pageid=1]. Hospice excels in comfort care and patient/family support. You, her physician, and team mutually agree on the treatment plan. If she is alert enough to participate, that is invaluable. Hospice is not giving up or doing nothing. It is all about providing respectful care at end-of-life so that her quality of life is the best possible under the circumstances. It also allows for a dignified natural death when that time comes. In the event that she does not meet hospice eligibility criteria, palliative care can still be provided. Hospice and palliative care share the same philosophy. Hospice is under the Medicare benefit, therefore subject to specific regulatory constraints. Palliative care may be available as a “bridge” to hospice program or under the auspices of Home Health.
Barbara, I hope you and your mom both get the support you need.
Peace & Blessings,
Pam
Pam, my grandmother just turned ninety eight and in hospice care because of her slight dementia. She doesn’t want to eat or drink anymore but expressed a desire to keep living. We have had many conversations in her periods of lucidness(morning or upon waking). I am confused on what to do. She said she is not ready to go but does not want food. She will drink water occasionally and just lost her taste for ensure. Would a feeding tube be appropriate? Or, should I just watch her starve herself to death?..Robyn
Hi Robyn,
I can appreciate your uncertainty about your grandmother’s situation and her mixed messages. Since she is in hospice care, have you already discussed it with the team (MD, nurse, chaplain, social worker, etc.)? Sometimes a family meeting is very helpful. I suspect that if her dementia is slight, she has other significant medical problems and/or her functional ability has declined so much that she meets the adult failure to thrive classification. There are some assessment scales used by hospice (such as FAST: Functional Assessment Staging, and the Mortality Risk Index Score). It may be very helpful for you to have a hospice nurse, nurse practitioner, or the medical director assess her condition in terms of functional decline and talk with you about her current status and what to expect. That information should help you look at the entire picture and guide further decision-making. Hospice teams also have access to Ethics Committees, should there ever be care dilemmas or controversies that can’t easily be resolved.
In my experience, it’s very common for frail elderly folks at some point to just not have the interest or the energy to keep eating anymore. Perhaps it is nature’s way of preparing them and the family for end-of-life. Who knows? Our own perspective as loved ones or caregivers is typically conflicted to some extent. Regardless of your decision, this is a perfect time to explore many different ways to express your love and comfort your grandmother (holding her hand, giving a backrub, sharing a memory, listening to music, reading/reciting a favorite prayer or verse, etc.).
Robyn, I hope that you and any other relatives are getting the emotional support you need. If not, please talk with the staff. I encourage you to also utilize Hospice Volunteers in whatever way will help. If you are a primary caregiver, respite care may also be helpful at some point, to prevent/address exhaustion and burn-out.
Peace & Blessings,
Pam
I care for my 97 year old mother who has alzheimers. She has recently stopped eating and is losing weight – over 45 lbs in 6 months. I have tried soup, soft pasta, ice cream that she used to love, all with no success. She will eat 2 or 3 bites and when I feed her more she just spits the food out.She only drinks 3 or 4 sips of ensure so I know she is not getting enough nutrition. She is sleeping more but still does jigsaw puzzles. I still take her out with me in the wheelchair. I know she is not depressed but she is shutting down. She stopped speaking awhile ago but I could at least get a yes or no out of her. Now she doesn’t answer me at all. She no longer uses a toilet and I am amazed that she still has bowel movements when she is hardly eating. What can I expect if she continues to refuse food? I have read that some people only live 6 months once they have stopped eating.
Eliz,
One consideration with advanced dementia, is that the area of the brain that controls swallowing may be affected. Weight loss and physical inactivity further contribute to progressive weakness. Any coughing, gagging, or choking needs to be reported to her healthcare provider. We should be mindful of other factors such as sores in mouth or dental issues that may explain decreased eating. As you mentioned, her reduction in eating and drinking has been gradual. It is thought that the hunger and thirst areas in the brain are no longer functioning as before. I have not observed any signs of distress or suffering from reduced intake in people with dementia. Even at early to moderate stages, it’s common to hear, “I’m just not hungry.” Mary, in my original post (now age 91), told me that several times this past weekend. It seems to be the caregivers who suffer most.
It’s very tough to witness a loved one’s physical and mental decline. You have done much to make a difference. It’s pretty amazing what the human body still manages despite minimal nutrition. Of course, her caloric needs are much less than they used to be. As you mentioned though, it can’t be sustained long-term. Your own conclusion is that she is not depressed but instead is shutting down. If your mother does not have hospice care, I encourage you to explore it now. Hospice expertise and support can make the end-of-life transition easier for everyone involved. Your love and presence is invaluable; quality of life matters to the very end.
Peace & Blessings,
Pam
My husband has stage 3 going into 4 of congestive heart failure. The past 3 mos. he has been in and out of hospitals + is now at a rehab center to get stable on his feet. He isn’t cooperating with the nurses, won’t weigh himself daily, won’t let them take a sugar check. Today he refused lunch and dinner. He has stayed in his PJ’s for past 2 days rather than getting dress and shaved. I had thought he was getting better but seems to be going into a downward spiral. He is verbally abusive and I am at wits end. I tried talking with him tonite as nurses said maybe candor would help but he doesn’t listen. What can I do with this man?
Thanks for sharing this challenging situation. Your husband may well be discouraged and depressed. He may think, “What’s the use in trying anymore?” It’s normal for him to be angry about his condition. Many times people lash out at their loved ones. Sometimes they are just so miserable that it spills over onto anyone who comes into the room. I believe more intensive support for both of you is needed.
His treating medical provider needs to know, if he/she does not already. A complete review of his clinical condition and reappraisal of prognosis is important. Discussion of treatment choices needs to flow from that. Does he want any more hospitalizations if his health changes? Maybe he just wants to be kept as comfortable as possible at home. Palliative care (expert symptom control) or hospice (if he meets criteria for his stage of heart failure) are options to explore.
Usually in a rehab center, there are social workers (often with counseling training) and spiritual care providers. I recommend you ask for consultations with both professionals. The dietitian also needs to be involved, since fluid balance and blood sugar control are issues, regardless of whether he eats or refuses food. A family conference with care team members may be beneficial.
Trying to reason with someone who is emotionally upset (whether anger, depression or other mood) is not helpful initially. They can’t just “snap out of it.” Their focus in more inward; their ability to problem-solve and even do self-care activities is very limited. Their biggest immediate needs are to feel understood, to know that people care (and will not abandon them), and to feel safe. Simple words coming from the heart (“I care about you and what you’re going through”) and presence can help. Avoid saying, “I understand”; we seldom do, at least from their point-of-view. Sometimes it is easier to talk with someone outside of the family. Does your husband have a close friend who could visit? Or a trusted spiritual care provider?
This is also an important time to make sure your own needs are being met (physical, emotional and spiritual). As caregivers, it’s easy to become anxious and feel down. We often feel all alone. Listening to music you love, taking a walk, talking with a friend, and praying are all examples of strategies that can help nurture and sustain you.
Perhaps readers have other ideas to share….
Peace & Blessings to you!
Hi, all.
It is my mother in law.. She’s always had a great figure & looking at her best friend they must have been the slimline queens of their time:-) They are both beautiful women, but sadly are now melting away in front of us.
She loves cooking & feeding people, but if she ever has more than 3-4 desert spoons of food on her plate it would be a lot. I’ve also never seen her ever even finishing it.
I’ve been complaining to my husband that she is losing too much weight & that I’m scared that she might get very sick.. We love her very dearly & we will just die if we must lose her now. She is only 72.
My worst nightmare came true when she was admitted to hospital a couple of months ago. Her heart is not as strong as it used to be. I am positive it is because she isn’t eating enough. She is very obviously under weight. I can’t hug her anymore becasue of this as she feels like a walking skeleton. She tries to hide her thin body behind clothes, but it is not possible. I don’t have any guts to speak to her about my feelings – I also don’t want to hurt hers.. What to do???
H
Hi Hester,
Has your MIL (mother-in-law) had a thorough physical exam recently? Sometimes follow-up after hospitalization is more focused on the admitting diagnosis. She needs a medical provider to look at her overall health to make sure there is no undiagnosed condition to account for weight loss (e.g., hyperthyroid, diabetes, etc.). Your MIL should also have psychological screening (depression, anxiety, eating disorder, substance use (cigarettes, alcohol, prescriptions, etc.) and referral to the appropriate providers and counselors. Some areas of the country have geriatric practices that are multidisciplinary (physicians, nurse practitioners, social workers, dietitians). Having her seen at such a center, if available, would be a great start! A heart-felt “I statement” such as, “I’m really concerned about your health and safety since you’ve lost so much weight,” might be worth trying. Eating disorders are more common in teens and young adults, however they can, and do occur later in life. A good overview is: http://www.mayoclinic.com/health/eating-disorders/DS00294. An abstract on eating disorders in the elderly might be worth showing to her medical provider and raising the question about whether it may apply to your MIL. Here’s that link: http://www.ncbi.nlm.nih.gov/pubmed/20170590. Best wishes with your MIL and her friend.
Peace & Blessings,
Pam
My mother is not eating – only one or two spoons of food. She is constantly nauseous and dizzy. She is extremely weak and I don’t know what to do. I have her on Ensure, Rehydrate, Energade, but she only takes a little bit in. He blood pressure is extremely low and I don’t know what to do to make her feel better, please any advise!
Moonie,
The symptoms you are describing need to be addressed by a medical professional. Constant nausea, dizziness, weakness, and low blood pressure are all symptoms that need immediate attention (such as in an Emergency Department).
I don’t know if your mother has an advanced illness and whether or not she may be near end-of-life. Both of you can benefit from getting more support to cope with this situation. It can be really exhausting if you are doing the caregiving by yourself, especially under these circumstances.
Does your mother have an advance medical directive to help others know what her wishes are when she is unable to speak for herself? Are you or another family member or friend designated as her health care proxy or decision-maker? Medical personnel will ask these kinds of questions.
You have done a good job selecting fluids with nutrition and electrolytes. Has she lost a lot of fluid through vomiting and/or diarrhea? If the nausea subsides, she may be able to take more fluids by mouth once again.
Everything you do with love will add to her comfort and your peace-of-mind. Best wishes for successful resolution of her symptoms.
Peace & Blessings,
Pam
Mom sadly passed away midnight today 😦
Moonie,
You and your family have my sympathy on the passing of your mother. I’ve heard it said that one is never old enough to lose a mother; I agree from my own experience. From what you have already shared, you did a great job attending to her needs. I hope you have support through your time of bereavement and find comfort in memories.
Peace & Blessings,
Pam
Thanks Pam. She had 2 AAA repairs done before and this time one returned. The Anurysm was 17.5 cm long by 5.3 x 4.2 cm width. I had a peak at moms file at the hospital and the ultrasound diagnosis said possible AAA leaking? Thinking back all her symptoms like nauseousness, dizziness, abdominal pain could be that the AAA has been leaking for a while.
Thank you for your support and advise when I needed it.
Moonie,
Thanks for the feedback. I’m glad your mom was evaluated and treated in the hospital. When a loved one’s health deteriorates and they die, caregivers generally have peace-of-mind knowing that anything needing attention and treatment was promptly addressed. As you discovered, your mom had a serious medical condition. It’s always good to touch base with medical providers whenever there is a significant change in condition, symptoms, and/or behavior.
Peace & Blessings,
Pam
Thank you so much for all this information.
I think my mother’s loss of appetite may have stemmed from a change in heart medication and possibly having some type of prolonged mild flu. Her appetite is back to almost normal now after having a 3 week period late last year when all I could get her to consume was three Ensure 350 calorie drinks a day.
Yes, appetite can certainly be impacted by illness and medications. If her appetite is almost back to normal, and the medication has not changed, the illness may have been the key culprit. Good that you are observant and were able to get her to drink Ensure regularly. Ensure Plus has just a few more calories (360), including 13 grams of protein and 50 grams of carbs. There are several flavors available as well. Personal attention and regular encouragement are so important!
My Mom is turning 87 this month and my Dad the same age is caring for her. She had hip replacement surgery almost 7 ms. ago and has had several set backs since then. Hgb. went way low while in rehab and she had to have blood trans. Then fluid build up and she had to go and have drainage that happened twice which the last time had the surgical procedure to stop the buildup from happening again. Finally the Dr says was Cong. Heart Failure. She has never had a heart problem. She does have htn. Never a stoke as far as we know. Has generally been healthy. She does take meds now including the Lasix and other meds for her conditions. She just is not bouncing back and me and other family memebers don’t know what to think, She is on something for depression. She is loosing weight , doesn’t want to go out to get her hair done, church which used to be so important to her. My Dad stays home with her. We feel like she needs to make herself go a little more. She is, it seems ALWAYS nauseated. She is eating ok with the help of my Dads cooking. Plenty of good food. what do you think we could do to help her? She went thru the surgery to help her have quality of life and it has gotton worse.
Lynda,
It can be discouraging to see quality of life diminish when you have all worked so hard to improve it. I don’t know whether or not her congestive heart failure is well-controlled or at what stage it is considered to be. But when the liver and digestive system become congested from the heart failing to adequately pump with each beat, they don’t receive a normal supply of blood. This alone can make people feel nauseated or full, even if they have not eaten. You note symptoms of clinical depression such as not participating in activities that have been important to her in the past. It may be important to discuss her nausea with the prescriber of her antidepressant (as well as other meds), as nausea can be a side effect.
If she is still somewhat anemic, her energy level would be affected as well. A simple blood test can verify whether or not than is an issue. Labs can also be done to evaluate her nutritional status.
Does she experience any physical pain? If she needed a hip replacement, she may well have more arthritis or other sources of pain that need to be addressed. Persistent pain can contribute to both nausea and depression.
If she has not had a complete physical examination recently, I do recommend that be done as a priority. All of these potential factors I have mentioned could be questions to pose to her health care provider(s) to help seek explanations and guide any further treatment.
Once the nausea is addressed, then more attention can be paid to intake of food. You already mentioned that your Dad makes lots of good food. Putting the emphasis on socializing during a meal, enjoying the companionship, perhaps background music of choice, can help encourage eating. Perhaps she can help do a small task such as setting the table. Choosing between a couple options for food and beverage can also be empowering and minimize resistance. Focusing on eating or pushing to have more can be counterproductive at any age. Once the medical issues are clear, it may be useful to consult with a clinical dietitian, which could be arranged through her doctor’s office. Particularly if she has lost very much weight and muscle mass. She may need minerals and electrolytes such as potassium and magnesium replaced from being on the diuretic (Lasix). There are several excellent dietary sources. Perhaps nutritional supplementation is appropriate; once again, her doctor and dietitian can provide guidance.
Her health challenges as well as recent birthday (and being in her late eighties), may have resulted in fears surfacing or emotions such as hopelessness. I do encourage some form of counseling, whether with a spiritual advisor, a lifelong friend who is caring and will truly listen, or a counselor who works with people who are experiencing depression.
I commend your Dad for his devoted caregiving to your Mom. At the same time, it is really important for him to be able to get out, see friends, and just have a little space and find some enjoyment in each day.
I hope some of these considerations will be helpful to you, your Dad, and Mom.
Peace & Blessings to you all.
Pam
HELP! My Grandmother now 90 years old has stopped eating. Everything tastes bad. She was moved to two old homes the past year because of her health getting weaker. I cannot understand that she went from walking all by herself a year ago to lying in a bed unable to move. She was admitted to hospital today after not eating for three months. She is now on a high calorie drip. What can I do when this does not work? She stays in an old home 250 kilometres away. Will her will to live come back if I move her to the same town as me.
Dear Gertie,
Sometimes not eating is a signal that the body is wearing out and winding down. It is very common to notice a more frail appearance and decline in stamina the last year or so of a person’s life. If she has lost so much weight over the past 3 months that she is lying in bed unable to move, she is probably not likely to be able to carry on a conversation about what led to this situation. Perhaps you know more about whether she had health setbacks and just did not bounce back from them, or whether she was depressed. Of course, both can exist at the same time. Food tasting bad can be related to specific medical conditions such as thrush in the mouth or throat, or even loss of smell or altered taste from a stroke.
Does she have any Advance Directives or a Living Will that gives guidance about what type of care she does and does not want when she can no longer verbally communicate her wishes or choose/decline specific forms of treatment?
If a hospice or palliative care consultation has not been obtained, that would be helpful to everyone involved. If you are in the role of a decision-maker for her care, a team meeting with her treating physician, nurse, dietitian, social worker, and spiritual care provider or chaplain would be useful. They can provide a professional opinion about whether there is a good possibility of improvement, whether she is already in the process of dying, or whether further attempts at curative treatment may be more of a burden to her than a benefit. This information will help you determine next steps (such as a move to your town or home).
When you are able to be with her, assume she can still hear you and benefit from your presence. Kind words, soothing touch, sharing special memories, and thanking her for being a grandmother to you is always appropriate and healing for you both. Take care to get whatever emotional and spiritual support you need for yourself in this situation (and beyond). May you both be at peace.
Peace & Blessings,
Pam
I am not a doctor but I am a CareGiver. My mother went through a three week spell where she was not hungry. I put her on three Ensure drinks a day with the extra protein and 350 calories per bottle.
Out of desperation I changed her heart medication back to what she had been on prior and her appetite came back. The type of care your grandmother may need might be best found among family and not institutions which many times can’t afford to give too much attention to one patient at the expense of others.
I should add that a combination of an institution and daily visits from family members might be a good scenario.
My 95 year old mother in law is in an assisted care facility. She moved in 4 months ago. We visit her there but it wasn’t until we brought her to our home for a 10 day visit that I noticed how little she is eating. She is in good spirits, walks with her walker, visits on the phone and is totally alert and involved with life. She can only eat a spoonful or two of food and she is full to the point of feeling like “heaving”. She can get a Boost drink down but it takes an afternoon of sipping and using water to push the heavier liquid down. She complains of it being too rich. Her doctor has an order in for her to see a specialist in case there is a blockage but who knows when that appointment might happen. She lost 10 pounds in 6 weeks. We understand the body begins to simply wear out and shut down but Is there anything we can do for her in the meantime?
Gail,
It is not normal to eat or drink such small amounts and feel full enough to “heave.” If she has not been seen by her doctor recently, a focused history and medication review, physical exam, and preliminary screening tests can be valuable while awaiting evaluation by a GI specialist.
Hearing that a liquid nutritional supplement is “too rich” or “too sweet” is quite common. It may be helpful to dilute it with water first before offering it to her. Sometimes adding a little flavoring or even lemon juice can help. She may also benefit from meeting with a dietitian for additional ideas. Losing 10 pounds in 6 weeks can be significant depending on her starting weight.
Since her mood is good and she is actively engaged in life, it would not seem that her body is shutting down at this time. Hopefully there is a reversible cause. You and she will want to make sure that through this journey, the benefits of any proposed diagnostic studies outweigh the potential risks and associated burdens. If she does not have an advance directive, this is a good opportunity for you and her providers to discuss her health care wishes.
I encourage you to continue advocating for her timely medical follow-up.
Peace & Blessings,
Pam
Thank you so much for your reply.
I have alerted the care facility and they are going to try some different food options and tactics. The lemon juice could be a good thing to try – she loves that!
I also talked to the GI’s office and they have moved her up for an assessment – but did mention risks. It’s a good word to monitor if the benefits outweigh the risks and not just head naively down the path.
The personal directive she has always resisted however I appreciate the reminder to revisit that.
Thank you so much for your caring approach, information and availability. It’s a challenging time and it is true that one can feel rather alone in it. The system isn’t always real keen to invest a lot of time in a 95 year old. So again, thank you.
Gail Rodgers
Gail, good job! Happy to assist. Blessings, Pam
hi i am rizwan from India my mother doesn’t like the food she age is 56 but she is diabetics patient and also blood pressure so pl z help me how can i rectify the problem
Dear Rizwan,
I was excited to find a resource listed in a community forum on the American Diabetes Association website to recommend for you and your mother. It is the second edition of: Indian foods: AAPI’s Guide to Nutrition, Health and Diabetes. This online book (free download) is by The American Association of Physicians of Indian Origin (AAPI). Some of the reference information is also printed in regional dialects. Contributors include MDs, PhDs, and Registered Dietitians.
This comprehensive resource provides sample menus, meal modifications, and healthy snack ideas based on traditional cuisine from different geographic regions of India. Carbohydrate counting for Indian foods is addressed. This reference also includes seasoning alternatives to salt (important with high blood pressure).
There is a chapter on the potential role Indian spices and condiments may play in promoting health. A couple examples include fenugreek seeds and cinnamon.
I hope this resource will encourage you and your mother to have fun creating food that both tasty and healthy for diabetes and blood pressure self-management.
Enjoy,
Pam
Mom is 88. 2 years ago in December she had double bypass surgery. I left work to become 24 hour a day caregiver.My husband and I live with mom because she doesn’t want to leave her home.
Gradually, after finishing rehab, she was able to get back to driving and water aerobics.So I went back to work. I adjusted my work so that I could be home more .
Her health is rapidly deteriorating now. Heart is weakening, she has a hard time eating and hss belly pain.
C.t. scan showed swollen and “dying” lymph glands in pelvic area.
She is being treated with antibiotics for now and going to physical therapy when she can.
She can’t drive.
I feel I need more help. I can’t leave home for very long because she won’t eat or drink, is very weak and a fall risk. I have to work.
What is my next step? A 2nd opinion, a dietitian? Home health care?
How do I proceed?
within the last couple of months her strength and health has rapidly diminished.
She can no longer drive, is very weak and short of breath, has abdominal pain, and has a difficult time eating.
We have visited the local clinic and tests showed water around chest area, as well as
This past summer her strength has diminished and I have
Karen,
It sounds like you and your husband have done a great job caring for Mom over the past couple years. While she was able to bounce back from her bypass surgery, it sounds like her reserve is gone and her health has steadily deteriorated recently.
All the symptoms you mentioned suggest that she may be closer now to end of life. With the proper treatment and supportive care, she can have better relief of symptoms (e.g., shortness of breath, abdominal pain, etc.) and improved quality of life. At the same time, you need more assistance and support. All of this can happen through one vehicle: hospice.
Hospice should not be reserved for just the last few days of life. Much can be accomplished, especially with earlier referrals (weeks to months). Hospice includes a multidisciplinary team (nurse, nursing assistant, social worker, chaplain, specially trained volunteers) under the direction of her own physician, or if you choose, another one. Regardless, there is a Hospice Medical Director for expert consultation. Other disciplines can be accessed, as needed, such as a dietitian.
You can ask her health care provider to request a hospice evaluation. Or you can initiate that on your own with a phone call to a local hospice, in which case, they can make contact with the provider for you. Based on her insurance, you can find out if you need to select from certain preferred agencies (especially if she has a Medicare HMO). You can also ask other people you trust about recommendations.
People often have some misconceptions about hospice; at the very least, lots of questions. The staff is excellent about addressing all concerns. It is truly a collaborative process. At the same time, you can rely on their expertise and experience.
It is possible that other decisions may need to be addressed. For example, does she need a paid caregiver with her while you are at work, or does she need to be in a nursing care facility at this point? The hospice social worker can certainly assist you in exploring such matters.
Your own health, relationships, job, and self-care also need to be considered. You can get a lot more support, plus potential for short-term respite care of your Mom, with hospice.
Karen, I encourage you to make that call…so relief can be on the way soon.
Peace & Blessings,
Pam
I am a caregiver but do not have a medical background so I am just asking a question. Has your mother been considered for a pacemaker? It might be that her heart is slowing down too much at night when she sleeps, and that allows fluids to accumulate which sap her energy and possibly even her appetite and can cause more dangerous conditions as well.
I personally am not a fan of long term use of pills to lose daily excess water because they can be hard on the kidneys, although that is probably better than doing nothing. Just throwing out that the pacemaker option could help. I don’t have a medical background, I just know that my mother got a “second life” after having her pacemaker put in.
A good reminder that getting a second opinion is often a good option.
This site has been very helpful to me. Thank you so much.
Thanks to all who shared comments & experiences. I am dealing with my 84 year old mother who is going through very similar problems with not eating, dementia, excessive sleeping and not wanting to be social. I have a feeling she is starting the stages of shutting down. I hope I can stay strong for her, she’s been a wonderful mother.
My 90 year old nan has suddenly stopped eating , she lives with my mum and is fiercely independant with no mental health issues she has always had a small fussy appatite and whenever she has a common cold always enduces vomiting this may sound odd but she has done it her whole life until last week when she complained of a tummy ache and cold so did her normal vomiting which lasted 2 days then refused to eat for fear of vommiting again now that has passed and she still refuses to eat and is getting very weak ive managed to convince her to drink some actimal to help line her stomach and mum has seen her eat a little rice and bit of bread but she still is getting weaker, she has always been very strong for a old lady up untill last week how can we regain her strength and are we giving her the right food to aid in this ?
She is on angina and artharitus medication that has been the same for years.
Kama,
A tough situation. I hope your mum and nan have been able to talk about the situation and decide what to do. If they have not consulted a health professional, that is an important starting place. Elderly people with vomiting can have electrolyte changes and dehydration; weakness can happen from those reasons alone, not just decreased eating. She may need intravenous fluids and/or medications. There are several other possible medical issues that may have affected her. Sometimes long-term use of arthritis medication may affect the GI tract and have given her the tummy ache; if she is still taking it, there is potential risk for that to worsen. Elderly people can also have what is known as a silent heart attack; without typical signs commonly seen in younger folks. Sometimes they only experience nausea, feeling poorly or weak. Elderly folks may also have infections that may not be obvious. I hope these few examples will help you and your mum to seek appropriate medical attention for your nan.
Is your nan experiencing distress, pain or suffering in any way? If you suspect that or know that to be the case, she again needs medical assistance.
Actimel is certainly an option to consider at home if she will drink it. She may benefit from flavored, low-sugar electrolyte replacement fluids or freezer pops such as you might use with children who have vomiting or diarrhea. Any easy to eat foods that she likes or appeals to her are best. A few ideas include: applesauce, ice cream, sherbet, pudding, mashed potatoes, broth with rice or noodles, etc.
Once she has medical evaluation, it will help you all know if this condition is likely to improve quickly with supportive care, or if there are other circumstances that will affect her health going forward.
Best wishes for a good outcome.
Peace & Blessings,
Pam
My mother stopped eating once for several weeks. I was able to get her to drink three 350 calorie Ensures a day until she got her appetite back. Ironically, I have brought this up before, I think this occurred just before she got her pacemaker put in. My mother’s heart was beating so slowly at night she would retain water which I think affected her appetite.
I care for a 85 year old lady she was my Moms best friend.She has dementia we have her on a pill which seems to be helping all of a sudden appetite has decreased she’s hardly eating anything she would eat a leg and have a piece of toast in the morning and then it’s hard to get her to eat anything the rest of the day I’m worried about her she’s lost a lot of weight your teeth are very bad she said she feels like there’s slime in her mouth could this be the problem
Melony,
Yes, it’s very likely there is something going on with her oral health that is affecting her desire to eat, and perhaps her ability to do so without effort or discomfort. It is important to have her examined promptly by a medical provider, and perhaps after that, a dentist. At the very least, any infection can be treated.
Sometimes when people have dementia, it is more challenging for them to receive dental care. I recall that when my elderly relative with dementia needed to have a tooth extraction, she developed a dry socket afterwards and needed more frequent follow-up for the first week. She just couldn’t (and wouldn’t) follow through with the aftercare instructions. But it turned out just fine though. Dental care provides a good example of a situation where one has to weigh the potential benefits and risks of a recommended treatment (preventative or restorative).
In the meantime, soft foods and adequate liquids such as shakes or protein drinks should be encouraged. It is important to avoid anything hard, rough/scratchy, or acidic (like citrus juice).
I hope that this condition is quickly reversed. It’s great that you are noticing changes and listening to what she tells you.
Regards,
Pam
Melony,
This is probably obvious, but good mouth care is essential. It may be challenging; she may not want to brush her teeth anymore nor be able to do so. If if a toothbrush is used, it needs to be a very soft brush and possibly the size used for children. The foam-tipped mouth swabs are perhaps best suited for this type of situation. They can be purchased from several places on-line. She may be able to swirl a moistened swab in her mouth with a little supervision. Usually people accept someone else doing it for them fairly readily when given a short explanation. Perhaps other folks have additional suggestions.
Regards,
Pam
I have more of a comment than reply.
My mom is 96, lives with me but we have a state agency supplying care givers, ( when they can find someone who wants to work!)
Anyhow, mom loves sweets, and gets snacks throughout the day mostly by the caregivers, when 5:30 rolls around she says she isn’t hungry–why would she be hungry? She has smacked all day and when I try to serve nutrious food she doesn’t want it. This is a 7 day a week battle. I’m getting frustrated, but my wife says to give her the junk foods, I don’t agree…hospice tells me this is a battle I won’t win. Any suggestions as to how to get a better variety of whole foods in her?
Jeff,
Thanks for writing about your 96 yr-old mother receiving hospice care and your dietary concerns. I’m glad you have caregiving assistance despite some associated challenges. You can request dietary consultation from a hospice dietitian. It would be tailored to her specific situation, taking into account factors such as: her medical conditions; her teeth/mouth status, her alertness and comprehension; and food likes/dislikes.
If her nutritional status is severely depleted and it impacts her current health (like protein deficiency delaying or preventing wound healing), then that would need to be addressed with the team. If her weight and nutritional status are reasonable, then it may be more of a quality of life issue for your mom, and a collaborative challenge for you. A couple of thoughts that come to mind….What goal or outcome do you ultimately want to achieve? What difference does attaining that result make for your mother, and for you?
Your mother is likely not to eat as much as she may have in the past. Her appetite may also be diminished. It may be appealing to have bite size pieces of food on a small plate or bowl with white space around. A small piece of her preferred treats may be used as a “reward” for eating some of the other nutritious foods first. If her energy level is better during the day, perhaps eating a meal at night is not realistic.
If you want easy- to no preparation for the caregivers, that will also influence the food choices. A few ideas might include: individual size servings of: leftover meal such as a casserole, a scrambled egg with melted cheese, cottage cheese with fruit, pudding made with whole milk, slice of bread with nut butter (then served in quarters, perhaps with banana slices on top), etc. Smoothies offer a range of possibilities, especially when they include flavored or unflavored whey (or other protein) concentrate. Plain Greek yogurt or Carnation Instant Breakfast are options, depending on tolerance for dairy. Almond milk may be another palatable choice. Either fresh fruit or frozen unsweetened fruit make tasty and colorful additions to shakes or smoothies. Some pretty healthy products that still offer that “sweet” taste include Oatmega, and ThinkThin Protein & Fiber Bars or Think Thin Protein Bites.
It’s pretty common in our society to offer food or view eating as a symbol of love and affection. When the foods we go to effort to prepare are ignored or even refused, it feels like our love is being rejected. Even if that is not the case in this situation, it is an opportunity to look at a variety of ways to express love, affection, and gratitude.
Perhaps some readers have additional ideas to share.
Peace & Blessings,
Pam
I found this article and responses very helpful for my situation. My mother is 91 and able to care for herself with minimal assistance. She has an internal defibrillator and suffers from CHF. She was recently hospitalized for excessive water retention and is now in a rehab facility awaiting approval to go home. Similar to others here, she eats about a teaspoon of food at mealtime, despite saying the food smells and tastes good. When I asked her why she wasn’t eating, she said she doesn’t like to “chew” and the chewed food makes her feel nauseated. She only wants to eat soft foods that go down easy. I saw no problem with that as long as she had vitamins, minerals and ate properly. My sister and I plan to make her pureed soups for the freezer so she can simply heat them up in the microwave. She is still very sharp mentally and very alert. I was wondering if anyone else had heard of their elderly relatives being nauseated when chewing? We have ruled out inner ear problems, etc. She said she just doesn’t like the texture of the chewed food in her mouth. Thank you so much for your article and tips.
Christine,
Thanks for your comments. I’m glad your mom has been able to do well enough to live independently with support from you and your sister. I understand you have been diligently looking at what may cause her nausea that is noted when chewing textured foods. You mentioned she was recently hospitalized for excessive fluid retention. A couple thoughts come to mind that could be further explored with her cardiologist, if you wish. If her fluid retention also involved the liver or gut, it would not be surprising for feelings of nausea to occur, at least during the acute phase while hospitalized. Sometimes the effort/energy to chew food can cause fatigue; so depending on her degree of heart failure, perhaps there is a relationship. Changes in appetite or interest in food may be related to her underlying condition or even to medication side effects. It’s also possible that it is completely unrelated. So I do encourage regular follow-up with her doctor, as you are doing.
Good for you–to plan ahead and provide pureed foods that can frozen and easily reheated. In the process of pureeing food, usually the addition of liquids are needed. So I would keep an eye on the amount of sodium (from broth, for example). Also liquids may mask or dilute the flavor of the food. With loss of texture, the smell, color, and temperature of food remain important contributors to enjoyment. So I would try to avoid mixing different pureed foods together, which might result in a odd color (brown or gray) and potential loss of flavor. Knowing that the vivid orange color one sees is sweet potato or carrots, for example, may enhance the experience.
Sometimes just mashing foods is an good alternative. The root vegetables, especially, lend themselves to mashing. Some examples of foods that are easily mashed include: potatoes, sweet potatoes, carrots, squash, pumpkin, rutabaga, turnips, parsnips, beets, and cauliflower. If interested, see Every Vegetable You Can Mash That Isn’t A Potato.
Silicon baking cups, custard cups, or ice cube trays may all be convenient to prepare or transfer food for freezing and reheating. You may want to using non-stick baking spray inside the container first, for ease of removal.
Crustless mini quiches may be another type of food to consider. You may be able to include small amounts of other ingredients for taste, nutrition and visual appeal. Potential examples: flaked salmon, cheese, grated zucchini or carrot, or veggies such as tiny bits of broccoli crown, asparagus tips, etc.
Possibly a thin film of nut butter spread on a small rice cracker, may be a “melt in your mouth” change of pace. Other food items that come to mind are polenta, gelatin, frozen yogurt, pudding, and custard.
I hope your mom’s nutrition needs are met with whole foods that she can recognize, smell, taste, and enjoy. She may also need small amounts unflavored protein powder added to foods, or flavored protein shakes to supplement her meals. As you noted, small amounts at a time are necessary. If she is still in the rehab facility, you may also be able to confer with a registered dietitian about her specific nutrition needs.
Perhaps our readers have other ideas or recipes to share.
Peace & Blessings,
Pam
I am not a doctor, all i can share is my experience observing another family member. If an elderly person’s heart rate goes too low at night, that can wreak havoc and cause the build up of water.
You say your mother has a defibrillator which I have no understanding of, but does she have a pacemaker which might help reduce the retention of water by making sure the heartbeat does not go below a certain rate, especially at night when she sleeps?
my sister is in a care home paying over 800 pounds per week she is 90 yrs old she just has myself and brother ,she only weighs under five abd half stone and she wont eat ,i love her so much ,i looked after her at our house for over twenty years when her husband died because she never had children ,but now i am 76 and in ill health myself ,she is refusing to eat saying she wants to die ,i try all ways buying things i think might tempt her but to no avail ,is there any thing i can do please i dont want to lose her .thank you .
Dear Maureen,
My heart goes out to you! Of course it’s hard to think about losing your dear sister.
It’s challenging sometimes to know when someone is giving up (but could benefit from specific help) versus when someone is near end of life and they just naturally have little interest in food. A couple things that could potentially turn this situation around, is if she is in pain and/or depressed, as the reason for wanting to die and having little appetite despite all the tempting things you offer her. Perhaps getting a medical visit/exam for her can make a difference. It might also provide peace of mind for you and your brother, to know that nothing reversible has been overlooked. Maybe hospice care is an option to explore. Not only would it help your sister, but the rest of your family can benefit from their guidance and support.
This is also a time to consider meeting with a spiritual care provider (clergy, chaplain, parish nurse, etc.); individually and perhaps, jointly. Our spiritual foundation can help us not only live well, but die a natural death with dignity, and find comfort in our grief and losses.
Sometimes just being together, holding her hand in yours, and being able to share special memories and how much you mean to each other, is precious.
You are in my thoughts and prayers,
Pam
One thought to add to all of the good insights above: Even comfortable dentures will wear down. My 84-year-old mother (who has dementia) was eating more and more slowly. One night when I was cleaning her dentures I ran my finger over the molar regions and realized they were almost completely smooth. We have a new pair for her now and after a couple of adjustments, she seems happy with them. Unfortunately, she’s showing improvement with only certain foods. Others that she was accustomed to stuffing into napkins if they were at all a challenge, still end up stuffed in napkins. I’m afraid that, at this point in her decline, it might be expecting too much for her to learn to chew again.
In short: For denture wearers, check the molars.
Judy, a good reminder! Thanks, Pam
Hi Pam, i have read some of the things others are dealing with for there love ones. Mom is 85 and just developed this thing that all food taste sour. even if she fines something she likes one or two bites and she is full. she still knows and loves her family. mom thanks God for her boys ,she said we are so good to her. we lost our dad in 1970 and our sister about 4 years ago. mom has chf and copd as well.mom will drink insure, but its hard to get her to eat anything. I know God will help them who will help them self, so i am looking for any help i can find. I want to think you for helping others and caring for all. If you have any ideas that may help me with mom please share them with me , i know you will. again i know everything has to be in Gods will but we have to do our part also. Thanks you ever so much.
Louie,
Thanks for your question about ideas for your mom’s situation. Is sounds like the sour taste she notes with all foods is a recent change. If she has not had the opportunity to see her health care provider yet, I recommend that as a starting place.
One potential consideration is gastroesophageal reflux disease (GERD), where the lower esophageal sphincter (LES) relaxes or is weakened allowing stomach acid to reflux or flow backward into the esophagus. People with GERD may notice a burning sensation (heartburn) from the backwash of stomach acid, and potentially a sour taste in the mouth.
Bacterial growth at the back of the tongue is normally kept in check by saliva flow. But if you mom has dry mouth, especially at night, certain bacteria can grow and may create a sour taste. Likewise, if she has post-nasal drip from sinuses, that can lead to increased buildup of bacteria. Tooth decay or infection could also be a factor.
While these may be more common explanations, there are other potential causes. So it is important to identify the underlying cause for successful treatment.
A few general principles may be helpful. Good oral hygiene such as brushing teeth and rinsing mouth following sleep is worth doing to get rid of sour taste. Ideally, encourage your mom to sit up for at least 30 minutes following a meal/drinking Ensure before lying down. If she is on a fluid restriction for CHF (congestive heart failure), try to spread out the fluids throughout the day so her mouth stays moist. Her health care provider can determine what amount of fluid she should drink on a daily basis; sometimes that needs to be re-evaluated. There are products available that can be used for dry mouth, if needed.
Hopefully, this situation will be turned around quickly, so she can enjoy the taste of her food once again. Keep up the good work!
Peace & Blessings,
Pam
Good day all,
About two years ago i started taking care of my father. Some background: He is 88 in march this year, up until 3 Christmases ago he was cycling 100 miles every week (the end of a gradual decline as he has 3 trophies from his cycling club commemorating his reaching sufficient mileage to have cycled around the world) as well as playing tennis on a regular basis. He has always been into sports and an active lifestyle. about 2 months before i came to him, he had a mild stroke which caused vascular dementia. We had continued with his routine, playing tennis and walking roughly 3-4 miles a day in the 4-5 months after my arrival.
i decided to take him to the Philippines for 3 reasons… 1. no winter, cold weather; 2. healthcare was way cheaper to include in-home care and caretakers and 3. He had expressed a desire to leave Louisville as most of his sports buddies and work acquaintances were dead or not around anymore.
as well other circumstances were emotionally depressing him.
This was 2 years ago, initially we still played tennis as well as walked regularly, i hired a caretaker husband and wife team who have been very helpful. He still can get around on his own , feed himself etc. Also i got him a good doctor who gives him checkups every 2-3 months. over the last 6-7 months, i have noticed a decline in him which i attributed to his coming to terms with his age. now though, he is not eating a lot (which is very unusual for him), he has slowed down on his exercise to the point where he has stopped going on his pre and post breakfast walks preferring to lay down and raise his legs a little.
I am an army veteran who served in the gulf war, and combined with the other experiences i have had in life tend to seek solutions to problems along his line of thinking… “what does not kill you makes you stronger”… obviously at his age that does not necessarily apply but i worry that i am not doing enough, may have done something wrong or am missing an aspect of his care. I am worried about his eating and constipation which seemed to have cropped up at the same time. Yesterday was particularly bad, as he tried to have a bm all day but it wouldn’t come out… but then he was refusing to eat which didn’t help. I gave him a mild laxative and at some point during the night he managed to get it out… I assume, since his memory is spotty at best. But all the symptoms from the day before are gone… no stomach pain, no burning in the rectal region. This happened before but when i took him to the hospital and while waiting to be seen, he used the bathroom and everything was ok (we ended up going home without speaking to anyone as he had a scheduled checkup with his physician the following week).
is it time that i added a nurse to the staff? I am about to ad an elderly care trained person to the staff for him and am engaging a yoga instructor to come to the house regularly to work with him for about an hour daily. I also have planned to take him for short trips around the region visiting nice resorts etc…
any advice would be greatly appreciated.
P.s. He originally wanted me to put him in an elderly care home and leave him there (he has led a very very solitary life), but that went against my gut feelings… Should I have?
Dear Errol,
It sounds like you and your father have both enjoyed a pretty good quality of life the past couple of years. Kudos to you for actively engaging to help make that happen. It’s great that you have a good caretaker team and a doctor to see him every 2-3 months.
You mention noting a gradual decline in his condition over the last 7-8 months. I’m wondering what his doctor has to say about it. Is there any change in his heart function, such that he does not have the stamina he did before? Is it just his short-term memory that is affected, or is there a significant limitation now with his cognitive abilities? Is he clinically depressed? If his doctor has not had the opportunity to evaluate for these and other specific changes that can be treated, I encourage you to do so.
Regardless of the reasons for your father’s decline in well-being, now is a good time to look at a range of issues to determine his preferences and care going forward. Does your father have Advance Directives? If so, have they been reviewed and updated, if needed? Do you, his doctor, and caregivers know how to respond in the event of a sudden change in his condition or unresponsiveness?
Preferences are not just about end-of-life decisions; they are at the center of what you are now contemplating: potential travel, hiring a nurse, yoga instructor, etc. Asking an open-ended question about what he would find enjoyable and bring him pleasure, is a good starting place, to see what he identifies. If he is more limited in processing information and giving responses, you may just want to offer 2 choices and ask which he prefers. Another question, about what would bring him peace and contentment, may be worth exploring. Does he need to reminisce about important people and experiences in his life? Does he have regrets that are bothering him? Would he benefit from talking with a spiritual care provider? Are there spiritual practices that are easy to incorporate in his day that would be meaningful to him?
At least for now, while his energy level is lower, any activities will likely need to be based on what he can do without further compromise. So maybe 10-15 minutes is all he can tolerate at a given time. Perhaps 5 minutes of activity, 3-4 times a day would be helpful. Any plan needs to be tailored to him and where he is now (physically, mentally, emotionally). If his condition improves and he has more stamina and interest, the time intervals and range of activities can expand.
It’s not surprising that constipation would become a challenge as a result of decreased fluid intake, eating substantially less food, and relative physical inactivity. There are several dietary options that can help prevent and/or treat constipation. Specific management with occasional use of stool softeners and/or laxatives can be addressed with his doctor.
Adequate intake of water and other liquids is essential, though the specific amount needed is generally less for the elderly than at younger ages. Unless someone is on a medical fluid restriction, fluids need to be readily accessible. Sometimes elderly folks drink less to avoid trips to the bathroom or incontinence. Those with memory disorders may not realize that they haven’t had anything to drink for a while. With your father’s caregiving team, they can monitor fluid intake more closely and provide small amounts frequently (6-8 oz at a time). So anytime he eats or takes a pill, is an opportunity to drink a small glass or cup of fluid. Sometimes fruit-infused water (lemon or orange slices, berries, etc., in a pitcher or glass of water) can be tasty and refreshing. Adding food to the diet that naturally has a high water content (watermelon, cantaloupe, pineapple, strawberries, cucumber, tomatoes, broccoli, etc.) is yet another strategy. Coconut water may be enjoyable and tend to minimize constipation. Aloe vera juice can help with constipation, but may need to be mixed with fruit juice for palatability. Drinking a tea before bedtime such as Smooth Move® can be helpful for occasional irregularity; it contains organic senna leaf, an herbal laxative. For some people, coffee in the morning can be a stimulant to the GI tract, and result in a bowel movement.
When people significantly decrease their normal eating, they often end up eating primarily high fat and low fiber foods. In general, limit: red meats, fried foods, and processed foods. Protein and fats take longer to digest…resulting in slower transit time through the intestines. Calcium-containing dairy (cheese, ice cream) can be constipating.
Some foods that can help prevent and/or ease constipation include: fruits (such as berries, apples, pears, figs, prunes); vegetables (especially leafy greens); ancient grains; seeds (chia seeds, ground flaxseeds) and nuts; beans and legumes; and probiotic or fermented foods (kefir, sauerkraut, Kimchi, Kombucha, plain yogurt with live active cultures). High fiber foods need to be introduced slowly to prevent excess gas and bloating. If someone is already constipated, suddenly adding more fiber may make things temporarily worse…so use regularly in a preventative fashion.
A dried fruit mixture can be spread on bread products like a jam or added to food such as oatmeal, smoothies, and puddings. There are several recipes on the internet. The texture can vary from finely ground (food grinder) to a paste (food processor or blender), depending on the individual’s ability to chew and texture preference. While dried fruit has more calories and higher sugar content, it can be welcome dietary addition for people of all ages as a natural aid to bowel regularity. Typically the mixture contains pitted prunes, dates and/or figs, and seedless raisins. When I have made it, I included some ground dried apricots and cherries for additional flavor and tartness to counterbalance the sweetness. I personally avoid the recipes with added brown sugar. A little prune juice and/or orange juice can be used simmer chopped dates to soften enough before combining with other ingredients, or to thin the mixture to your desired consistency. Some recipes circulated include the addition of senna powder, leaves or tea. I would not include senna unless a health care provider who knows your particular situation recommends its use. A commercial product called Fruit-Eze™ (blend of prunes, raisins, dates) is a convenient option.
Errol, I encourage you to trust your gut feelings throughout your caregiving journey. I hope that one or more ideas from this response or from our readers helps you and your father.
Regards,
Pam
My dad is 95 and he has been on Hospice for little over a year. He has that dry cough ever so often, and I have a question. My dad had congested heart failure and he seems to be ok sorta. He makes these groaning moaning sounds when he get to the table to eat. I ask him is he’s in pain he says no, his stomach just feel full and he just cant eat. He will take maybe two bites, but that’s it, and its now got to where its more often, been three days now. I give him and some times he ask for chocolate milk and that’s the carnation breakfast drink. He will also go a week without taking a shower. He has no swelling and the nurse comes every Monday and she say he sounds good. I asked daddy if he wanted to go see a Gastroenterologists and he says no my stomach just feel weak. Or he’ll say it feels nervous. My step mom had a stroke two years ago and I have been taking care of her and my dad. She can walk and feed herself and that’s a blessing in it self. She seems to be ok she is 91. I do have help with her four hours in the morning. While I help my dad get dressed in the mornings. He can dress his self, but real slow. My dad has poor circulation in his feet bad, his feet feel numb, like their asleep he says. He sleep most of the day. Some times they go to bed at 7:00pm and we get them up every morning at 8:00am. They eat breakfast, dad says he just feels full and can’t eat. And around 9:30am he is in his chair with his electric throw and goes to sleep on and off all day. My question is, is this normal behavior for older people that have congestive heart failure? In 2000 he had five emergency bypasses. Any suggestions would be helpful. Thanks,
Sheryl Batchelor
Dear Sheryl,
Thanks for your comment. I’m glad that your father (and you) have hospice support. For him to be on hospice care for heart failure, he would be expected to have significant symptoms at rest and not be able to do even minimal physical activity without shortness of breath and/or chest pain. In addition to heart failure, he may also have other medical conditions that impact his health and well-being.
It’s hard to know what a “weak or nervous stomach” means to your father. So further clarification with his medical providers might be helpful to determine whether he has a specific condition that if identified and treated (or supported), would improve his ability to eat and get nourishment. You may ask his hospice nurse to have a registered dietitian make a home visit to assess him and consult with you. Based on that assessment, he or she can discuss findings and recommendations with the rest of his care team (including medical director). Another option may be to ask the hospice nurse to request a home visit by a physician or nurse practitioner to take a closer look at his condition.
It may be that his symptoms can be improved. So partnering with other members of the hospice team is an easily available option.
Kudos to you for all you are doing for both of your parents.
Peace & Blessings,
Pam
My mom is 94. Up till now she has had no food issues. Twice recently she has eaten a cold cut sandwich and gotten an upset stomach. During the most recent upset she vomited. Now she is very weak and is afraid to eat. I am giving her light healthy foods but do not feel this is,enough. I know she does not have the same appetite. Any suggestions of what I can make for her?
Dear Jan,
It is not surprising after two episodes of eating something and experiencing a stomach upset (including vomiting) that she would be afraid to try other foods. Did her symptoms completely go away after each episode? If she has any lingering nausea, pain, cramping, or change in bowel habits, checking in with her health care provider is important.
Deli meats can be contaminated with bacteria. Elderly folks or those with weakened immune systems are more vulnerable to getting sick as a result. Bread can also have mold than may not be noticed, particularly if she made a sandwich herself.
If she is otherwise free of digestive symptoms after these experiences, but remains nervous about eating food for fear of it happening again, here are some suggestions.
Include hand washing as part of her preparation for eating meals or snacks.
Select foods that are among her favorites, or familiar/comfort foods (even from years ago).
If she is open to prayer/praying before a meal, ask for the food to be blessed and that it only have beneficial effects on her health and well-being.
Small amounts of 2-3 foods (with different colors, aromas and textures) may be appealing to present together. For example, pudding/yogurt/ice cream with berries or banana slices. One egg prepared however she likes it (hard-boiled, poached, scrambled, etc.) and a mini-muffin or half an English muffin with a topping/spread that she likes.
Sitting at a table for meals whenever possible helps normalize it; there may be less association with thoughts of illness than a meal eaten in bed or in a bedroom. Making it enjoyable (i.e., a colorful placemat, playing background music, being able to look out a window, having a companion when possible, etc.) is another consideration.
Consider using nutrient dense supplements or shakes between meals; just a couple ounces is likely to be enough at once. Do a taste test for yourself; if you wouldn’t drink it, then she may not either. Serving it chilled is generally preferred; be sure to refrigerate after preparing, or opening the ready-to-use shake. Orgain® is a product worth considering; you can likely find it at a local store.
Good mouth care is important after meals.
I hope some of these ideas are helpful for you and your mom. I invite readers to share other suggestions.
Peace & Blessings,
Pam
If your mom still wears a bra, that can actually become stifling later on in the day and can cause an upset stomach. I think these upset stomach episodes require a doctor’s visit. Soups can have a lot of good things in them and be easier to consume, but a doctor should be the one to order a change in diet.
My own parent once went three weeks without eating. I was fortunate enough to get my parent to drink 3 ensures a day during that time. Then one day my parent vomitted and simultaneously had diarrhea. Then right after their appetite came back. I think I asked the doctor to change their heart medication back to what it used to be at the same time. So it could have been a virus, it could have been too much medication, or a combination of both.