Problems with over eating

[Ann Mac]

Mils appetite and attitude towards food is now becomming a bit of a problem. When she moved in, she had lost a lot of weight, due to an inability to prepare food, and a determination not to accept our ideas of help, which had included providing both ready meals, and home cooked and then frozen meals. The weight loss was a good thing - her breathing (she has COPD and asthma) had improved - but, her diabetes wasn't too good and she was anemic, and her appetite was really poor. It took a couple of months, but eventually we established a routine of 3 sensible meals a day, and increased her fluids - her breathing remained good, her diabetes improved, the anemia was sorted and for a long while, her weight stayed stable.

Over the last few months she has become quite 'fixated' on food, however. From starting to get the munchies whenever she is agitated, and often insisting on 2 or 3 breakfasts, she is now extremely greedy with all food - especially sweet stuff. At family meals, I plate up food in the kitchen and carry it through to the table - if she isnt served first, she often is very rude and cross - if she is served first, she dives in and starts bolting before anyone else has their meal. The sight and sound is not nice, she will use fingers to get the food to her mouth quicker and - the worrying part - in the last week alone, she has started to choke 3 times, because she is eating such large mouthfuls so quickly - and each time, she continued to try and put more food into her mouth as she was coughing!. She can finish a meal, and be asking for food again within minutes - and when you explain that she has just eaten, she sulks and strops and you get comments about 'begrudging' her a 'bite to eat'.

She will 'sneak' food, if she can - often find pockets and her handbag (and even her bra) filled with sweet wrappers, half eaten biscuits, fruit - even half a sandwich in her coat pocket the other day, which she must have lifted in day care. She tries to say that any treats she sees the kids or us with are most definitely hers - Christmas day, she was furious when within minutes of me unwrapping a gift of chocolates from a friend, I refused to hand them over in response to her insisting they were hers. She got quite nasty, and verbally abusive with me again the next day, when she spotted the box and went to help herself - I know she would have ate the lot - and I stopped her. A couple of days ago, I made her, my daughter and myself sandwiches for lunch, and the phone rang just as we sat. By the time I'd dealt with the call she had finished hers and she repeatedly asked me to give her 'a bite' of mine, as I tried to eat, getting more and more demanding and cross each time I refused - she even cried

Part of me thinks to hell with it - dementia has taken so much, let her enjoy what she wants to eat - but the weight she has gained (about a stone over the last 6 weeks) has already impacted on her breathing and mobility, and is causing her distress and discomfort, and that I don't want.

I've cut portion size, and am saying no and trying to distract, but what else can I do? Not only about the fixation on wanting to eat all the time, but about dealing with the rudeness and crossness? Has anyone got any tips? Especially for how to approach this with day care, because I'm pretty sure that she is eating absolute masses there - biscuits and cakes seem to be on offer several times a day, she has a two course lunch, and I recently found out that she is getting toast at around 10a.m., and then sandwiches at 4! She would be very offended and upset if she didn't eat with us, and I'm pretty sure that a low cal alternative to what everyone else is eating would also not go down well!

 

[WILLIAMR]

Mils appetite and attitude towards food is now becomming a bit of a problem. When she moved in, she had lost a lot of weight, due to an inability to prepare food, and a determination not to accept our ideas of help, which had included providing both ready meals, and home cooked and then frozen meals. The weight loss was a good thing - her breathing (she has COPD and asthma) had improved - but, her diabetes wasn't too good and she was anemic, and her appetite was really poor. It took a couple of months, but eventually we established a routine of 3 sensible meals a day, and increased her fluids - her breathing remained good, her diabetes improved, the anemia was sorted and for a long while, her weight stayed stable.

Over the last few months she has become quite 'fixated' on food, however. From starting to get the munchies whenever she is agitated, and often insisting on 2 or 3 breakfasts, she is now extremely greedy with all food - especially sweet stuff. At family meals, I plate up food in the kitchen and carry it through to the table - if she isnt served first, she often is very rude and cross - if she is served first, she dives in and starts bolting before anyone else has their meal. The sight and sound is not nice, she will use fingers to get the food to her mouth quicker and - the worrying part - in the last week alone, she has started to choke 3 times, because she is eating such large mouthfuls so quickly - and each time, she continued to try and put more food into her mouth as she was coughing!. She can finish a meal, and be asking for food again within minutes - and when you explain that she has just eaten, she sulks and strops and you get comments about 'begrudging' her a 'bite to eat'.

She will 'sneak' food, if she can - often find pockets and her handbag (and even her bra) filled with sweet wrappers, half eaten biscuits, fruit - even half a sandwich in her coat pocket the other day, which she must have lifted in day care. She tries to say that any treats she sees the kids or us with are most definitely hers - Christmas day, she was furious when within minutes of me unwrapping a gift of chocolates from a friend, I refused to hand them over in response to her insisting they were hers. She got quite nasty, and verbally abusive with me again the next day, when she spotted the box and went to help herself - I know she would have ate the lot - and I stopped her. A couple of days ago, I made her, my daughter and myself sandwiches for lunch, and the phone rang just as we sat. By the time I'd dealt with the call she had finished hers and she repeatedly asked me to give her 'a bite' of mine, as I tried to eat, getting more and more demanding and cross each time I refused - she even cried

Part of me thinks to hell with it - dementia has taken so much, let her enjoy what she wants to eat - but the weight she has gained (about a stone over the last 6 weeks) has already impacted on her breathing and mobility, and is causing her distress and discomfort, and that I don't want.

I've cut portion size, and am saying no and trying to distract, but what else can I do? Not only about the fixation on wanting to eat all the time, but about dealing with the rudeness and crossness? Has anyone got any tips? Especially for how to approach this with day care, because I'm pretty sure that she is eating absolute masses there - biscuits and cakes seem to be on offer several times a day, she has a two course lunch, and I recently found out that she is getting toast at around 10a.m., and then sandwiches at 4! She would be very offended and upset if she didn't eat with us, and I'm pretty sure that a low cal alternative to what everyone else is eating would also not go down well!

Hi Ann Mac

When my step mother went in to care she only lasted a week.
When we visited she always complained the care home was not feeding her.
Every morning she eat at least 2 full breakfasts, a large lunch.
We always took her something like a Cornish Pastie and on 3 occasions eat that and then complained we had not taken her anything.
Just after lunch we caught her eating another residents chocolates. We think she eat half the box.
Of course they had to be ones which could not be replaced as they had been bought from Switzerland.
All we could do is buy that resident some good quality chocolates available locally.
Just after we left she stole the nurse's Mars bar.
Later we had a call saying she was being taken to hospital. Sadly she died later that day.
All we could say she was well fed for her journey to the Pearly Gates.

William

 

[CeliaW]

That's a tough one Ann - my only thought would be to give her a big mug of low cal squash or similar, (to fill her up - as you do when dieting) that she could drink whilst you were preparing the meal. One slightly unpleasant thought is whether she has worms? I know it's more likely to be as a result of her dementia but thought worth a mention.

 

[Witzend]

Not sure what you can do without a lot more hassle and ructions than you've already got, which is usually more than enough by the sounds of it.

If it were me I think I would think, well, it it affects her health then so be it - is it worth endless, wearying arguments and moods? Is it better to be healthier but feeling hungry and cross and miserable all the time, or less healthy, fat and happy? (Or at least not cross and miserable because you're feeling hungry).

Not saying I know the answer, or even that there is a right one in the dementia-circs!

 

[Ann Mac]

Mil sometimes swears that she hasn't had a 'thing to eat' for hours/days, William - but equally, she can acknowledge that she has just eaten, and insist that she is still hungry She will even say 'Its just that I am greedy' As is often the case with dementia, I can explain why its bad for her to have so much, remind her about the diabetes and her chest problems, she can agree and 30 seconds later, still ask for more food.

Celia, I've tried a drink and even fruit offered when she says she is hungry - it seems to make no difference. I have to help her wash her bottom area most days - she isn't using loo paper, from what I can tell - and she often forgets to flush too, so I think I would notice signs of worms - but I will keep it in mind.

Witzend, thats the view point I swither over! I find myself thinking that she has little enough to be happy over, dementia has made it that contentment is pretty much an impossible state for her, so why not? But then I hear her puffing and panting at the top of the stairs, and getting weepy because she doesn't like the feeling of being breathless; or I am helping her wash, and I see that the creases under her ever growing tum are chaffing (despite daily washing, drying and cream being applied) and I second guess myself.

Pre-dementia, she always had a sweet tooth and a big appetite, and we also went through a phase, when she had the ability, after diagnosis - where she would order a taxi to a local supemarket, and spend a small fortune on chocolate, trifle, ice cream, cakes, etc - she ballooned to a size 22 at that point, as she was also the ice cream vans best customer! I don't know whether she can't recognise she is full/had enough, or whether its some sort of obsession with her. I do know that aside from sundowning, the refusal of demands for food is the most likely thing to set her into a really awful mood at the moment

 

[alypaly]

My Mum is exactly the same. She eats jam sandwiches all day and if you try to stop her she sneaks a pile of them into her bedroom - which I find later on stale and even more horrible. I've tried not buying jam but she just uses anything she can find - pataks paste, lazy garlic anything! I've tried hiding the bread but she just goes round the streets begging for bread and I get complaints from the neighbours who think I am starving her.

Now I have decided its just not worth the hassle as she gets upset if I confront her and I get cross. I worry about her putting on weight but at least she is content. I do wonder if its the Aricept that is making her like this as a couple of times when she has missed a dose she seems to be less hungry.
Sorry I haven't got a solution but its good to know that I am not the only one with this problem.

 

[Onlyme]

I thought loss of appetite was a side effect due to nausea.

 

[CeliaW]

Ann, reading your post made me curious (Mum has the opposite - loss of interest in food) and I wondered how her diabetes is treated? I have been reading about glucophage (Metformin) in treatment for hyperphagia and the connections between diabetes / insulin uptake etc and dementia so maybe a specialist or Diabetes UK could advise?

 

[Izzy]

Hi Ann

My husband's appetite has increased dramatically as his dementia has progressed. He was always a very polite eater who chewed his food heaps of times before swallowing. Being slightly less genteel myself I was always finished a meal before him. He also had quite a small appetite and very rarely cleared his plate. He especially was keen on vegetables like broccoli. Now he is the exact opposite he clears everything on his plate and I think would attempt to eat the pattern on the plate if one existed. He eats all vegetables, even those he wouldn't eat before. If I left a whole packet of biscuits out in front of him he would finish them pretty quickly. He has diabetes which has been fairly recently diagnosed but it is diet controlled, no insulin.

In some ways it's reasonably easy for me as he doesn't (can't) prepare any food. He eats what he is given and really doesn't have access to any more. He also doesn't complain that he hasn't been fed.

He does bolt his food as well now. He will have a mouth full of food and still be trying to stuff another forkful in. When I was away overnight recently and one of our carers was staying with him in our house he choked on a brussels sprout! She got quite a fright. She sorted him out and before she could blink he was back trying to finish the food on the plate. I find that he does this more when he is unwell through an infection.

Sorry, I haven't been of much help. It was just that there seemed to be lot of similarities with my husband. The difference is, I suppose, that I can distract him and he doesn't get nasty or cross or anything. I have told our day centre that he shouldn't get chocolate biscuits and they keep plain tea biscuits for him. I don't know how many of these he gets through though!

 

[Deputypink]

My dad goes through periods when he will eat and eat and eat . The community nurse has said that when the patients are trying to use their brains and are finding it hard to make sense of what is happening - some sufferers will eat more to try and get the energy to make sense of life ?? But who knows if that is correct!

 

[Grace L]

My husband had this food stage (stage went on for ages though), where he would bolt food,
and no matter what I gave him, it was never enough.

He was always served first, and would shove most food in as quickly as he could, even piping HOT food.
As soon as (even before) he had finished he would ask for more, and if I 'was going to eat that' on my plate.
Often he would try and grab food off my plate, which I did my best to ignore and I would stand up and move away.
It was a bit relentless, and did not make preparing and eating food pleasant, as I was always anticipating his reactions.

He was like this with company, or we were alone.... eating out / in ... anywhere.
One of the reasons we stopped eating a full meal out was his behaviour.

As he had had a stroke, he mostly ate with one piece of cutlery, but in the rush to get food in, he would often use his hand, and it was a lot like a baby eating with its fingers and palm. Not finger food but any foods.
Sometimes the food would go in so fast , but he would forget to chew, until his mouth was bursting, where he would spit it out.... or choke.

The stroke Doc said the part of his brain that controls appetite was affected.
He used to eat so fast that at times his colour would change, and would go red-faced.

I tried all kinds of 'little tricks' , to stop this bolting food ... sometimes I gave him a small banana before we were due to eat ... to fill him up beforehand.
He could eat a full roast , but less then an hour later would be asking when lunch/dinner was.

Psychologist said.... don't tidy, or clean kitchen, see if the visual clues helped him believed he had been fed.
Husband told SW he was always hungry, SW told me to feed him more !!
(SW and I disagreed on so many things ).

It did get a little better when he went on medication (anti-psychotics) , but if there was something remotely sweet it triggered some kind of out of control anger.... extra greedy.

I tried to monitor his weight, as he had fibrosis (lungs), sleep apnoea (not that overweight).
As he could not walk any distances due to strokes (VaD) , it was important to keep weight in check.

I sometimes gave him a small bowl of homemade soup (1 piece of bread) to fill him up before the main meal.

I hope this food stage passes for you soon.

 

[Spamar]

Just curious about this whole eating thing. OH Has always had a fleeting appetite ( usually hungry on the day I wasn't pre-dementia). Nowadays, his appetite is small. He used to say, but I don't need much food, I'm not doing anything, so he would get reminded that you need enough calories to survive!
A few years ago he went to 7 stone from his normal ten and a half and it took all my efforts and quite a lot of time to get him to put back that weight. He now says his stomach is full and he can't eat any more or would be sick! I, on the other hand, rarely feel full and could nibble all day. In these days of stress need to get out of that habit.
What I really meant to say, do people regress to what they were? Do big eaters still eat a lot or small eaters not bother with food?
I have no help for you Ann, opposite problem!

 

[pippop1]

Sugar free jelly, which you can buy ready made in pots as well as in the more traditional form, is quite filling and v low in calories.

10cal for a pot (like a good sized yoghurt pot). I use it when I am dieting and it's v sweet but made with artificial sweetner sugar. It's also in very bright colours, although maybe it's not the easiest thing to eat nicely!

 

[ASH74]

FIL had the jam sandwich phase ......every 2 hours day and night! He was anaemic at the time and the Jam sandwich obsession improved with his Hb. Since he has been on memantine his appetite has really normalised.

He had lost weight too before we were allowed to "help" GP gave him fortisip/ensure drinks and puddings ....at least it was healthier. He is so food obsessed he tried to eat son's madras curry. FIL hates curry so gawd knows what would have happened if son had let him!




Sent from my iPhone using Talking Point

 

[Sue J]

Bad phases I need to eat loads it is really as if no energy is being processed inmy brain at all, try to compensate and keep lucozade indoors as don't want to get overweight, thankfully never have been but really should be now the amount I eat, but I'm not. Makes not a blind bit of difference to 'know' that I have already just eaten, when in a bad phase, time makes no sense at all then.

 

[WILLIAMR]

Mil sometimes swears that she hasn't had a 'thing to eat' for hours/days, William - but equally, she can acknowledge that she has just eaten, and insist that she is still hungry She will even say 'Its just that I am greedy' As is often the case with dementia, I can explain why its bad for her to have so much, remind her about the diabetes and her chest problems, she can agree and 30 seconds later, still ask for more food.

Celia, I've tried a drink and even fruit offered when she says she is hungry - it seems to make no difference. I have to help her wash her bottom area most days - she isn't using loo paper, from what I can tell - and she often forgets to flush too, so I think I would notice signs of worms - but I will keep it in mind.

Witzend, thats the view point I swither over! I find myself thinking that she has little enough to be happy over, dementia has made it that contentment is pretty much an impossible state for her, so why not? But then I hear her puffing and panting at the top of the stairs, and getting weepy because she doesn't like the feeling of being breathless; or I am helping her wash, and I see that the creases under her ever growing tum are chaffing (despite daily washing, drying and cream being applied) and I second guess myself.

Pre-dementia, she always had a sweet tooth and a big appetite, and we also went through a phase, when she had the ability, after diagnosis - where she would order a taxi to a local supemarket, and spend a small fortune on chocolate, trifle, ice cream, cakes, etc - she ballooned to a size 22 at that point, as she was also the ice cream vans best customer! I don't know whether she can't recognise she is full/had enough, or whether its some sort of obsession with her. I do know that aside from sundowning, the refusal of demands for food is the most likely thing to set her into a really awful mood at the moment

Hello Ann Mac

People may not like me saying this but people with dementia tend to have very limited life left.
When my step mother was in care we asked if the food she was eating was ok for her.
The nurse replied probably not but she has only limited life left so let her enjoy herself as best as possible and let her do what she wants.
We had to agree with this advice but I will leave you to do as you think fit.


William

 

[SoyHJ]

My OH is termed as being at early stage/mild Alzheimers. Though he never had a particularly sweet tooth, recently I've noticed that he's forever picking at sweet things which disappear at an alarming rate. He says he may have had one or two.....(!) but denies eating it all. If I don't buy sweet things then when he goes out he buys stuff himself. I wouldn't say he's eating way in excess but still far too much to be good for him.

Something else which has recently surfaced too. In the past, if I was a bit heavy handed with the salt when I cooked something he'd immediately notice and comment, in fact it had become a bit of a standing joke. Lately if I've overdone the salt he doesn't say a thing, just wolfs the meal down saying how good it is. He no longer seems to notice if I've overdone it (a failing of mine!). Also he'll often add extra salt to his meal at the table as a matter of course, something which he never did in the past.

 

[CeliaW]

William, as I read it, Ann's concern is as much about how this affects her MiL's other health problems. I agree if it has no impact on health issues such as lung / heart or Diabetes problems, then the pleasure / fulfilling the need hopefully outweighs normal concern over general health.

 

[WILLIAMR]

William, as I read it, Ann's concern is as much about how this affects her MiL's other health problems. I agree if it has no impact on health issues such as lung / heart or Diabetes problems, then the pleasure / fulfilling the need hopefully outweighs normal concern over general health.

Hi Celia

You are correct.
An example at the care home was a gent who was diabetic and he was eating a large bar of chocolate a day which was not good from the diabetic point of view.
He was only expected to live for a few weeks.
How he managed to live for nearly a year after that nobody knows.
I think it was correct letting him have the chocolate but I will not argue with anybody who disagrees with this.

William

 

[CeliaW]

Apologies, I think my comment was misleading, I should have said "if there are no health issues such as lung / heart or diabetes that it could adversely impact on, etc...."