Diet Issues

[Flo 54]

My mother who is 90 next month lives alone in an Assisted Living flat. Ever since my dad passed away, twelve and a half years ago, I have been responsible for her grocery shopping which I now do by a supermarket delivery service. The changes in what she asks me to order and what she eats are one of the things that alerted me to the possibility of dementia and she has just been diagnosed with Alzheimer's.
The only things that she actually asks for now are chocolates, biscuits and icecream. When I check her fridge I find all the healthy things, vegetables, salads etc. well past their sell-by dates and going off. She will heat a ready-meal in the microwave and eat it but has stopped making meals like she used to like casseroles and simple pasta dishes. She doesn't even make a sandwich any more and I find unused ham and cheese as well as bread and spread. I'm quite sure that she has been 'filling up' by replacing meals with the sweet things. There is Type 2 Diatbetes in the family and I am very aware that a healthy diet is important but she doesn't seem to be. Her doctors agree with me that the sweet foods should be limited but it is very hard for me. She begs me to order icecreams and biscuits and I have tried low sugar versions but she doesn't like them. The brands that she asks for are the high calorie ones. My brother says that if he takes her a box of chocolates she eats them all at once in an evening. She seems to have forgotten how to be sensible, a large packet of biscuits that used to last a week or more now only last a day or two. On one hand I want to please her but on the other I feel responsible for getting her to eat a healthy diet. Sorry for rambling but I would be very interested to hear if anyone else has these issues and any advice on dealing with them.

 

[Sarasa]

Until her eyesight got too bad my mother used to do her own on-line grocery shopping. When she couldn't see to do it, I took over and every other week she'd phone me up with an order. She usually had the same things so it was easy enough to do. At first she wrote things down, but over the last few years it got more and more vague 'I want some of that brown cereal'. Then the last few months it has become much more haphazard, but I still do one occasionally. She has one coming on Tuesday and what she wants hasn't changed at all. In between orders she buys random stuff and I have noticed that sweet things have become more usual. Mum is obsessed with not getting fat so this is a bit unusual for her, but I understand a love of sweet things is a comon trait among people with alzheimers. It does tend to mean that she'll have a scone while we're out while I'm having a sandwich for instance, and she probably has cake sometimes instead of a proper meal.
I try to check her fridge as she can't see used by dates. Last week I threw out four out of date tubs of a dairy spread. I said something like 'It looks like you forgot you had some in and bought some more'. Her excuse was that the neighbours put it there, but that's another story .
I only see mum once a week or so and she does tell me that she's eaten x, y or z. I think she is telling the truth about the ready meals, but any stories about cooking stuff from scratch I tend to discount.
I try not to get too worried about it. She is 90 and I don't think it will make a load of difference to her well-being one way or the other. I do worry that she's taken to having the odd glass of wine at home alone though. Wine does make her rather wobbly now.

 

[karaokePete]

The sense of taste is one of the things that is lost with dementia. The last of the ‘tastes’ to go will usually be sweet or sour so it’s common for this move towards sweet things to develop. Sometimes a reasonably healthy diet is maintained by moving to more fruit or fortified, but sweet, drinks and the like. My wife would also load up on sweet things if I wasn’t around to restrain her.

Cooking can simply become too complex a task as most of the duties of normal living fall away with the loss of cognitive function. This can be because things like recipes are forgotten or the ability to use appliances is lost. I would describe my wife as early stages dementia and I already have to assist and supervise when she tries to prepare meals.

 

[Beate]

Flo, she's 90. I cannot see that diabetes is her major concern right now. It's very typical for people with dementia to shift their appetite to sweet things. If that all she eats, humour her - at least she still eats. There comes a point with dementia where nutritional values don't matter that much anymore - what matters is that she eats. Her GP comes from a medical point of view but probably doesn't understand the realities of dementia so I'd be inclined to ignore all the nutritional wisdom and get her the food she craves now to make sure she doesn't lose the joy in eating.

 

[Kevinl]

She's 90 years old! does it really matter? I do think there's a point where all the healthy eating ceases to count for much and also count your blessings at least she is eating we have so many residents in care with my wife who refuse to eat and that's more of an issue from a health perspective.
My mum went off her food but there were certain things she'd always eat, any kind of soup and anything chicken based so I just made what I knew she'd eat, her relatively unhealthy diet wasn't an issue to me anyone making it to 90 has to be doing something right.
I know where your mum is coming from not wanting to cook anymore, I'm the same and I'm near 30 years younger then her. The whole process of peeling, chopping, cooking and worst of all washing up after is a pain. When the kids were at home I was cooking for 5 and it's hardly anymore difficult than cooking for one and I could make them do the washing up.
I used to enjoy cooking but now it's just another job like gardening that I used to like doing but now it's just become a chore.
K

 

[Distressed55]

Flo, she's 90. I cannot see that diabetes is her major concern right now. It's very typical for people with dementia to shift their appetite to sweet things. If that all she eats, humour her - at least she still eats. There comes a point with dementia where nutritional values don't matter that much anymore - what matters is that she eats. Her GP comes from a medical point of view but probably doesn't understand the realities of dementia so I'd be inclined to ignore all the nutritional wisdom and get her the food she craves now to make sure she doesn't lose the joy in eating.

I'm inclined to agree. I have the same issue with my dad. He's in a care home and doesn't want to eat the healthy stuff. He wants sweet things. So I've told the home to let him eat what he wants. I'd rather he was happy and kept a bit of weight on his bones rather than not eating at all. Three good months are better than three bad years, in my view. But my dad is further down the dementia road than your mum, and all of us here know how hard it is when this is all new.

 

[Szaitisja]

Would it also be worth asking GP to prescribe something like ensure? they are sweet but also have some nutritional value? Sometimes that's the only thing my friend would have during the day as getting her to eat and drink is difficult at times (she is 101)

 

[Flo 54]

I'm quite relieved to hear so many people giving me permission to let Mum eat what she wants. I wish that I didn't feel such a responsibility for her health. No one had told me before that the inclination towards sweet foods was common in Alzheimer's. This is all so new for me. Thank you all very much, I'll put some icecreams on the order this week.

 

[Flo 54]

Would it also be worth asking GP to prescribe something like ensure? they are sweet but also have some nutritional value? Sometimes that's the only thing my friend would have during the day as getting her to eat and drink is difficult at times (she is 101)

I'd never heard of Ensure so I just googled it. I also would not have thought to ask for it on prescription. Thank you.

 

[judyri]

Adding my voice to the "let her eat what she wants" vote.

Another thought is that urine infections can play havoc with sense of taste. My mother used to complain from time to time that she was being fed rancid food ... and I in turn would complain to providers ... only to twig eventually that this was a symptom and not an indictment of the quality of food she was getting.

 

[Duggies-girl]

I'm quite relieved to hear so many people giving me permission to let Mum eat what she wants. I wish that I didn't feel such a responsibility for her health. No one had told me before that the inclination towards sweet foods was common in Alzheimer's. This is all so new for me. Thank you all very much, I'll put some icecreams on the order this week.

I do the same, my dad has been living on ensure and meritine shakes since Christmas, approximately eight a day, I think his record was twelve. He only gets three a day on prescription so it has cost him a fair bit as they are expensive to buy but hey ho it's his money and he has not got a lot else to spend it on at the moment.

The last few weeks he seems to have gone off of the shakes a bit and I am lucky to get three down him as he seems to prefer smoothies at the moment which are ok but really they are just a lot of sugar but he seems to prefer them. I make sure that he has a scrambled egg for breakfast with added cream and butter and whatever small thing he has for dinner is followed up with a generous helping of ice cream with cream on top. Ice cream is of the full fat variety as is everything else.

Terrible diet but he has cancer as well as dementia so I am not too concerned about his cholesterol. He has actually put a bit of weight on.

 

[Szaitisja]

I'd never heard of Ensure so I just googled it. I also would not have thought to ask for it on prescription. Thank you.

I only know about it because my friend has been prescribed those for years and they have been really great some of the time. She also often wants only sweet things even tho i try with a healthy meal almost every day. It's a bit hit and miss at times.

 

[Jale]

I'm definitely with the "let her have what she wants" group. Mum went off her food a few weeks ago and all we could get to eat was shortbread, biscuits or cakes. She is currently in hospital and we noticed that she was having more difficulty chewing and swallowing, but she does manage sweet stuff - rice pud, jelly, ice cream and the occasional yoghurt.

I found it difficult at first because I was worried that she wouldn't get a good diet, and no it isn't, but it is better than nothing and that is what I have now accepted.

Good luck

 

[Linbrusco]

My Mum has Alzheimers and in care. Mum still goes for the sweet treats anyday. Her weight fluctuates and rhey have her on fortasip drinks.
Dad 80 still lives at home next door to me. He has cognitive impairment but is being reassesed tomorrow, for what we feel is frontal temporal dementia.
Now, Dad has always been a shocking eater and has been borderline Type 2 diabetic for over 10 yrs.
You wouldnt beleive it but my brother has moved in with Dad. He “supervises” , I am Dads carer, but my brother is also a Head Chef.
Dad will not touch food he cooks.
Its his way or no way.
No veges, no fruit. His diet consists of meat, bread, biscuits, lollies, coffee, tea & sugar!! Oh and cooking oil & marg!
I emailed our GP a year back saying that surely Dad must be lacking in vitamins!? Could he get scurvy, rickets ?? GP laughed and did nothing.
We cant get Dad to change his eating habits, so we leave him.
He can still cook at this stage ( not that we would eat it )

 

[Distressed55]

I'm quite relieved to hear so many people giving me permission to let Mum eat what she wants. I wish that I didn't feel such a responsibility for her health. No one had told me before that the inclination towards sweet foods was common in Alzheimer's. This is all so new for me. Thank you all very much, I'll put some icecreams on the order this week.

I know, the responsibility can feel quite overwhelming, and she is your mum and you love her, and it's only natural that you want to do what's best for her. But no one will criticise you for giving your mum what she wants to eat, given what she's going through. My dad seems to love Fortisips, which are milk based and laden with calories.

 

[Amy in the US]

@Flo 54, hello and welcome to Talking Point. I'm sorry you have needed to find your way here but hope you will find this a welcoming and helpful place.

I have been where you are with the not eating issues with a person with dementia (PWD), although not the diabetes aspect.

My mother lived alone with no support other than myself (and I lived at some distance and could only visit about once a week). I discovered due to weight loss noted by her doctor, and reports from friends and neighbours, that my mother was not eating properly. This was before her diagnosis and so I really didn't know what was going on.

She would often say she was "not hungry," that she would "eat later," or that she had "just eaten." She would talk about what she was going to shop for and prepare. What I did not understand at the time, was that this was the dementia talking. Although she was still going out to shop, she wasn't buying what she needed to eat. She wasn't capable of planning or preparing a meal. She was, in fact, no longer capable of even heating up a ready meal from the freezer. (I discovered all this from evidence in her home when we cleared it out.) She was mostly eating ice cream, sweets, biscuits, that sort of thing. And like your mother, because of the dementia, she couldn't "be sensible" and only eat a few biscuits or a small amount of ice cream, she'd eat the entire container! Reason, logic, and good decision making were lost earlier on for my poor mother.

When I would visit her, she would want to go out to eat, never to eat at home. At the restaurant, she would again say she wasn't hungry, but I soon learned to persuade her to order several items (by saying I was hungry and wanted a certain starter and so on), because the minute the food was in front of her, it would trigger her appetite and she would eat everything, because she was so hungry due to not eating.

I also noticed that she would eat only as long as someone was sitting directly across the table from her, and also eating. If I put my fork down for one second, even to take a drink of water, she would stop eating. She clearly needed both the company and the social reminder and the visual cues, to eat. She was somewhere in early to middle stage at that point. Three and a half years later, she still will only eat if someone else eats with her. The staff at her care home tell me this is not uncommon and their tables are arranged so she always has someone across from her.

I know more about dementia now and I am still not sure if the dementia was causing her to not feel hungry, or if it was her other issues (medication and health) that were interfering. Or both, or something else; it can be difficult to know.

I can understand your concern about the diabetes and her blood sugar levels, but I would have a frank (and private, not with your mother there) talk with the GP. There comes a point when calories trump nutrition. You may also be able to find some high calorie foods with less sugar in them, that she will enjoy eating (soups with double cream added, full fat yogurt, maybe some comfort foods or childhood favourites?). Here in the States we can often get an appointment with a nutritionist to help advise but I am not sure if that's available where you are.

The liking for sweets is common with dementia, something to do with how tastes change.

There is some good information here: https://www.alzheimers.org.uk/get-support/daily-living/eating-drinking

In fact, there is a lot of good general information about dementia and various issues on the Alzheimer's UK website. You might have a look around when you get a chance.

The fortified drinks like Ensure can be a good way to get calories and some nutrition in. You may even be able to get them on prescription, to help with costs.

My mother also will lose her appetite (for anything except ice cream, and sometimes even that) when she has an infection or is unwell in any way. Just something to be aware of. And as you probably know, infections, especially UTIs (urinary tract infections) are very common in our PWDs.

Sometimes there are other problems that prevent eating, like a dental issue, sores or pain in the mouth, dentures that don't fit or hurt, or a swallow issue. If you notice problems with swallow I would ask for a referral to the SALT (speech and language therapy, I think) team, as they are the ones who diagnose and treat that issue. The swallowing problem is also courtesy of dementia, I am sorry to say.

I am sorry for the very long reply and personal digression. I hope you can find a solution and feel more reassured about your mother. Very best wishes.

 

[Amy in the US]

@Linbrusco, my mother was SO deficient in Vitamin D (partly due to a medical issue other than the dementia, but still) that yes, she almost got to the point where she would have gotten rickets. It's not an unreasonable question!!

 

[Angela57]

Flo, she's 90. I cannot see that diabetes is her major concern right now. It's very typical for people with dementia to shift their appetite to sweet things. If that all she eats, humour her - at least she still eats. There comes a point with dementia where nutritional values don't matter that much anymore - what matters is that she eats. Her GP comes from a medical point of view but probably doesn't understand the realities of dementia so I'd be inclined to ignore all the nutritional wisdom and get her the food she craves now to make sure she doesn't lose the joy in eating.

I agree with Beate, at least your mum is eating and still enjoying what she chooses to eat. That would be a blessing for me because my dad is wasting away because he eats so little, and he's only 86.

 

[jknight]

I do the same, my dad has been living on ensure and meritine shakes since Christmas, approximately eight a day, I think his record was twelve. He only gets three a day on prescription so it has cost him a fair bit as they are expensive to buy but hey ho it's his money and he has not got a lot else to spend it on at the moment.

The last few weeks he seems to have gone off of the shakes a bit and I am lucky to get three down him as he seems to prefer smoothies at the moment which are ok but really they are just a lot of sugar but he seems to prefer them. I make sure that he has a scrambled egg for breakfast with added cream and butter and whatever small thing he has for dinner is followed up with a generous helping of ice cream with cream on top. Ice cream is of the full fat variety as is everything else.

Terrible diet but he has cancer as well as dementia so I am not too concerned about his cholesterol. He has actually put a bit of weight on.

Well done, you!