not eating

[parmit]

Can anyone help me. My mother has vascular dementia and has been home from hospital for about 3 weeks, after a two week stay. She was hospitalised after a fall causing her to cut her head badly. They took her off haloperidol, (which we have since had re instated) but she now does not want to eat. Before she went into hospital she would eat anything and everything, Her appitate has dimished since she came home and in the last 24 hours we have not been able to get her to eat anything and all she has drunk is one glass of orange squash. She has lost 11.5Lbs in weight since coming home.
We have tried all her favourate foods and all sorts of ways to try to encourage her to eat, but to no avail.

 

[Bookworm]

She sounds almost obstinate - in the midst of such caring - offering all sorts.....thus my first thought is - could she be depressed - does she appear to be on "hunger strike"?

Second thought - has she got nausea/abdominal discomfort due to constipation??

 

[parmit]

Bookworm, she does not appear to be depressed or in pain and is not constipated, but she doesn't seem interested in eating. I tried to give her some readybrek this morning, her normal breakfast, but she just closed her eyes and fell back to sleep. She doesn't even want to eat chocolate or ice cream.I hate to say it, but she appears to have given up.

 

[Bookworm]

but she appears to have given up.

Call me Sue!

I thought that you thought that - you must rule out other causes though - if she is very dopey & wants to sleep all the time, the docs will want to check bloods for e.g. low thyroid, anaemia, other problems e.g. kidneys not working right. She must be very dehydrated too - sounds like home visit asap - no later than tomorrow - but the other thing - you've maybe been here long enough to hear the big issue - is underlying infection that she cannot perceive or tell you about e.g. urine infection - if in doubt get someone in today - this is not going to improve without help - & if it is not going to improve then at least you can get advice....wishing you strength for this difficult time. Worsening like this needs checked - then if nothing can be done you have a clear conscience (which you will find important in grieving if worst comes to worst...- sorry to be frank but maybe it needs said) with regard to yourself, your mum & other siblings etc, x

P.S. Maybe she has has a mini stroke? Again this is reason for GP to visit

 

[parmit]

Sue
She came home from hospital with a chest infection which cleared up with penicillin and has had a urine check last week which was clear. Her GP saw her last monday and wants to see her every 2 weeks, but I will be taking her or asking for a home visit tomorrow if there is no improvement.
She went to the day centre on thursday friday and saturday and they could not get her to eat much either.

 

[Bookworm]

Good for you - re GP - you are her advocate, her voice.

Possibly even a toothache or badly fitting dentures? Or maybe as you say - she has just decided its enough - which is very hard for you, I'm sure you are very sad & stressed about it.

((((Parmit)))

 

[parmit]

Sue
Sad and stressed yep, but if she has decided it is time to go, then I will let her go peacefully, She has deteriorated so much in the last 3 months, from someone who lived in her own flat, to someone who doesn't speak, needs someone to wash, dress her and see to all her personal hygiene. She was shuffling round with a frame until yesterday, but now does not want to even move. She is doubly incontinate.

I didn't realise quite how much she has gone down hill until I looked back to how she used to be. She was so independant, always looking after someone else, and now it's her turn I don't think she can accept it.

Pauline

 

[mad mel]

Hi Pauline
Sorry if I am stating the obvious,but can your Mum still feed herself.With my Mum her decline was rapid,one day she could walk upstairs with support,the next not even stand.She left her breakfast uneaten and then lunch and I realised she no longer knew how to eat.Mum was reluctant for me to feed her but once I made it clear she would die if she did not eat and she said she did not want to,then she let me feed her.Can your G.P presc
ibe high protein shakes?
Mel

 

[Canadian Joanne]

They took her off haloperidol, (which we have since had re instated) but she now does not want to eat.

May I ask why you had the haloperidol reinstated? It is an antipsychotic normally used for schizophrenics and used off-label (meaning not for which it was developed) for behavioural problems. It can also make a person extremely lethargic and drowsy. It did that to my mother, without affecting her bad moods at all. She was still angry and violent, but in slow motion.

Perhaps if the haloperidol is discontinued your mother may regain her appetite. I think you should ask the doctors why they wanted to discontinue the med. It is an old-fashioned drug with a lot of potential side effects. There are newer, better ones which you can investigate.

 

[parmit]

Joanne
mum was taken off haloperidol because they said that in the long term they can cause falls, At 83 she has not got long term and she has suffered falls for at least 2 years, due to her blood preasure dropping when she stands up. She had only been on it for about 8 weeks and the mental health team had agreed that this was the best medication for her. Before she was on it she spent 21 hours out of 24 pacing up and down. They tried several different drugs before settling on haloperidol.

 

[Margarita]

Before she was on it she spent 21 hours out of 24 pacing up and down. They tried several different drugs before settling on haloperidol.

How many milligrams is your mother taking, how many time a day is your mother taking it ?


My mother was not on those kinds of medication, but did go through a stage of not wanting to eat or drink, would only eat smell bit of food, drink only a little . Then mum started eating normally . That happen after mum had a fall . It did set mum back a bit .

If your mother not eating anything at all. or drinking anything at " all " in the next 24 hours. Ring the doctor tell him what is happing about your mother not wanting to eat or drink "Anything" .

 

[parmit]

Margarita
Mum is on 500 micrograms twice a day. She has eaten a little bit of rice pudding at lunch time a has had a couple of half cups of tea. She has got an appointment with her GP in the morningI could have got one today with another doctor, but would rather her see her usual GP who has seen her every 2 weeks for the last 6 months.
Will let you know more tomorrow.

 

[Tarika]

Just a thought- when you see your GP consider having an assessment done by a Speech and Language therapist. Sometimes a person's swallow can be affected in dementia and also they can forget how to chew. This happened to my mum who wouldn't eat or drink very much for months. After being assessed she was put onto pureed food and thin fluids. On a good day she will clear her plate and drink loads of liquid.

Love Tarika

 

[Libby]

HI Parmit

My mum also went through a stage of not eating - like Margarita's mum, it was after a fall. I thought she'd somehow decided that enough was enough, but gradually, her appetite picked up again.

Do you know how much weight she's lost?

Libs

 

[Margarita]

Margarita
Mum is on 500 micrograms twice a day.

Now that does sound like a high dose to knock anyone out, with a dementia or not .

I have taken only 2micrograms of different kind of medication of anti-psychotic drug, it feel like I am in a different planet in my mind it make me feel tried all the time, and just want to sleep . That I stop taking it . Just after few days . They are really such a powerful strong drug, let alone 500mg .

It can also make a person extremely lethargic and drowsy.

I know that the side effect of haloperidol medication is weight gain, but then with your mother dementia, like Joanne says haloperidol can make one feel lethargic and drowsy anyway it must also take your mother motivation away to eat , because I don’t know how far your mother is in with her dementia and from my own experience of mum dementia if I never got mum up in to a routine of eating stranding next to her to eat ,encouraging mum to eat , mum would of never brother to eat at all . My mother never took any type of anti-psychotic drug to make mum like that , it was just a symptom of her dementia.

I am no doctor; please talk to doctor about your mother motivation with not wanting to eat with such a high doses of haloperidol, but then your in a catch 22 because the dementia can progress so much that the person does not want to eat, but even one different I know.

Is your mother very challenging towards you when awake waking up down all the time?

You Could just ask doctor to try to lower the dose of haloperidol for few weeks or so, see how your mother motivation to eat improve or not in staying wanting to stay awake for 2 weeks . as your going to your mother doctor regularly he can monitor the eating to see if it improves with a lower dose haloperidol.

Sorry have not read your past post , but am wondering do you care for your mother full time with the help of day care ?

 

[alfjess]

Sue
She has deteriorated so much in the last 3 months, from someone who lived in her own flat, to someone who doesn't speak, needs someone to wash, dress her and see to all her personal hygiene. She was shuffling round with a frame until yesterday, but now does not want to even move. She is doubly incontinate.

I didn't realise quite how much she has gone down hill until I looked back to how she used to be. She was so independant, always looking after someone else, and now it's her turn I don't think she can accept it.

Pauline

Hi there
How long has your Mum been prescribed Haloperidol?

Does it coincide with Mum's deterioration?

Haloperidol is not a good drug for some dementia sufferers.

In my experience with my Mum in hospital assessment ward with haloperidol, made Mum incontinent, side effects was she had parkinsonism shakes and stoop. Eventually she was comatose. Possiby other drugs were involved, but I think haloperidol did most damage

On entry to care home, the nursing manager said we will get her of Haloperidol as soon as we can.

They did and she improved, so much that, she walked the corridors all day, without a stoop

I really don't want to frighten you, just make you aware, so you can be on your guard about the various and amount of drugs that can be given to dementia sufferers.

Alfjess

 

[parmit]

Took mum to doctor today and no UTI. She said it is another stage in her dementia. Her brain is not getting the right signals, ie it is not telling her she is hungry/that she is full up. She has prescribed ensure drinks so she gets all her vitimins etc. She is sleeping a lot because she is not eating therefore not getting any energy. Will see how it goes.

 

[lin1]

big hug for u Parmit. I know this is a very difficult time for u. The only advice I can give is offer small amounts ie one or two spoonfulls of her favourite food every couple of hours, maybe best 2 puree it. if she will take soup u can get a food/drink thickener called Thick & easy it's tasteless (from chemist or prescription)

 

[ella24]

Hi Parmit

you can also get Complan/nutren (similar to ensure/fortisip) in a variety of flavours, including coffee and chocolate flavours that make a passable hoc choc/coffee that maybe you could encourage at the same time as you would be having a cuppa?

We used Ensure as a sort of 'pour-over' like cream, over fruit, and that worked too. You can also use it in custard etc - I found this recently which has some ideas too http://www.christie.nhs.uk/patients/booklets/text/nutritional/default.aspx (was written for cancer patients but very good information in it)and this http://www.christie.nhs.uk/patients/booklets/text/advice/default.aspx

I have had to have liquid diets due to surgery, and even having slimfast (which is a meal replacement) will work (it is very similar to ensure in constituion) - and can vouch for the liquid drinks - you can even freeze them into lollies!!

other idea - tinned fruit purreed (like peaches) is quite nice, sweet and has a good strong flavour, especially if taste buds need some waking up

good luck

e

 

[Margarita]

She is sleeping a lot because she is not eating therefore not getting any energy. Will see how it goes.

Doctor made good point there , because also not drinking enough water can make one have less energy.

My mother ended up so dehydrated at one stage, that she had a fall, bang her head really hard on to the floor had to go to hospital .

After Many From tests even a brain scan as mum started to vomit so they done the brain scan, but it was all clear.

Then when they done a simple urine test after not finding any urine infection. It was all down to dehydration.
As one of the many symptoms of dehydration is vomiting, feeling sleepy , dizzy .