Mum's weight is now 5.5 stone

[gillybean]

What on earth can I make her eat to get weight on?
I have encouraged her to use full fat everything, but I suspect she's just not eating at all some days looking at what I throw away in her fridge. The GP knows she is frail and has given her shake drinks but these are supplements for vitamins not really for putting weight on.
She told me she never feels hungry these days so obviously isn't prompted, I call her each day and ask what she's eaten, like a broken record. Then I go round to find the ready meals are too much and half is left in the fridge so she's eating minute amounts, her stomach must have shrunk so much. I fear if she gets ill then there is nothing about her to fight it.
She has lost a further half stone since last September, has previously had scans ets now the consultant is checking for other issues i.e hyper thyroid, diabetes etc in bloodwork done Tuesday.
Any ideas what I can do?

 

[stanleypj]

I can understand your worry. As things stand, it would appear that the situation can only get worse.

Her eating needs daily supervision if she is to stop losing weight and, of course, in the longer term she must get some weight back on.

If it's not practical for you or another family member to visit a couple of times a day, say, to encourage and prod her into eating, perhaps you need to see if you can arrange for care workers to call and stay long enough to see that she has eaten.

My experience, and what I have read, tell me that this is a crucial matter and, unless she absolutely refuses to eat, every effort must be made.

To put it bluntly, it's about eating to survive, as I think you have recognised in your post.

 

[Perdita]

Hi Gillybean,

Sorry to hear about your mum. A couple of years ago my mum was in a similar situation and I was in despair about what to do, she was almost skeletal.

Is there any way you could eat a meal with your mum when you go to visit? Even if it's only a few times a week it may encourage her to eat a little better.

I have posted previously on here that my mum has gained no end of weight since being on the assisted feeding table at the care home. I know it doesn't help you in your situation but I think not eating alone has helped her no end.

 

[cragmaid]

I learned that it was no good asking Mum what she'd eaten. Like you I was throwing food out daily, she'd defrost or cook a ready meal and then put it back in the freezer, the oven, the micro..the pantry... The carers used to make her toast ( when she'd let them) in the mornings and they were there at lunchtime to supervise her making a sandwich....but " Oh I've had one/am going out/it's too soon"....all the excuses were there.I had to go around and actually heat the food up, set the tray and sit her down to eat.
Now she's in the CH, the meals are made served and she eats such a tiny amount that the weight is still falling off her. In two years she's lost about 3 stones. Even her absolute favourites - Rose and Violet Creams ( chocolates), are ignored.
Sorry!

 

[lizzybean]

This may sound silly but does she know what a knife & fork are & can she use them appropriately? There was a gent at a course I went on recently & his wife had lost the ability to recognise cutlery & know what to do with it. Maybe she heats the meals up, then doesn't know how to eat them?

 

[gillybean]

At the hospital, she agreed that she'd let someone come in to prepare a meal, yesterday I made a call to a company who I'm meeting with soon I hope, the manager agreed that she needs someone to actually watch her eat, but I guess they would as it's more money! She does eat when I'm there if I make a meal then potter round while she eats, she always says when I prepare the meal at 4.30pm, it's too early I'm not eating yet, so I leave in the micro to reheat, this is my problem having the time to wait, which at teatime and preparing family meals is an issue for me, I can only do so much.
Hopefully with support she'll put on weight, if not, well, I don't want to think about it

 

[gillybean]

This may sound silly but does she know what a knife & fork are & can she use them appropriately? There was a gent at a course I went on recently & his wife had lost the ability to recognise cutlery & know what to do with it. Maybe she heats the meals up, then doesn't know how to eat them?

Yes she does know, but has issues with arthritis and uses a spoon so I have to get sloppy kind of meals like shepherds pie etc but it must be boring for her

 

[Sasky]

Hi gillybean

I know exactly what you are going through my mum also only weighs 5st 12lbs. She has had numerous tests, scans and x-rays but nothing showed up. GP referred mum to a dietician but that didn't help either as she wouldn't eat what was suggested.

My mum lives with my husband and I so it easier for me to monitor what she is / isn't eating but it is still a real struggle to get her to eat properly on a daily basis. A typical day will be spaghetti on 1 slice of toast for breakfast, Swiss roll and custard for lunch. Dinner is a real problem I try to vary it according to what I know she will eat I.e egg and chips, fish and Chips, lamb chop and mashed potato And chicken with mash or chips. To be honest it's a nightmare however she will also eat between 12-16 chocolate biscuits so helps with the calorie intake. This has helped to maintain her weight at 5st 12 for the past 2 months now. I have told the GP what she is eating although the diet is not ideal at Least it's better than nothing

I can really sympathise with you it is such a worry especially when the weight is so low and my mums body is like a skeleton

 

[Austinsmum]

My mum was sectioned late last year as a result of her 24/7 sundowning. Whilst she was in hospital her weight dropped rapidly as she was expending so much energy even though she was eating everything they gave her. She now has regular fortified drinks. Don't know what the name is but they have worked wonders for stabilising her weight.

 

[gillybean]

Yes, it was so painful for me to see her skeletal body when she had x rays, really upset me. She is having fortified shakes but no weight gain. Awful isn't it when I am hypothyroid and trying to keep my weight stable and not increase!

 

[pippop1]

I buy my MIL those chilled toddler ready meals that are sold in supermarkets. Some are a bit sloppy but others are OK. There are at least two brands. One is a lady's name. The best choice of them is in the poshest supermarket beginning with W but all the big supermarkets seem to stock them.

They are small-ish but have good nutritional balance and low or no salt as they are for little ones. They don't look babyish either.

Another good thing about them (from my point of view) is that, although chilled and not frozen, they have long sell by dates, for example 3 weeks, compared to normal ready meals that are usually less than a week. They are also not too adventurous in composition (MIL won't eat spicy food for example).

 

[gillybean]

I buy my MIL those chilled toddler ready meals that are sold in supermarkets. Some are a bit sloppy but others are OK. There are at least two brands. One is a lady's name. The best choice of them is in the poshest supermarket beginning with W but all the big supermarkets seem to stock them.

They are small-ish but have good nutritional balance and low or no salt as they are for little ones. They don't look babyish either.

Another good thing about them (from my point of view) is that, although chilled and not frozen, they have long sell by dates, for example 3 weeks, compared to normal ready meals that are usually less than a week. They are also not too adventurous in composition (MIL won't eat spicy food for example).

Thank you for that I have looked quickly at baby foods but didn't want her to realise that's what they were as she'd be offended. I will look again though as the long sell by date appeals!

 

[lizzybean]

They're not baby foods as such just a smaller portion. Have seen them in something that starts with an M & has another capital letter, I think they call them toddler meals or childrens meals. Have not used them so don't know what they are like.

 

[Spamar]

I fed OH the W meals for children and they worked a treat. He says he hates leaving food, so these were the right size for him at the time. On a previous occasion I found the fortified drinks helpful ( there are several different makes).
Please remember that if someone has eaten very little for a while, the stomach can 'forget' how to work, so foods have to be introduced very carefully.
People can forget how to use cutlery, and use their fingers more and more. You might have to adjust food to suit. OH at the moment tends to use one hand, but when using both knife and fork, doesn't know which hand to put them in. I can sympathise, as many years ago when I lived alone, laying the table for one was a mass of indecisions! I learnt have to use either hand for either piece if cutlery, which made laying the table worse, but was effective with way!

 

[Nebiroth]

The GP knows she is frail and has given her shake drinks but these are supplements for vitamins not really for putting weight on.

Are you sure? Most often in this situation the shake drinks that are supplied are something like Fortisip - which are also used when patients can't manage solid foods for whatever reason.

Fortisip is not only vitamins and minerals, but has a high protein and calorie content (about 300 calories per 200ml drink). It is also gluten and lactose free so that lactose intolerant and coeliacs can have it. Fortisip is designed to be a complete food, in that you can actually live and be well nourished having it and nothing else, so long as you take in enough to have sufficient calories.

If the decline in weight is solely due to not eating and there's no underlying cause for lack of appetite then it is down to just getting in as many calories as you can, any way that you can. Forget about balanced diets and "healthy" food, if someone is starving then calories take priority over everything.

Many, many people with dementia develop a sweet tooth - even if they hated sweet things before. This can be an advantage because you can get them to eat calorie-dense foods. Also in the elderly the tastebuds that sense bitterness are the last to fail, which means all foods can taste bitter - which is why the elderly all tend to have sweet tooth anyway

What you can try:

Sweet things, of any sort, biscuits, cakes, sweets, chocolate, puddings
Always use sugar, never sweeteners
Full fat milk or cream, custards etc, not "healthy" versions
Offer in small amounts as large plates of food can intimidate
Finger food in case there are issues with cuttlery
Leave biscuits and sweets in plain sight so that they can be nibbled
Try some high-calories savouries like cheese if it's acceptable
Don't present food choices as in "what would you like for lunch?". People with dementia can find it hard to deal with choices. It is better to say "we are having xxx for lunch today, that will be nice"

Has there been an assessment by a SALT? There could be a swallowing issue and perhaps even choking incidents leading to a reluctance to eat.

Sadly in advanced stages dementia can mean that people forget to eat, do not know what hunger means or even not know what to do with food when it is placed in their mouths.

 

[gillybean]

Are you sure? Most often in this situation the shake drinks that are supplied are something like Fortisip - which are also used when patients can't manage solid foods for whatever reason.

Fortisip is not only vitamins and minerals, but has a high protein and calorie content (about 300 calories per 200ml drink). It is also gluten and lactose free so that lactose intolerant and coeliacs can have it. Fortisip is designed to be a complete food, in that you can actually live and be well nourished having it and nothing else, so long as you take in enough to have sufficient calories.

If the decline in weight is solely due to not eating and there's no underlying cause for lack of appetite then it is down to just getting in as many calories as you can, any way that you can. Forget about balanced diets and "healthy" food, if someone is starving then calories take priority over everything.

Many, many people with dementia develop a sweet tooth - even if they hated sweet things before. This can be an advantage because you can get them to eat calorie-dense foods. Also in the elderly the tastebuds that sense bitterness are the last to fail, which means all foods can taste bitter - which is why the elderly all tend to have sweet tooth anyway

What you can try:

Sweet things, of any sort, biscuits, cakes, sweets, chocolate, puddings
Always use sugar, never sweeteners
Full fat milk or cream, custards etc, not "healthy" versions
Offer in small amounts as large plates of food can intimidate
Finger food in case there are issues with cuttlery
Leave biscuits and sweets in plain sight so that they can be nibbled
Try some high-calories savouries like cheese if it's acceptable
Don't present food choices as in "what would you like for lunch?". People with dementia can find it hard to deal with choices. It is better to say "we are having xxx for lunch today, that will be nice"

Has there been an assessment by a SALT? There could be a swallowing issue and perhaps even choking incidents leading to a reluctance to eat.

Sadly in advanced stages dementia can mean that people forget to eat, do not know what hunger means or even not know what to do with food when it is placed in their mouths.

I forget the name of the shakes, it's such a big issue for her to take this, its a wonder she doesn't have UTI issues as she has stopped drinking tea (think she struggles to boil kettle these days despite buying a light travel one etc). I think she has a shake every other day, GP said they are only 'short term' so I almost have to beg each time she needs more. I think there must be something better that can offer a higher calorific content in this situation?
Tried leaving out snacks buying chocolates sweets etc. She has always had full fat milk and lurpak, it's volume she needs too, I know for a fact she has only eaten 1 ready meal since last Sunday.
Today I have said if she doesn't eat she will end up in hospital and I am sick of nagging her she must be so bored of me and hate me for it. I know my aunt has delivered fish and chips today so that's good, but I think she has it over 2 days
as it's too much for her.
I don't think she has choking issues (as my Dad did) I have never heard her cough or choke so I think she's OK with that.
She also gets embarrassed to eat in front of me and I feel like I'm imposing. Awful isn't it.

 

[stanleypj]

It does seem clear that, whatever the usefulness of all the suggestions here, and they are useful and pretty comprehensive, unless and until there is some solution to the basic issue, you will have an increasingly serious problem.

The problem surely is, from what you say, that your mum is unable to take responsibility for her own nutrition and wellbeing. I can only think of two possible answers: one is very regular visits from experienced care workers who will be able to supervise the eating and the other is residential care, where her nutrition could be even more carefully monitored.

Sorry if this sounds blunt, but I can't think of any other answers and it doesn't look as though anyone else can.

I suppose the positive feature is that your mum can still eat and swallow, which is something to be grateful for.

 

[gillybean]

It does seem clear that, whatever the usefulness of all the suggestions here, and they are useful and pretty comprehensive, unless and until there is some solution to the basic issue, you will have an increasingly serious problem.

The problem surely is, from what you say, that your mum is unable to take responsibility for her own nutrition and wellbeing. I can only think of two possible answers: one is very regular visits from experienced care workers who will be able to supervise the eating and the other is residential care, where her nutrition could be even more carefully monitored.

Sorry if this sounds blunt, but I can't think of any other answers and it doesn't look as though anyone else can.

I suppose the positive feature is that your mum can still eat and swallow, which is something to be grateful for.

I know what you're saying is right, blunt yes and it brings home the reality of it all for me.
She would of course argue that there's nothing wrong and she is quite capable thank you, clearly she's not. Up till now she's refused people going in to help but I am afraid I have to step up here and say enough is enough and without this you will die!

 

[stanleypj]

Believe me, I do understand the problem. At one point my wife stopped eating properly and lost a lot of weight. It was very difficult to get her to eat but at least I had the advantage of being with her 24/7 and eventually she did improve. She's now been at a 'normal' weight for a couple of years. In fact, at one point she was putting on too much weight.

Fortunately, by then she was eating everything that I put in front of her, so having this control I was able to get her back to the weight she had always regarded as her ideal.

I can well appreciate the frustration of your situation.

 

[gillybean]

I recognise that part of the problem is her being unsupervised and alone. Only answer to that is to pay for support going in there several times a day, which I am arranging, let hope it helps her because somethings got to give