Dementia and Appetite!

[Ditto]

No matter how good or bad her day, there is no end to my patients appetite. She has always enjoyed her food despite the fact that at 88 years she's still got the same figure as she had 40 years ago! Aaaargh! (not fair) But since her Dementia really started taking over, I've noticed that her appetite has escalated. Read before and now below for a rough idea of how her appetite has changed in the last few months. It's quite extraordinary and I wonder if any of you are experiencing similar appetite surges with your Dementia/Alzheimers patients/partners/parents? I'd be very interested.

BEFORE:

Breakfast
1 x slice wholewheat toast with marmalade, orange juice and coffee

Lunch
1 x poached egg on toast with spinach salad

Dinner
A full dinner excluding potato and rice

NOW:

Breakfast
Cooked breakfast of eggs & bacon or sausage,tomato or mushrooms, toast, orange juice and coffee

11am snack
Tea, biscuits, slice of cake

Lunch
A full lunch of a hearty salad with baked potato or a hot pasta or chicken, veg and potato.

3pm snack
1 x salmon or ham sandwich, tea, 4 x lemon biscuits

Dinner
A full dinner of lamb, beef or chicken casserole with veg and rice or Baked fish with mashed potato and 3 x veg etc.. followed by a dessert. (usually icecream and wafers or jelly and cream or fruit salad and ice cream.

Also, plenty of fluids throughout the day.. passionfruit and water, limejuice and water, cranberry cordial etc.

 

[jenniferpa]

It's variable of course but: I do know from my reading that for many people, as dementia increases, their ability to metabolise food decreases. In other words, no matter how many calories they take in, a fair number are simply excreted. All power to you if her appetite still allows you to provide sufficient calories - for many this decreased metabolism comes at a time when the appetite decreases as well.

 

[Skye]

Hi Ditto

My husband John also has a huge appetite, despite almost constant infections, including MRSA. In fact, the nurses say that it his intake of calories that enables him to fight off the infections. In fact, in the eight months that he has been ill, he has only ever refused food on two occasions. When that happens, we really worry!

 

[Carolynlott]

Before he went into his CH my Dad ate very little - and mainly cakes, biscuits. Now I am told he "loves his food". Could be lots of reasons - now he doesn't have instant access to snacks, and has proper meals put down in front of him. He is getting very thin though.

 

[citybythesea]

.....wonder

mom had times when her appetite wained and other times her appetite just was not there. I have read (trying to figure out how the experts know..) that they lose their ablity to also recognize hunger or the feeling of being full.

I do know that if a big meal is put in front of mom (before this week) she would finish it. If a smaller meal was put in front of her she would finish it, but she never would start to eat seconds if the smaller plate emptied. It was like..the plate is empty therefore I am full....

Wonder if this is what is actually happening.

Skye, I too make sure mom gets lots of protein so that her body may heal her wounds easily. I have taken to putting protein pwder in everything from drinks to dessertto extra in the main course.

 

[Cliff]

Oh, I wish......

Dee's appetite is zilch.

Today: 1 bread finger with marmalade,
Lunch, two mouthfuls of sweet and sour chicken,
Tea, 1 meringue cream cake/

Normally she downs a breakfast with more bread and marmalade and a bit more at lunch but needs spoon feeding,

The GP has tried fortified drinks but Dee refuses to drink them.

So if your "cared for" eats well, enjoy it.

 

[ChrisH]

food, glorious food!

My problem is not knowing how much mum eats as I'm a long distance carer. All I know is, I've had to go through her wardrobes and clear out nearly 2 bin bags full of stuff that is now way too big! She's never been huge, but she did have a bit of a tummy which meant she needed larger sizes to fit round her waist. There were clothes ranging from size 12 - 18!! I suspect that some things have simply been taken off the clothes shop rails because she liked it and there hasn't been much thought about trying on or looking at labels, but as she's down to 7 stone and she was at least a stone heavier than that, I can only assume she isn't eating anything like as much as she did a year or so ago.

I've mentioned on another thread that she seems to be telling porky pies about what she eats. Her friends have told me they've had to throw out mouldy food from her fridge. Her sense of smell seems to have gone and she just doesn't detect the odour. Yet she constantly insists she 'always' has breakfast (probably), lunch (again probably if only a small sandwich) and a main meal, usually in the evening, and that's when she takes her tablet (probably not always). Even when I present the evidence that what she thought she'd put in the microwave and eaten was actually in the fridge, she still insisted she'd eaten. She tells me she goes in to town 2 - 3 times a week and eats in the pub. But then she'll tell her friend she goes in nearly every day and then change the story the next time her friend enquires about food. We're all trying to suggest meals on wheels or similar but at present she won't consider it.

Mum always loved her food and would prepare home cooked meals whenever we went to see her. Cakes were made at every opportunity for friends, coffee mornings, the local fete (where she won competitions). Sadly the only cakes in her house now are the stale ones, courtesy of Mr Kiplin, that she insists the poor OT and support worker have on their weekly visits (along with the probably tepid cup of tea). When we eat out there is usually a fuss over 'I don't want too much on my plate' and she ends up leaving a fair bit.

So Ditto, don't worry, a good appetite is probably quite a rarity so just enjoy that she still appreciates food.

Chris

 

[lesmisralbles]

Ron has a very good appetiate? (he likes to eat) Spelling again

Ron has lost weight, Doctor tell's me it is not fat but muscle. lack of use of leg's and arm's.
So, we have been doing exersizes - sorry, spelling again, well at least I know when it is wrong Also, I am tired, and Ron is snoreing for England. No sleep for me again tonight. Sorry, went a bit of track there.
A couple of tin's of bean's, in a carrier bag, on each leg, ankle. Well he lift's them up, and it is making his muscles stronger.
As for food, he eat's like there is no tomorrow, great.
I do not know how long this will last, but forever would be good
Love Barb & Ron XX

 

[germain]

Ditto - you can come and live with me anytime !

Good morning all,

Ditto - do you prepare all this food ? We've got a spare room here for a good cook !


As others have commented already - Our Mum went down the usual "starvation" route when living by herself - mouldy food, uneaten prepared stuff etc etc. We could never understand why she didn't have constant food poisoning given the things she would sometimes eat ! (or is most of the mould actually penicillin ?)


One time, when she came out of hospital and couldn't return home, she stayed with me for just under a month. She "ate for Britain" I planned every single meal and snack so that she was eating the maximum amount of protein and calories that I could get into her. She loved it ! - and because she could never remember when she had last eaten we got loads of extra snacks down her. BUT - she was still losing weight and I was absolutely knackered (sorry) . Of course, hubby loved it
- he was in foodie heaven !


We noticed that she would only really eat properly if we all sat down together - perhaps this was a throw back to her usual way of eating. Given a snack or cup of tea on her knee , she'd forget about it.


Unfortunately, towards the end her appetite went totally - her consultant told us that its very common that people no longer recognise a lot of physical signals any more - i.e. hunger, need for the loo , thirst etc.


Ditto - love the menu's - can I come too ? It's possible that your patient has really settled with you and because she feels secure now she will eat . Do you keep her company - this could be helping too. Or is she just past recognising the signal of feeling full ?


It seems to be very common to veer between "stuffing" and starving - depending on the stage each indiviual is at .


Whatever it is - keep up the good work. As others have said, good nutrition goes some way towards helping when the infections strike.



Regards
Germain

 

[Lynne]

Oh boy, "It's not fair" is it ...

Ditto, I have the opposite problem; Mum is 5'-0" & has always been trim (10 years ago aged 79, healthy weight was 7 stone & she was active & looked healthy) & it has always been standing joke in family that she only ate enough to keep a chicken going. Now she's 4 st 12 lbs, & looks like a starvation victim.

I was even reported to Social Services by Mum's Daycare team, despite the fact that I brought up the subject with them last year & asked them to keep an extra eye on her at lunchtime, make sure she had her glasses on etc.
Where's the smiley symbol for "tearing hair out"?

 

[CraigC]

Interesting thread

Hi All,

Dad has always had a strong appetite and we have been lucky, he continues to eat very well, a bit to well.

Here are my thoughts and experience if it is any help.

One care home manager told me that there seems to be two types when it comes to eating, those that eat very well and those that lose their appetite altogether as alzheimer's progresses. I'm not sure if she is right but she has a lot of real life experience.

Although I am relieved that dad still has a very hearty appetite, it has always been really difficult to explain to all dad's carers that dad must not been overfed. I think dad would eat all day if you let him. Alzheimer's seems to have seared his stop button or he just can't recall when he last ate. I explain this to the carers all the time who at one time were giving him double-portions as he always seemed hungry on the standard portions

People just love to feed dad, I do too. They all mean well and it is difficult to make too much of thing about it. Food is one of the few things he still really enjoys and you get so much more interaction when he is fed. His face lights up with the taste of chocolate (although that goes for the rest of my family ).

Inevitably dad has put on weight, particularly as he loses his mobility.

So I worry about his weight and worry when his trousers don't fit, worry about how to approach the carers on the issue again knowing that they care for him in such a loving way. Worry about his heart and cholesterol. He was always a fit strong man who watched his weight and looked after his body. Then, I kick and remind myself he has alzheimer's. What's a few pounds around the middle at this stage of his life? I should just be grateful that he still loves his food.

Mum went the absolute opposite way for the last two years of her life so I can understand how difficult and frustrating it can be when someone loses their appetite. She at hardly ate a thing for the last 3 months.

Hope this helps more than a chocolate tea pot
Craig

Lynne - Have the doctors discussed appetite stimulants? They did discuss this with mum - think it was a refined form cannabis - don't remember the drug name but just got this on google "delta-9-tetrahydrocannabinol may be administered orally, in capsules, or in tablets, or by injection", may be worth discussing that's all. The drug if refined so the patient does not get the undesired effects that come with narcotics.

Read my signature as always ;-)

 

[Jane.B]

This is a very interesting thread, Rupert my husband seems to go from being very hungry all the time to not wanting to eat very much, a month or so ago, although he seemed to be eating much the same, I and his CPN noticed that he seemed to be losing weight, and I took in his trousers which were much too big, she suggested that I get some Build Up milk shakes which he loved, now suddenly he's eating much more, always seems to be hungry, and his trousers are getting tighter. There seems to be no pattern to it at all.
Something different, do others find that those they look after, can never sit still at the table during a meal, Rupert will eat a bit, then get up go to the sitting room, then come back for a bit more. Sometimes I end up giving him his pudding on his lap.

 

[CraigC]

Hi Jane,

Dad was very like Rupert early on and would wander off during a meal. He had ants in his pants most of the day. That was when he was still feeding himself. We used to make sure he sat at the table in the least accessible spot to make it hard to wander off. Mum would be constantly telling dad he needed to sit back down to finish off. He had some amusing replies

I think half the problem now is dad has aided feeding and would eat until he pops. Those with the deep mothering instinct who feed him just don't know when to stop as he enjoys his food so much! But, not complaining, it is better than neglect you seen in some homes.

Very interesting topic and glad it has been raised.

I also think that in care homes it is difficult to prepare healthy food all the time. Too much stodge in my opion. The food in dad's home is good and freshly prepared but been a while since I've seen a salad.

You've reminded me, I'll take him some sweet fruit in for the visit tomorrow instead of chocolate! Time to practice what I preach more often!

Kind Regards
Craig

 

[andrear]

HI there

Dad has a good appetite but he looks like a skeleton. I think this is because of him not being able to stand or sit still for long at all.

Today he had porridge for breakfast, a place fillet for dinner, but he wouldn't eat anything else with his dinner. He drinks a couple of cups of tea per day and mainly fresh orange juice of similar during the main part of the day. For tea time he will have maybe a yohurt with some fruit. I have to say he eats lots of fresh fruit each day, 1 banana and an apple everyday and usual another piece of fruit. Mum and dad have always been very healthy eaters, no nonsense foods for them, always liked fresh fruit and veg.

What I have noticed since Xmas is that dad is eating lots of sweets, i.e. boiled sweets. He's got a thing about buying them every time he goes out, not just one packet but could be 20 packets he buys at a time. I pressume the sugar is keeping him going because he's not on any medication other than for blood pressure as he refuses any medication available to him. I don't know what he weighs but he is most certainly underweight but at least I know that he eats good food at least.

Andrea

 

[CraigC]

Hi Andrea,

What I have noticed since Xmas is that dad is eating lots of sweets, i.e. boiled sweets. He

The change in preference for sweet food is quite common for people with dementia. Dad always had a savoury tooth until dementia set in and it wasn't long before he had many sweet cravings. Even in the early mid stages I noticed his craving for ice cream etc.

I asked a couple of staff in the care home and they also said this change in appetite is common for people with dementia. They also said that the sweet taste sense is one of the senses that holds on the longest. Hence the pleasure dad now gets with chocolate and the temptation to let him enjoy it so much.

Just ran a quick search and found this on ElderCare Online:

Tips on... Eating (Early and Middle Stages of Dementia)
http://www.ec-online.net/knowledge/Articles/eatingtip1.html

In the early to mid stages many things can develop eating problems for the individual affected by Alzheimer’s Disease. The sense of taste can change leading to a craving for sweets. /QUOTE]

Kind Regards
Craig

 

[LittleVera]

This is a very interesting thread.

My mother has Alzheimers, and while she was living with my father prior to his death they both ate like sparrows.

Since she has been living with me and going to daycare, she has been putting on weight. At daycare they have tea and biscuits about every 10 minutes, a full cooked lunch with a hot pudding (jam roly poly, chocolate sponge) then tea and biscuits all afternoon followed by cake at 3 o'clock. If there are lunches going spare, Mum will eat them too. It is as if she has no idea when she is full.

At first I was also giving her a cooked meal in the evenings as this is when we as a family eat (sandwiches at lunch) but I have now stopped doing this as I am worried that if she gains excessive weight we will start to have to think about diabetes and so on (Mum also has a thyroid condition).

So now I make the evening meal a sandwich or perhaps egg/beans/cheese on toast with a yoghurt or some fruit and her weight has balanced out, although she has still outgrown many of her trousers!

LittleVera

 

[CraigC]

Hi LittleVera,

Sponge puddings seem popular ;-). This thread is making me very hungry.

On a serious note, I find it a delicate subject to approach the care staff about. Feels like I'm saying 'you are caring a bit too much!' I've tried dropping hints but it is difficult to get the balance right. Also as mobility goes and the wandering slows down there are less calories burnt off. Hard to tell if dad is bloated or a little overweight now, wish he could give me more signals.

Getting the balance right between concern and complaining is not always easy.

take care
Craig

 

[Grannie G]

My husband has a smaller appetite, is overfaced by `normal portions and often leaves food uneaten.
Then 10 minutes later asks what we will be having for our meal.

His weight is the same, but his girth has increased, whilst his arm, leg and hip measurements have decreased.

 

[Lynne]

Craig, thanks for the link you posted (in post 15 of this thread)

Both the article, and further links from it, were informative and useful. It does help to have other carers' opinions & experiences, and outside points of view, to encourage one to try to see things differently.

Regards

 

[andrear]

Hi Andrea,

The change in preference for sweet food is quite common for people with dementia. Dad always had a savoury tooth until dementia set in and it wasn't long before he had many sweet cravings. Even in the early mid stages I noticed his craving for ice cream etc.

HI there Craig
Many thanks for that - how intersting, it really seems to be a craving for anything sweet for dad, but I don't know why he is losing so much weight. I'll have to read the link asap.
Although I dread seeing anymore sweets coming into the home cos' I have to say they are becoming too much of a temptation for me also!!!
Love
Andrea