Weight and BMI

[Sterlingtimes]

My mother weighed 44 kg prior to her hospitalisation and subsequent discharge to a nursing home.

Today, she was weighed using a sling, which I have not seen before. She weighed 40kg, which is surprising, given her skeletal appearance. How low would BMI go for someone who is approaching the end of life?

 

[nitram]

There is no corelation between BMI and end of life.
Before hospitalisation her BMI was only 16.2, give it some time and see what happens.

 

[Sterlingtimes]

There is no corelation between BMI and end of life.
Before hospitalisation her BMI was only 16.2, give it some time and see what happens.

Thank you. This helps.

 

[Kevinl]

You could use my mum as a toothpick she was so skinny, didn't stop her helping me look after my curve (but not fat) wife, over 30 years younger than her with early onset AZ.
Mum perked up massively when she came to live with us, 3 meals a day and my wife to look after that plus having someone to talk to as well, wasn't perfect but we made work.
Believe me now they've both passed away the world can be a lonely place after something over 10 years looking after them both.
A low BMI can be down to self neglect sometimes, cooking for one is a pain when mum and wife used to cook for a family of five or more. Have to go pasties in the microwave. K

 

[Dirge]

My mother is weighed using a hoist system which appears to be constantly moving so that her weight readings fluctuate by 2-3kg both up and down over short periods. I have argued that this makes the weight readings meaningless and I only use them as indicators rather than hard data.

 

[Sterlingtimes]

That is interesting, Dirge. Is your mother completely bedbound (as my mother is)? Does her food intake vary from week to week?

 

[Dirge]

That is interesting, Dirge. Is your mother completely bedbound (as my mother is)? Does her food intake vary from week to week?

@Sterlingtimes Yes my mother is bedbound, its difficult to say what her food intake is each week but it's certainly not varying enough to make a difference of plus or minus 2kg, she only weighs around 40kg so thats a significant amount in percentage terms especially when measuring BMI and MUST score.

 

[Sterlingtimes]

I am sorry to hear this, Dirge. Our respective mothers appear to be in the same boat. My mother is also 40 kg. The nursing home keeps a food diary: she mainly "eats" Fortisip, yoghurt, ice cream and a few spoonfuls of soup. Often, food is marked as "refused".

 

[mhw]

my mother is totally immobile and being hoisted and i presume how they are weighing her, although monthly form what i can gather. she physically looks like she's dramatically lost weight in her face and round her neck and shoulders to me in photos her partner sends 3 times a week but they insist she is eating well enough although having to be fed and made to drink. According to them she had put on 8lbs from when she was weighed in hospital with pneumonia in Jan but honestly I dont see it! She was always a fat woman ( 5ft 2 and approx 14 1/2 st before dementia) but now they are saying she weighs 11st7 and 7lbs of that put in since leaving hospital and going into the home. Either they are weighing her wearing different clothes etc or the hoist isnt accurate compared to the hospital scales etc its very frustrating as you can physically see the loss and they still insist shes 'fine' and eating ok and gaining weight.

 

[Sterlingtimes]

Either they are weighing her wearing different clothes etc or the hoist isnt accurate compared to the hospital scales etc its very frustrating as you can physically see the loss and they still insist shes 'fine' and eating ok and gaining weight.

I suspect now that a person with severe weight loss can look worse than the actual weight loss would indicate. Perhaps in a bedbound situation, there is a drastic loss of muscle.

At 44 kg, my mother looked thin, but losing 4 kg further made her appear to have only skin over her bones.

 

[Sterlingtimes]

I am trying to get a perspective on my mother's daily food intake by reference to her food diary.

Does the following estimate seem reasonable?

Breakfast: Slice of toast with marmalade. Crusts not eaten. 200 calories.

Lunch: Half a small bowl of soup is 100 calories, and ice cream is 80 calories. Soup is sometimes listed as spoonfuls, e.g., 4.

Dinner: Half of a small bowl of soup. 100 calories. Ice cream is 80 calories.

Fortisip: Half taken. 120 calories.

TOTAL: 680 calories.

 

[sdmhred]

Hello @Sterlingtimes

Im no good with calories if that’s what you’re asking…

What are you looking for?

I think end of life and deterioration is marked when food intake declines. If your mum is stable eating this amount of food it sounds ok to me And could keep her going for some time. She will be using little energy up being in bed.

 

[Sarasa]

My mother ate very little during her last couple of years of life She liked the Fortisip drinks and the occasional bowl of cornflakes, but not much else. If your mum is eating I think as @sdmhred said that could keep her going quite a while.

 

[Chizz]

I am trying to get a perspective on my mother's daily food intake by reference to her food diary.

Does the following estimate seem reasonable?

Breakfast: Slice of toast with marmalade. Crusts not eaten. 200 calories.

Lunch: Half a small bowl of soup is 100 calories, and ice cream is 80 calories. Soup is sometimes listed as spoonfuls, e.g., 4.

Dinner: Half of a small bowl of soup. 100 calories. Ice cream is 80 calories.

Fortisip: Half taken. 120 calories.

TOT
AL: 680 calories.

Hi @Sterlingtimes
Just a thught:
One sign for worry, I was told, was when the food and liquid intake is so small that the body retains it all and there is no bowel or bladder movement at all during in the day/night.
Is the bowel/bladder movements noted in your mum's notes?

 

[Rayreadynow]

Professionals use a combination of BMI and MUST scores ( Malnutrition Universal Screening Tool ).

 

[Sterlingtimes]

Hi @Sterlingtimes
Just a thught:
One sign for worry, I was told, was when the food and liquid intake is so small that the body retains it all and there is no bowel or bladder movement at all during in the day/night.
Is the bowel/bladder movements noted in your mum's notes?

Thank you. How interesting! Yes, there are still bladder and bowel movements. But I will watch out for this.

 

[Sterlingtimes]

Professionals use a combination of BMI and MUST scores ( Malnutrition Universal Screening Tool ).

That is useful. Thank you. BMI is 14.7, and weight loss over the three-month period is 10%. So, we are in a high score category. Yet my mother is still eating some liquified food.

 

[jugglingmum]

I'm not sure if you are trying to predict end of life, but this is impossibly difficult.

When my mum went into her care home she had lost significant weight and was a size 12 to 14 clothes wise. 9 months later she was a size 6 based on the clothes I was asked to provide. 5 months after this I was told she had continued to lose weight and they considered her likely end of life, best estimate 2 weeks, but could be 24 hours or could be 2 years, she lasted 3 weeks.

The end of life was partly based on the fact she was no longer drinking much fluid, even with encouragement as well as eating less and less.

My mum was still mobile, able to make jokes, and eating and drinking small amounts up to and including the day she died.

Other posters on here have had for example relatives go 17 days without food and drink at actual end of life, and also several examples over the years of bed bound barely mobile unresponsive family members lasting years on a couple of teaspoons of yoghurt a day, which was very distressing for the relatives involved.

Throughout her time in the care home mum was offered as much food as she would eat, and fortisip type drinks were always provided. Whilst able to mum went to the dining room for meals 3 times a day, food was presented to her in different ways to encourage eating and was offered cake on top of this, but was still loosing weight.

I am not aware if she was weighed as I could see she was thinner, and felt no need to distress her, when the slow weight loss is an unavoidable part of dementia and dying.

My understanding is that the body no longer processes food in the same way in the later stages so measuring calories doesn't really make sense as the body might not be absorbing them.

Unfortunately there is no text book answer as each PWD will present differently.

 

[luggy]

@Sterlingtimes my mum has been at this stage with her eating for well over a year now. Her BMI fluctuates between 13 & 14 and she weighs 5 and 1/2 stone. Her 'normal' is to eat a weetabix mashed up with milk for breakfast, a few teaspoons of soup or yoghurt (but rarely both) for lunch and frequently declines food at teatime. She will drink her Fortisip. Her bowel movements are small and infrequent.

It beggars belief that someone could survive for so long.

 

[Rayreadynow]

If you are doing very little during the day I guess you don't need many calories. I think you can request a nutritionist to review food intake.