it didn't answer my needs. i have a 97 yr old who isn't passing the so called swallow test and the alternatives are tube feedings and they say (doc) thats worst so u starve them to death is that the best alternative methoid?

While I am sure that a regular meal is preferable to liquid diets or nutritional supplements...my Mama won't eat anything BUT things like Ensure and fruit juice anymore. After her last surgery December 2013, she went from eating regular full meals to refusing to eat or chew anything and the only thing she would touch was Ensure...or some other nutritional supplement...That was now going on 14 months ago. I bought a blender and add things like baby food, honey, peanut butter, applesauce, etc. and watch her nutritional intake regarding proteins, carbs, fats, calories, etc. and Mama has not lost one ounce since beginning her nutritional supplement diet...so while I know the article is well intentioned sometimes there are no other alternatives....oddly enough, after the surgery, she will not touch anything savory now..no soups, broths, etc...only sweet things...but still her blood work etc. is excellent and no weight loss.

Lately I fear she has begun an overall decline due to the alzheimers and she is not seeming to want anything but overall we have had an extra year plus which we might never have had had we not been able to provide nourishment via supplements...

williamheard27, does your dad require a liquid diet?

my dad is 97. his mind is perfect. he lives on tomato juice for sodium,boost for calories and sodium, prune juice for fiber. he wants me to find alternatives with more of all this. any suggestions?

I agree that a low calorie, low fat diet isn't always a good idea for elderly loved ones. My mom has to severely restrict salt (CHF) but otherwise we make her the foods she likes and supplement her calorie intake with 2 daily snacks. She doesn't eat a great deal at each meal so this approach works for mom. She has a real sweet tooth so her morning snack is a "protein shake" made with Greek yogurt, fresh or frozen fruit, a scoop of protein powder and some milk or juice to thin it down. We are lucky she likes all foods except carbs (I know, how weird right?) so she usually enjoys her meals. She has lost all her teeth and refuses to wear her dentures though. That complication makes it pretty hard to decide what works for her when putting together her meals. Overall, she will give most foods a try if the food is cooked to a soft enough consistency. We monitor her weight everyday because of the CHF so it is tracked closely. Because she eats better than she did before we started to take care of her, we have to be careful not to confuse water weight gain with actual weight gain!

Interesting. I think perhaps adding a 3 to 4 oz. dessert drink of Ensure to one or more meals might be helpful, and then allow wenough time before the next meal to build what little appetite they have

Elders that lose their appetite and weight quickly are a frequent concern by their children. A real fear by loved ones occurs when father or mother stops eating altogether or very close to that. My father stopped eating and lost all interest in food except for for drinking Ensure once in a while. 30 lbs. fell off in a month. Other family members tried taking him to the doctors which resulted in the conclusion he didn't have much time to live. Their prescription was to make the best of his remaining time. Family members were accepting this, however since I was a Chinese medicine herbalist, and he was my father, I heartfully, wanted to help if he and others would let me.

I explained that this formula that would increase his desire to eat and as a result would boost weight gain over the next few months. They didn't believe me at first but finally realize that there wasn't anything more to lose. The formula I gave him was Body Force from Longevity Mountain Herbs which is based on an ancient 500 year old formula and 100% natural. By the 4th day, his interests in food regained and his weight loss stopped and reversed 7 lbs over 3 months.

Would love to be able to feed my mom beans and veggies like the one person suggestion my Mom WILL NOT eat beans, rice or veggies. The only way I could conceive of feeding her this way would be if I brought her home from the nursing home.....pretty sure they do NOT feed multiple small meals, so my Mother gets like 2 to 3 bites of breakfast before she refuses the rest, 2-3 bites of lunch, 3-4 bites of dinner....that's it....she will always drink a lot, milk an ensure, 4oz of juice sometimes another carton of milk.

What about when the person will only eat 4 bites of each meal.....and will no longer even eat her ice cream sundae?

mariatadd, thank you so very much for this info about Ensure, because for a little while now I've been hearing and seeing some 'not so good' things about it, but wonder why the 'public' is NOT warned even more? I'm not a lover of kale but am willing to try your recipe though.

I really appreciate the information I just read because I was thinking that ensure was as good as a meal. Thank you so much for letting me know better.

Nutrition drinks should not REPLACE BUT SUPPLEMENT a diet.. I'm a caregiver for my elderly mother with medical issues making her basically bedridden. Discovering each person's digestive tract sensitivity is vital.. ie. seasoned foods, spices, milk products, vegetable fiber, etc. Then you can incorporate what their body will tolerate and slowly introduce others. All of this may be affected by what medications they may regularly or temporarily (antibiotics) take.

As we learned in the Atkins diet, a diet made mainly with fats and proteins , without complex carbs , eads to lowers the weight and to loose body mass, that it is just what we do NOT wants to elderly patients.

Then the suggestions to eats lots of fats and proteins Will works like the cetogenic diet (Atkins diet) to the elderly patients.

As the nutritionists teach us, to get body mass , we have to increases the ingestion of complex carbs (beans,etc) ,with a moderate ingestion of protein and fats.

Still according the nutritionists,to get muscles and weight ,the patient have to eat complex carbohydrates as beans with Rice , pasta, ,bread made with whole heat flour, etc, with small amounts of protein and fat.

And the beans ate not only the Best source of complex carbs and of magnesium, potassium , but according dr.Oz red beans , black beans, etc. are the number one in antioxidants : He says in his show that beans contains more antioxidants than blueberries , Cranberries pecans or broccoli, and that red beans (as others beans) “are full of phenolic antioxidants, they lower cholesterol, lowers the high levels of blood sugars in diabetics ,etc”

One of the main problems with elderly persons with dementia, is that they are not so ablet eat large amounts of food in only one meal as a lunch or dinner , as a Young person can do.
We made some adaptations for that dementia patients. Instead to have a breakfast,a lunch , snacks in the afternoon and a dinner only , they have a:

1) At 8:00 AM - Breakfast : a small amount of milk, bread made with whole heat flour with cheese (in a small portion according the acceptance),a tea spoon of extra virgin coconut oil and a small amount of a fruit juice.

2) At 11:00 A.M. – “FIRST LUNCH” – small amounts of bean (two or three table spoons),with a small amount of Rice (three or four Table spoons) , a small amount (two table spoons) of chicken breast (boiled or baked without the chicken skin),a table spoon of vegetables , boiled red potatoes , etc.

3) At 14:00 P.M. – “SECOND LUNCH” – small amounts of bean (two or three table spoons),with a small amount of Rice (three or four Table spoons) , a small amount (two table spoons) of READ MEAT (boiled without fat),a table spoon of vegetables ,etc. and a tea spoon of extra virgin coconut oil.

4) At 17:30 P.M. : “FIRST DINNER” – pasta , with vegetables and some chicken or fish or read meat , all in small amounts according the acceptance

5) At 20:00 P.M. : “SECOND DINNER ” – small amounts of bean (two table spoons),with a small amount of Rice (three or four Table spoons) , a small amount (two table spoons) of chicken or fish (boiled),vegetables.

NOTE : Between the main meals (between the breakfast and the saecond dinner) , we have to offer water , juices and snacks.

With that meals that the main ingredients are the complex carbs (beans with rice , pasta ,red potatoes ,etc), we are seeing that not only the patients keeps their normal weight , but very thin patients that needs to gain weight and body mass, starts again to get muscle mass and fat accumulation, and more than this , we see that in 15 days they get strenght and a better mood and behavior.

For patients that can not to bite and chew the foods, to the patient feels the taste of each food, we mix the soft foods with the fork (vegetables , potatoes , rice ,etc) , and the beans and meat, chicken chest,etc , we put in the blender .

It increases the job , but enhances the taste of the food for that patients that can not chew, once we do not put all the foods together in the blender.

One of the ingredients is maltodextrin.

The molecule is 3 parts sugar and one part H2O. In other words SUGAR WATER! This highly toxic and inflammatory which causes early aging and cortical dysfunction.

I agree with the article the drinks like Ensure are for in between meals for adding calories and supplements for an elderly person. Relying on them as a meal substitute is dangerous.

My mom is 90+ and I let her eat whatever she wants. Cookies, ice cream, chocolate, whatever.

Yes, most commercial products have artificial ingredients. Whole Foods sells a good tasting supplement called Orgain - you can also probably get it online. It is not a "complete food." At Whole Foods, it is usually on the top shelf near the boxed soy & rice, etc. milks. It's not in the nutrition supplement section and the staff frequently know nothing about it. Check with the grocery stock person. When making homemade shakes, etc. be extra careful about food safety with an immaculately clean blender, etc. Older adults are more vulnerable to food safety issues.

Ensure, Boost and several drug stores brand contain artificial ingredients, which can promote bad moods. Please consider something more natural or homemade if you are a caregiver, possibly something in a blender.

The original article has some good information in it, and there are things caregivers should know. But individual cases don't always conform to generic advice. A person with dementia who refuses to eat is not in the same position as a frail but alert elder who has a hard time swallowing or craves only sweets. Yes, caregivers should think twice -- even three or four times -- before offering nutritional drinks. But they shouldn't feel guilty if all things considered that is the best choice under the circumstances.

Thanks, rdrosec. Mom has a dietitian , they want her on 4 cartons of isosource a day, but I am lucky if I can get 3 in her. When we first got her feeding tube, I thought it would be easy. Boy what an education I have received. You can only put in what her stomach will hold, so far that is about 3 a day. Ever time I try to up it just another tube, which is only 60 mls, she vomits. Her water intake is very low, due to her low sodium levels. She is so thin and frail. She is finally maintaining a weight of 106.5 lbs. Thanks so much for sharing your knowledge with me. I feel so alone in all this.

rdrosec, thank you for taking the time to share your expertise.

Isosource is a complete feeding, so it should be ok as long as she is getting enough of the tube feeding formula to meet her needs. Do you have a home care nurse or company you work with? Someone should have come up with a tube feeding plan for your mom. You may want to consult with a registered dietitian who makes home visits and who knows tube feedings - or if you can take your mom to the outpatient nutrition department of a local hospital if she is mobile - but first make sure that the registered dietitian knows tube feedings and has access to some recent lab work so that the best possible plan can be determined for your mom. Depending on the kind of tube someone has, it may not be wise to blend food and put it down a feeding tube - there can be food safety issues, clog issues, volume issues, a whole host of problems. Your mom needs to get the amount of calories and other nutrients from the tube feeding and extra water through the tube feeding to meet her nutritional & hydration needs - consult with a knowledgeable health professional who has access to your mom's medical information for advice.

Mom has no esophagus function. I tube feed her isosource 3 times a day. She can swallow nothing. Even a small drop of water makes her have problems. Should I be trying to blend regular food for her feedings? Am I doing the wrong thing by feeding her just the isosource? Never sure if I'm doing the right thing.

I am a geriatric registered dietitian, licensed nutritionist. Older adults need an individualized nutrition care plan with minimal restrictions and their food preferences honored. There are so many issues to consider, including compassion and common sense, in addition to the clinical picture. Liquid nutritional supplements have their place in terms of providing a source of calories, protein, vitamins, electrolytes & minerals in many situations. Some elderly with advanced dementia live on Ensure Plus and other fluids because they refuse to eat - you can not force someone to eat and drink. As long as their weight is stable, labs normal, skin in good condition, hydration good, bowel & bladder good - this is an acceptable strategy for them. Tube feedings are great for temporary nutritional support during an acute situation or if someone will never be able to swallow properly due to head and neck cancer or stroke, etc.; but, are not a great or desirable long term strategy for advanced dementia or during the final decline of someone's life where their body is just shutting down as they move into the final phase of life. Yes, tasty, fresh, clean foods are best for nearly everyone - but it is often a challenging issue dealing with the food and nutrition issues of aging. Consult with a registered dietitian who is experienced with working with these often complex issues. Work together to create an optimal nutrition plan.

Wonderful and insightful article, just what I needed to read for my mom, thanks for posting this.

Sorry Ensure and some of those other sugary drinks only hasten their demise! My 96 year old mother drinks Isagenix whey protein drinks and ads her Isa Fruits and Vegtables to the shake. She still lives on her own, works in her garden and prepares all her own meals which consist of 3 or 4 small meals with one of them being the Isagenix shake.

I might add that Trader Joe's has good smoothies and theyr'e natural. THAT's what my mom drinks as she won't drink the Ensures or Boosts b/c they are full of chemicals. I know they should be supplements and not replacements but one of hte shakes has 440 calories a bottle and if she drinks it that's 440 more calories she's getting than turning up her nose at other choices. You got to pick your battles in caregiving.

Ensure isn't an option with my Mom because she has diabetes, but the nutritionist recommended a Glucerna a day to help stimulate her appetite by keeping her stomach busy and to supplement her calorie and nutrition needs. I'm a bit on the fence about it, but there is no question that her lack of appetite from morning till early evening is a bit part of the exhaustion and fatigue she suffers after a whole day of not eating, especially with diabetes. She doesn't trust easily and my healthy diet makes her frankly suspicious so unless she can identify ingredients and it isn't something "gross" then she won't eat it. Me making shakes is out for now. The look on her face if you even mention Kale is something to remember. She has diverticulosis on top of it, so that makes meal making a very, very delicate balance with the diabetes on top of it. In my situation...what do you all suggest?

My dad has always loved milkshakes. I keep a couple Ensure in the fridge cold and he will drink as a supplement. I keep soft chewy granola bars available in a candy dish. He has a "horrible" sweet tooth. If it has sugar he will eat it. The granola bars are good and help with fiber. He is 86 with dementia. His appetite is waning and he has more issues with the texture of food and has difficulty with a fork. His weight is stable now but he is not getting hardly any exercise. He use to work in the yard and in the garden. can't be up for more that 15 minutes with our getting winded.
My sisters complain because i buy whole milk and use butter with him and I save bacon grease to cook with later. I don't use it all the time but he's 86 and he needs to eat, I'll cook what ever works. I may not eat what I cook for him if I did I'd weigh 500lbs. Enjoy your day

Frequently the Doctors are at fault here for pushing the drinks as a cure all. Good article.