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cdeh61 Asked June 2012

Should appetite stimulants be used in the very elderly?

My husband's aunt (who he has Medical POA for) is nearly 96 years old. Seven months ago she had to be moved to a SNF following a UT infection and fall. At the time she was very malnourished. She was living alone and is very reclusive. She improved and gained 10 pounds, but has now declined a bit, has some swallowing issues and the Dr. prescribed an appetite stimulant. She has mild dementia and has expressed that she doesn't know why she is "still here". We both feel she is ready to die and that not eating may be her way of dealing with it. Any suggestions? she made here wishes know several years ago that she did not want any life prolonging measures, would this be considered that and eventually lead to feeding tubes, etc.?

cdeh61 Jun 2012
Thank you both for your answers. Jeanne, I agree I'd like a better explanation of the rationale for prescribing this medication. The problem is we don't have direct contact with the doctor. Aunt has not had a personal doctor in over 4 years! This Dr. is supplied by the SNF and makes his rounds and checks on people on an irregular basis. My husband is planning on requesting a meeting with him next time he's in. Yes, he is probably just trying to make her more comfortable, but even our Aunt expressed the fact she doesn't think it will work! The facility is giving her protein drinks daily, but she's not interested in drinking them. Maybe we should just let nature take its course?

3pinkroses Jun 2012
Does sound like doctor is just trying to make her more comfortable. If she doesn't feel like eating, has she ever been given the protein drink Ensure? From what my father told me, it tasted quite good and comes in different flavors. Fading away with no nourishment sounds uncomfortable. This drink would only make her feel somewhat better. Take care.

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jeannegibbs Jun 2012
It will only lead to feeding tubes if your husband allows it to. There is no automatic progression.

An appetite stimulant is not going to solve swallowing problems. I'm wondering what the doctor had in mind prescribing this -- have you dicussed it with him or her? Perhaps the doctor feels the eating a little more will improve the quality of whatever time she has left. Is Aunt alert enough to understand what the pill is, and whether she wants to take it?

I don't put it in the same category as a feeding tube, but I'd want to hear the rationale for using it at this point.

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