My mom, who has been repeatedly tested, EKG, blood, urine, B/P, oxygen, you name it; is a very healthy 85 year old woman.
Daily life with mom ... She shuffles along, refuses food and gags until she can throw up what little bit she does consume. On the phone with my siblings, she sounds vibrant and cheerful. But, with me, she is at death's door. If I have to be out, I get a sitter, she objects. She wants to refuse PT, OT, Nurse and Social Worker. Because I welcome them, allow their services, she "punishes" me by refusing food. She plays helpless. Hands her denture to me, tells me to put her nightgown on her. She fights taking her meds, but she doesn't win.
It feels like she punishes me for caring. OT told her she must do activities, like dress herself, walk to kitchen to return a glass, etc.
PT, is here now. "How are you doing?" Standard response ... "Oh, so, so"

Is this another game? How should I deal with it?

Also, she did her own shower, no problems. On January 4, my deceased father's birthday, she could no longer take care of herself. Poof, like turning the switch off.  This no shower is becoming a sanitation issue at this point.

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It could be that choosing whether or not to eat is the last thing your mother has any control over, in her mind. If you make a fuss over it, then she 'wins'. Just like a child.

How great is her caloric need? If she is not physically active, she may not need too many calories, or they could be provided in other ways. Nutrient dense snacks, Boost, cookies made with carrots, oats and banana. My kids great grandmother lived for over 15 years only consuming Campbell's Cheddar Cheese Soup. Not a balanced diet, but she was happy and healthy.

You say she is in good physical health, as she had a mental health/dementia assessment?

Can you get her out of the house to an Adult Daycare, Seniors centre or other place where she can interact socially? Especially one where lunch is served? Perhaps eating with others and you nowhere in sight will make a difference?
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Pat, regarding the gagging while eating, have your Mom tested for Pulmonary Aspiration. With aspiration what is happening is food is trying to go down the wind pipe instead of the pipe that leads to one's stomach. The test isn't all that pleasant, Mom would need to swallow a certain white liquid material so that it can been on a test that shows how the liquid is traveling within the body.

If Mom does in fact has aspiration, she is not punishing you by refusing food. She is just afraid to eat. My Dad had aspiration issues and he would cough big time any time he tried to eat.

As for not showering, many different issues could be happening. Some people develop claustrophobia being in the shower [I now have that issue for myself]... some older people don't like the way the shower water splashes on them.... then the major fear of falling while in the shower.

Buy Mom some shower wipes or baby wipes that smell nice, Mom can use those when she doesn't feel like showering. Then find some rose scented body powder that Mom can use afterwards. and only after she had cleaned herself up. Rose powder was very popular back in her generation :)
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