Mom's continuous weight loss does not jive with her excellent appetite. What is going on?

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I have asked a couple of questions here before you might recognize me or my mom. Mom just turned 91, and age none of us siblings ever in a million years imagined happening. I am the POA and Executor and the oldest child, and I also live 10 minutes from mom's long term memory care facility. I had to move about 6 years ago from my home in CA to NC. Mom has had demential for probably10 or 11 years, but we forced her to move the first time after a fall back in 2009. We told her Enough is enough. At the beginning she ate full meals and desserts, with some help, she could talk more coherently and it wasn't so bad. She slowly declined in other areas. A little while later, perhaps in 2010 or 2011, she became incontinent, stopped walking and is now in a wheel chair or bed full time and she is sleeping a lot more than normal. Over the past 6 or 7 months mom started shedding weight. 4 to 6 lbs. a month for a few month. 2 months ago she lost 10 lbs and this past month, 8.4 lbs. She is down to 124.8 which is very very low for her and she looks emaciated. Not too long ago she had to start on a pureed diet. Pretty gross, but they had to start it as she was losing teeth (just dropping out) and the food she did manage to eat caused pain, so she pocketed her food between her cheek and gums to save it for later, to not be embarrassed about not eating. Long story short, she eats full breakfast lunch and dinner as well a 3 nutrient fortified shakes a day. She is probably about 5.8 or 9, might be 5'11" for all i know. She is in the very last stage of dementia, but she keeps hanging on. She can still recognize my voice, although it is a hit or miss situation there. So the weight loss does not jive with her appetite and the full day of nourished products she gets. Most of the time she is almost asleep as we feed her. So is there anything else that could be going on here, such as cancer or some other internal disease or malady we are just not looking for? After all with dementia, we see so many different types of death signs, or behaviors, it is all attributed to that. I just wonder if it is anything else. And no we are not going to take precautions to get her better as her quality of life is the worst already, and nothing can improve it. So I was just wondering why the incongruity between the strong appetite, eating well, but consistent weight loss since 7 months ago and the loss seems to be a bit larger in the past couple of months than the first few. And then before that, she had gained a lot of weight over the past 3 years. It's just a mystery to me.

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As mentioned above, have your mom's thyroid checked as the thyroid controls metabolism. Maybe she may have a benign tumor or such on her thyroid.
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My mom is in the final stage of Alzheimer's. She eats well too...we hand feed her. My daughter is a nutritionist so I know she is getting what she needs. She has been steadily losing weight for a couple of years, but that made sense as she had quit walking so was losing muscle mass. About 5 months ago, she started losing at an increased rate...she went from 97 lbs. doesn't to 80. Hospice says this happens towards the end, the body just isn't processing and using all the nutrients. Other than that, my mom is still doing well so who knows ;-)....her bowels are still moving, her skin is not breaking down... We are at the same point as you...if it is anything, we will not treat...prolonging misery for my sweet mom is not my goal.
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Like Jessebells answer.
Moms AL didn't say anything to me about Moms weight loss, I noticed it and questioned.
Since she hadn't lost more than five lbs, they said nothing. But this was from the first of the year. They didn't count theweight loss in the previous year. I went to the Nurse and explained that Mom was on Thyroid medication and weight loss could be a sign the med needed adjusting.
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When I lost about 40 pounds without explanation it turned out to be diabetes. My husband lost weight in spite of eating fairly well during his dementia. The calories-in-weight-on formula just doesn't apply when certain conditions are present, and dementia is one of those conditions.

There is a saying ... "Don't do the tests if you wouldn't do the treatment."
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Sad thing is that cancers and heart problems go with the end of life. We're left deciding whether to treat them or not. I am so glad that hospice is there for us when it seems the best way to go. You know your mother best, so you'll have an idea what is right.
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Thank you for your answers. I walk a very fine line on wanting to know and then not wanting to know. Because we are going to do nothing to stop it. It might be that we are not seeing the dying process right in front of our eyes. And yes our cells deteriorate and decrease. You made me think I need to do more exercising each day!! I will be calling her doctor because if it is cancer, then I want her on hospice the sooner the better.
Thank you again
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Dear sdbike,

I know you love your mom a lot and I'm glad you are asking these questions. I would follow up with the doctor. Review her blood work, her medications, I think you are on the right track. I could be cancer. One of the signs of cancer is unexplained weight loss. If you want consider getting a second and third opinion about your mom's health. For myself I regret saying "I guess this is just the way it is" towards the end of my dad's life. I failed to see he was having heart failure. It was the reason for his weight loss. We all do the best we can, but it never hurts to dig deeper if you can.
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My mother is almost 91 and eats twice as much as I do. She eats a big breakfast and dinner and has snacks throughout the day. Yet she has lost about 40 lbs in the last 6 years, while I've gained a few pounds. She gets very little exercise. The thing is that she is old and nearing the end of her life on earth. Her small intestine is not digesting the food as well and absorbing it as completely. Her liver is not so good at processing the nutrients. Cells in her body are being lost much faster than they are being replaced. It is a normal process of life when we get old. The spirit may stay strong, but the body wastes away. It is actually a process that starts when we're in our 30s, but doesn't become noticeable until we get in our 60s. By the time we are in our 90s, the loss of cells and decrease in the efficiency of our organs is very apparent. Nothing unusual. It just means that we've lived a long time.
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