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My Dad used to love to eat just about everything. He is losing weight, is weaker and today had constipation so bad he went to the emergency clinic where they had to take painful and extraordinary measures to help him. He lives on his own but has agency help, close neighbors, friends who check on him and bring him food, and his niece in town (she's a nurse) His doctor gave him pills to enhance his appetite but it didn't work. I think moving him into an elder apartments where his friend lives would be good for him and might help his appetite. He is so stubborn and wants to remain at home. I'm the only child - Mom died 3 years ago. Up until a few months ago, Dad seemed okay (not great , but okay - he doesn't like the fact that my husband and me won't move there and he doesn't want to come out here to CA ) I feel hopeless and guilty about this at times, but do visit him every 3 months (a 2000 mile trip). ANy advice?

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I'm going to toss a small comment in here. I think one of the most common reasons for constipation in the elderly is dehydration. I tell my clients I'm the "water police" and I really encourage them to drink. Warm liquids tend to activate the digestive system more quickly than cold, so either weak tea, or even just warm water can help. One trick I use with the reluctant eaters is to cut food into small pieces and arrange it attractively. Vary textures, as others have suggested, and temperatures. But you're not there to do this! Do you have an after-Christmas update?
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Dad has asked his good friend to move in, but his friend declined because he already has a good situation in a subsidized housing. I'm trying to get Dad to move there but he doesn't want to leave his house (Mom reversed mortgaged it years ago without my knowledge - once Dad moves out, the house goes to HUD). Mom and Dad lived in the moment and didn't save much for their old age. They made enough to live on but were far from wealthy, which makes it a challenge for me now to figure out at-home help, which is so expensive. In the end I think subsidized housing or assisted living aided by Vet's Aid and Attendance (Dad's a WWII vet) is the way I'll go. It's just such a laborious and perplexing process filing with the Vets. They are quite slow in Louisiana.
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Does he have a friend that could move in with him????? My parents got several of their friends to move in with them and hired 24-7 help -- sort of a private nursing home. They had had all bathrooms handicap equipped etc. They all had a great time for quite a few years.
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It's so hard to tell with parents how they're doing overall. I've had many, many instances of thinking my mom was on her last legs, only to have her bounce back and be fine. Same thing with my cousin and her mom. With the little info you've given us, it doesn't sound to me like your dad is near the end. It sounds like he's lonely and would like to see you, but it also sounds like he's still sharp and doing as well as can be expected, all things considered.

Whatever you decide, don't beat yourself up.You're doing the best you can. None of us have a crystal ball about the future. Keep us posted on how he's doing.
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Thank you all for your comments. My cousin, who is a nurse, accompanied my Dad to his doctor 2 days ago. She has been really helpful. Anyway, Dad asked if he could go to the hospital (where my cousin works) for a few days for tests to see a possible underlying cause. Even at 93 his basic vital signs are all good, except for the appetite. Therapists are checking swallowing ability etc. They are recommending miralax too. But the doc has now put him on an anti-depressant, thinking that might help. I hate Dad to be on yet another pill, but it's not surprising he would feel depressed having his appetite be so poor these past few months. I am POA and will stay in touch with the doctors. I and my husband will be with Dad for Christmas season, but he is asking if I can come sooner. My cousin doesnt' think he's close to the end. My Dad has never been a loner and being a widower and getting older has made his need to always have people around him, that much more acute. I keep wondering if I should go earlier and that I am really selfish for not. It will be quite a bit of money to change the airline ticket, arrange my 2 pt jobs off work and I'm also in part time school. If I thought he was really dying now, I'd go in a heartbeat. It's just so hard to tell with Dad, as he always asks me to come earlier and hen apologizes for doing it. I do think he should no longer live alone, but he refuses to hear of assisted living or the catholic subsidized housing his friend is in. He wants to live with his sister, but she doesn't want him to.
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I recently listened to a program on NPR about how people coped with losing their sense of smell/taste. Did you know that one of the founders of Ben and Jerry's Ice Cream can't actually taste any of the flavors? But that's why the stuff is loaded with chunks of goodies. He learned to appreciate food by its texture.

You might suggest to his providers to experiment with foods with different textures-chunky soups and stews or creamy smooth ones. Perhaps serving some hot and cold foods in the same meal. Encourage foods that have a high liquid and fiber.

P.S. I, like some other folks, would suggest Miralax. It's gentle and works by pulling water into the bowel. I would only use the mag citrate on advice of father's physician--it's irritating and powerful and unless dad can move quickly, could have some unpleasant consequences.
One last thing, if your father is mobile, walking aids digestion and elimination. If that's not feasible, gentle abdominal massage can be beneficial, too.

I used to work for a pharmacy that supplied nutrition products. Have you tried any of the nutritional meal replacement/supplements? Many people enjoy the soothing texture of pudding and Boost and Ensure both make meal-replacement type puddings. Ensure also has a complete line of liquid supplements including Ensure Clear if the milkshake type is unappealing to him.
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Yikes. I'm a geriatrician (visiting, learning from you all) and your father's story worries me.

If over the last few months he's had a noticeable change in weight, appetite, and energy, then I would want him to be checked for a new (or newly worsened) medical problem.

New/worse constipation can be from something in the colon, from meds, or from just eating a lot less and being dehydrated. I do usually suggest miralax and also senna, but that's after having made sure that this constipation isn't signaling something worrisome that should be treated, or at least known about.

Eating less can be all kinds of things...can be due to losing sense of smell, can be dental problems, can be loss of appetite due to serious illness in the body, can be trouble getting to store because of cognitive/physical problems, etc.

I would look into the underlying causes of these changes before planning a living change...it is often a bad sign when someone his age loses a lot of weight...sometimes we find a treatable cause and turn things around and sometimes we don't.

It sounds like it's hard for you to accompany him to the doctor since you live far away, but maybe you can see if his doc will use visit sharing technology, or can someone you trust go with him? Tell the doc you want help understanding why he's having these problems, along with appetite improvers and laxatives.

Good luck!
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I've noticed with my mom (who will be 94 in a few days), if I'm there with her, she eats more. She's down to about 135 from her normal 170. So I imagine with your dad living by himself, his eating is no longer social, so it's not as appealing. Plus I think taste buds just get worn out and food doesn't taste as good as it once did. I get my mom the highest calorie things I can find. Pecan pie, full fat ice cream, mixed nuts, biscuits and gravy, mac and cheese...whatever high calorie foods I can get her to eat. At this point, any calorie is a good calorie. My mom eats 1/2 orange and prunes every morning for breakfast and stays regular. Knock on wood. Prunes have sorbitol which helps the gut start to move. We've used Miralax in the past for her and my dad, so I'd second that idea. Also make sure your dad is drinking enough. I buy my mom diet sodas, which she really likes. With that and coffee and water, she seems to be getting enough fluid to keep her regular.

It sounds like you've done what you can for your dad from a distance and it sounds like he has a good support system in place. I hope you can get the food/constipation figured out.
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PS Amazing you visit your Dad 2,000 miles away more than my siblings who live in the next town visit my mom! lol
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Thats a tough situation. I dont blame him for wanting to move, its his home, I wouldnt want to move either. You must be his DPOA, what does his doctor think? You should ask his doctor because if he is nearing his last days you could go live with him for 3 months. I took off from the FMLA to take care of my Mom to get her situated. If he is near death he will want you, how sad. As far as food, real maple syrup works wonders on thick french toast or anything! I have a prune pudding recipe if you want it, I give it 2 daily, with 1 teaspoon of miralax in real coffee everymorning, and 4 oz of prune juice every night. If I dont, regardless of how her bm's are, they will start to bind up, been doing this for 4 years now. The bowel is a long track, give it daily to keep the trac soft and moving, no matter what! Good Luck!
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Add Miralax daily to coffee or hot beverage, this should keep him regular. Hard with the appetite. Sometimes it's a matter of eating with someone vs by yourself. Keep a lot of high calorie nutritional drinks and snacks readily available so he can snack more than eat a big meal.

See if he will consider riding with a friend to local senior center for companionship and noon meal.

Hard being so far. Just visit when you can and call and send cards and little treats in between visits.
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You all have been so helpful. Your suggestions and your encouragement and support are very much appreciated. Thank you and bless you.
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The pills his doctor prescribed probably are causing the constipation. Almost all meds have the ability to cause constipation. Having said that, have him swallow magnesium citrate (this form) every day and perhaps 3X a day to prevent him from fecal impaction, and an ER trip. Being constipated is also an appetite suppressant. Have him drink his fruits and veggies in a very blended form to get nutrition inside. Also recognize his body is starting to deteriorate. God bless him for having lived to 93 and survived the death of his spouse. (Research shows a widower dies within one year of their wife dying, but widows fare much better). Know that you are doing what you can, nothing will stop him from dying, and you cannot move to be need him. Going as much as you can is great and you need to stop feeling guilty about not being there. We all die. No one can stop that process. God must need him in heaven, so rest assured He will take good care of him. Your dad will be with your mother. Merry Christmas!
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You know how when you have a bad cold that food tastes different...tastes kind of bland (if you can taste it at all)? One of the reasons is that taste is closely tied to smell. When your nose is stopped up, you can't smell.. and can't really taste. It is my understanding that as we age, our olfactory senses get weaker -- we've all come across elderly women who wear WAY too much perfume; that's because they can't smell how strong it is. My mother is nearing 90 and had a similar issue with not wanting to eat. Her doctor prescribed Mirtazapine, which is a mood elevator known to increase appetite. After the 3rd day taking it (yesterday), her appetite has started to improve. Hope this helps.
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