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My mother is 83 years old. She has Alzheimers and Osteoporosis as well as Cachexia. She weighs about 94 pounds when she used to be a solid 125 before her Alzheimers advanced. She is perhaps in the middle stages of Alzheimers where she is very confused, able to move around, recognizes people she sees all the time but has a 2 minute memory, thinks she has taken her meds when she hasn't and gets frustrated. I had to move her in with me recently when my father passed away (they were divorced but still friends). She is extremely confused naturally but I am very concerned about her weight. She literally has no 'meat on her bones' and her cheeks and temples are sunken in her face. She has had no appetite even before I moved her in. She used to have a very hearty appetite for food but now hates everything unless it's 'junk' food and sweets. No matter what I can't get her interested in cheese, meat of any kind, or an protein substance. She makes salads often which is good but drinks lots of coffee. She often complains of feeling like she needs to puke and I tell it's because she drinks nothing but coffee all day and has no breakfast. She eats usually once a day and picks at her food leaving most of it on her plate. I tried to get her to drink protein drinks of all kinds but she hates those too. I notice that if you ask her to try anything she automatically wrinkles her nose. We are all concerned and I'm at a loss as to what to do. I thought that once she moved in I could get her started on some kind of a meal schedule again but she resists everything. Does anyone have suggestions or have you had similar problems with a loved one like my mother's?

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Have you talked to her doctor about this?
Is it possible that she is having swallowing difficulties? Those need to be evaluated by a speech language pathologist.
There are meds, Remeron is the one that comes to mind, that is an antidepressant, but has increased appetite as a side effect. It had that effect to great benefit on my mom.

It feels to me like this is a medical issue and should be addressed by her doctor. Is she being seen by a geriatrician?
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Have you ever tried those protein drinks? I have. Bleuch. Like drinking sweet soap.

What about an ordinary milkshake, or an ice cream sundae? Real custard, jello, crème caramel, yoghurt. There are all sorts of tasty things which are also wholesome, especially if home-made.

She may like the coffee partly through habit and partly for the comforting heat of it. What about soup? You can sneak in all kinds of goodies with soup.

I should worry a little bit less about the protein content and concentrate first on getting calories into her.

And I agree with Barb that you need some medical input here, and I know it can be difficult to get a person's medical files smoothly transferred if there's been a change of practice. Has the weight loss been investigated? Has she had a check up since she moved in with you? Any other problems associated with the cachexia?
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I actually blend everything that my grandma cannot keep down such as meats, and vegetables. I use a mini chopper that chops everything down to the point of where it's more of a mash potatoes which she loves, rather than chicken or beef. She will eat it in soups and with her dinners each night. It's amazing how good chicken with a bit of ranch will taste when it's been chopped into the same consistency as shredded chicken sandwiches (only this isn't shredded and literally cut into such tiny pieces I can't tell the difference of mash potatoes and chicken). I add this kind of thing to her soups where I make a brocolli and cheddar soup and will dump in this soft chicken mixture and will sneak in cauliflower like this to the broccoli soup. I have even added it to creamy soups. I will add this mixture to rice which is easy for her to eat. I have added spinach cut up like this to chopped up spaghetti noodles and tomato sauce (although I have to be very light with the sauce as she has acid reflux that acts up a lot even on her pills). If she won't eat it do as suggested and make shakes or even blended soups to make. I used to make my mom all sorts of shakes to drink as she was on ensure. She mixed her ensure with ice cream to make it more hearty and then would drink a cup of soup for lunch where I had jammed packed all sorts of good flavors. I found some ideas on the internet (she was battling cancer and due to various surgeries where they removed part of her mouth and throat swallowing was a challenge and chewing was impossible!). She would love the squash soups I made when I added in nutmeg and other spices recommended. Her favorite was a cheddar broccoli soup I made for her where I would make sure it had high flavor. The trick is flavor. Make sure everything they ate has flavor so it tastes good. I have found that bland food although easily eatable, makes a person lose their appetite. Where something used to taste yummy when it tastes gross, they tend to not want to eat it which is what I was finding with my mom and now with my grandma as well. My mom also found each type of milkshake had a different flavor. She didn't like the basic ensure but instead tried an off brand from walmart and loved it. She said it was sweeter. So try some creative things and just because it doesn't work once, doesnt' mean to give up hope of it not working the next time.
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My father in law was the same before dementia set in, healthy appetite and good weight on him. Now he craves sweets and foods he never would have eaten prior such as pizza and chicken nuggets.
I am with the others, while protein is important I too would focus more on calorie content.
Giving her a milkshake as suggested is a good idea and protein powder can be added to that if you wanted to try that...remember there is protein in eggs, peanut butter and cheese and yogurt.
Dad eats lots of grilled cheese sandwiches I cut up into small squares that make it easy for him to manage. Skinned apple wedges offered with peanut butter to dip into is another favorite.
We give him cheese chunks along with various meats such as bologna, pepperoni and summer sausage with crackers on the side and he loves that.
Another factor that helped us is we stopped asking if or what he wanted to eat as he always, always said no or nothing - always. So instead we simply put his meal in front of him telling him there is some food, eat or don’t it’s up to him and we step back and leave him to it. Within minutes he eats everything offered.
Much like a child would act, he wants it to be his idea and doesn’t want to be told. Also too, many individuals with dementia or Alzheimer’s don’t seem to feel hunger or thirst and when they do it’s fleeting, meaning they forget they’re hungry or even often think they’ve already eaten when they didn’t.
When dad eats a “healthy” meal, we always offer something sweet afterward for dessert (reward) - that’s something he doesn’t ever seem to forget and looks forward to so maybe you could try that.
What I do know from experience is trying to reason with someone who has lost their reasoning skills is a waste of time so you’ve got to be creative and sometimes change your expectations.
Last suggestion - if your loved one is drinking coffee all day long, switch to decaffeinated if you haven’t already. We noticed all the caffeine dad was getting in cup after cup of coffee was making him edgier and jittery. Decaf made a marked difference in his moods.
Good luck to you!
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There is beneprotien you can add to her food and meals it’s a powder and also ensure enlive with every meal ..hugs to you and your mom keep us posted
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Our Dr told us to use instant breakfast inthe milk for cereal. We only use 1/2 cup milk to a pkg and it works well. We also put Ensure type drinks in oatmeal or make muffins. As someone else says dad preferred Wal Mart drinks until they changed the pkg to where he could not get the straw in the cardboard boxes. We also had to waste or change containers if he did not drink all. We get shakes and for some reason he gains weight with Sonic shakes if you have one near you. Of course I gain weight also cause they are good. Good Luck its a battle gain 2 and loose 3 lbs.
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As my mom got pickier, I started adding ensure plus to her coffee...like creamer. I started with just a little (vanilla) and increased the amount slowly over time. Now she drinks 4oz coffee with 4oz ensure. I warm up the ensure and add sugar... They tend to do better with things sweet.
I also feed her Greek yogurt (find a brand high in protein) add a little honey and raspberries... Mom loves it. You can use the Greek yogurt to make smoothies too. Protein is very important to prevent skin break down. (I have a daughter who is a nutritionist so I get lots of help)
The recommendation for you to get a swallowing evaluation is good too. I am lucky enough to have another daughter who is a speech language pathologist. She evaluates mom's swallow for me... She has a delayed swallow right now and needs to be watched and prompted. My mom is stage 7 and is 82lbs. She just gained 2 lbs, hooray!
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Add broccoli and spinach to her salads. They provide a noticeable increase in energy and for me are a substitute for meat. I always feel more energetic after I've eaten a salad.

You can also add some little tiny pieces of ham, chicken, beef or turkey; she might not even notice them.
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Lots and lots of good advice given. Will she eat any kinds of beans.
Eggs can be mixed into almost any kind of recipe. If you have one of those high speed mixers you use for smoothies almost any kind of protein can be blended into that.
For the sweet cravers most deserts, cakes etc will accept eggs and what about cheese cake or even cottage cheese mixed with something like canned fruit.
Pizza lovers can have any kind of meat or fish as a topping and of course there is the cheese.
Plus the crust can also be made with eggs.
The problem with this Mom I think is part of her decline and gaining weight may not be in her future so let her eat or drink anything she fancies at this stage in her life.
As far as the protein drinks are concerned I absolutely agree with anyone who refuses to drink them. The only one I will even consider is Bo**t and then only chocolate flavored. i am so off the taste of vanilla I won't even eat vanilla ice cream.
One final option is to request a feedig tube. I have one due to swallowing difficulties and it has stopped me from starving to death. Medicare only approves them 25% of the time (I had three swallowing test failures and great weight loss). They are a small hassle and I am fortunate in that don't have dementia and can manage the whole thing myself. You do have to use special feed and they have to be changed every three months which a dementia patient may not tolerate well. However if this Mom's health is otherwise generally good it could be a solution. I have a GJ tube which is inserted through the belly wall.
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Thanks for all your suggestions....The doctor does know and he is a general doctor. I asked the hospital she belongs to if there was a geriatrics doctor and they said no. I find that hard to believe but there isn't one listed in their directory. I hope to try out your suggestions. I will keep you posted!
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Yes, Juleskb, do keep us posted! The brain controls all of our functioning -- how we perceive temperature, whether we are hungry, how we perceive pain. With the brain damage in dementia just about any function can get out of whack. People who don't have close contact with those who have dementia may think is it only about memory. We caregivers know different!

When my husband lost his appetite and claimed eating made him nauseated, his geriatrician prescribed something that helped both.

Some types of dementia destroy the sense of smell, reducing the appeal of food. My husband liked spicy condiments to intensify the taste experience.

When he began to have swallowing difficulties he loved homemade milkshakes. One of his favorites was chocolate ice cream, chocolate instant breakfast, a banana, and a scoop of peanut butter, and just enough milk to get this all smooth in the blender. (We called it the Elvis Shake.)

Once I noticed he was having difficulty with chicken noodle soup. I said, "You know what? I'll bet you'd like that better as cream of chicken soup." I put it in the blender, reheated it, and put it back in his bowl. He could manage that much better.

My mother liked deviled eggs, and seemed to do better with snacks than with meals. That changed, though, and she had a healthy appetite later.

I agree with others that your first concern here is getting more calories into her, whether they are "healthy" or not.
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I think my Mother quit eating meat because it was hard for her to digest and also chew,with her denturesso I gave her Chocolate Ensure mixed with Hershey's chocolate syrup and added a bunch of ice and a tiny amount of water and my Uncle made and brought over baked custard in little ramkins,I could easily give Mother.Root beer floats worked good for Mom too. I hope you find some foods that work for your Mom soon.Take care~
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My father shunned most foods. Heavy meats and vegetables were not something he wanted. What I did was bought a lot of snack foods and made finger foods for him. He liked things like boiled or scrambled eggs. He didn't mind fish sticks, but he didn't want a heavy piece of fish. He liked fruits. He really liked snack cakes, cookies, and ice cream. I wasn't planning his meals with an eye to his future. He was in his late 80s and getting close to death. It was better to give him something he enjoyed.

When he was in the hospital during his last week of life, they found his stomach was inflamed. It didn't surprise me. He had probably had the problem for a long time, but wouldn't let doctors help him. He lived until he was almost 91, so I guess it worked.

If life is nearing the end and the person isn't diabetic, I think it is fine to let them eat whatever appeals to them. Many of the organs, including the stomach and intestines, are not working so well. Things like eggs are wonderful -- plenty of vitamins, proteins, and fats, and easy to digest. Heavy foods like meats and vegetables can be hard to digest.
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Ask her doctor about Megace. This medication is given to seniors that have no appetite and is used short term - maybe 1 -2 months max. It worked for my mom.
She needs calories to gain weight and protein to build muscle.
Whey protein powder can be sprinkled over her foods. It is tasteless and provides a lot of protein. Whey Protein Powder can be purchased in many retailers. 
Good luck to both of you!
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