How do I help my father with vascular dementia and Type 2 Diabetes control food intake?

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My dad suffers from the early(ish) stages of vascular dementia and full-blown insulin-controlled Type 2 diabetes. He is struggling with high blood sugar readings even with the daily insulin dosage. His GP is working on adjusting it, but I strongly believe much of this is due to his inability to moderate his food intake. I prepare the evening meal, balanced, with mainly meat and veggies, a small side of carbs on occasion, but he prefers to fix his own lunch - he orders a grocery delivery that contains canned soups, bread products, cookies and sweets, with some fruit and veg (often carb-dense). He also orders a lot of take-out food and hides it from us as I had a discussion with him when I started preparing more meals about how the amount of Chinese food and pizza ordered worried me. I want to find a way to help him eat healthfully and prevent bingeing behaviors. Does anyone have any resources or product suggestions I could look at? When I try to research I tend to find the opposite problem being more common for seniors with dementia - an unwillingness to eat, and we are definitely not dealing with that at this point. Any suggestions at this point would be welcome. My husband and I follow a low-carb lifestyle and my dad had showed some interest in it but does not care to stick with it.

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I suppose I fall into the category of younger folks here... But I honestly don't see my Dad as a patient, and I have never been told that he is dying so some of this discussion is a little jarring for me, although I certainly appreciate that anecdote in your circumstances and am glad the nurse saw eye to eye with you in the end! I make my dad plenty of delicious food that he does enjoy, I'm not trying to limit his small pleasures but to assist in managing his health so that what good time he has is of the highest quality and the most comfortable for him. He's often nauseous and uncomfortable in addition to his sugars being out of whack. He is most definitely a member of the family but I often feel that I'm not a natural born caregiver and worry I'm not doing the right things by him.
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Jeanne, good advice. I totally support your approach! I've done the same thing. Even though Dad is on a dysphagia diet, I do let him have sugar cookies, something he's liked since childhood.

After all, there's not much attraction to pureed food, especially after it's been cooked, shipped and reheated. Yuck.

I think that some younger folks, especially medical personnel, who see our elders as patients rather than family don't realize that at some stage it's appropriate and acceptable to allow deviations from completely healthy lifestyles. After all, emotional gratification and enjoyment can be just as important as eating properly and doing all the right things medically.

Thanks for sharing your insight.
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Just a little personal anecdote:

My husband, Coy, was encouraged by doctors to eat what he wanted to. Fortunately Coy liked a lot of healthy food, but lifting all his dietary restrictions was like an end-of-life gift. (Sort of like the Make-A-Wish program.)

In addition to dementia Coy had CHF. His heart clinic ordered a scale for him, hooked up to the clinic via telephone lines. It was useful in letting us adjust things for a few days if his weight went up suddenly (which would indicate water retention.) A nurse monitored Coy's weight and called if she had any concerns.

Once she called and told me that Coy's weight was up 3.6 pounds from yesterday. "Oh yeah," I replied. "That was probably the big pickle and sausage at the German restaurant. I'm watching his diet today and tomorrow a little more closely."

The nurse was horrified. "A pickle? A pickle? Don't you know how much salt is in a pickle? Why would you let him eat it?!" She really sounded mad at my negligence.

"Ma'am," I told her, "Coy is dying from dementia. His geriatrician and neurologist encourage him to eat what he enjoys. I am not watching his salt intake. I like knowing when he is starting to retain water so I can make some temporary adjustments. I'm trying to keep him comfortable and happy, not get him well or to live longer. If that makes us ineligible for this service, you can order the scale to be picked up."

Nurse: "Oh no, no. We want you in the program. Watching for sudden weight gains will keep him more comfortable. I understand your approach and I thank you for explaining it."
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Thank you Digusted and Llama. It's certainly something I have considered. At this time he is not considered incompetent so taking control of his finances could be tricky but I will be consulting a family law specialist for advice in that area.
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disgustedtoo: I already made that suggestion to the OP. Thank you for backing it up, though. Maybe the OP will consider that option if it's seen twice.
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Since he lives in your home, is there any way to control his access to money and/or credit cards? If you have DPOA, you could cancel or freeze his credit card(s) and limit how much cash he has on hand - that way he cannot order food from outside. Once that can be eliminated, allow maybe once/week pizza or chinese food as a treat?
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I'm not sure if you have considered Palliative care. I decided on that with my LO, as it was what she would have wanted. As her HCPOA, I went for comfort care. So, we do all we can to keep her as comfortable as possible. Her diabetes treatment is to keep her comfortable and not to extend her life. If blood sugars run too high, they can suffer from thrush, yeast infections, neuropathy, blindness, etc. So, there are real practical reasons to keep the blood sugars down to reasonable levels. Very tight control is not the goal with us, as we understand that her dementia is terminal.
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Hi Everyone, I'm sorry that I posted and "ran" - it's been a busy few days. I really appreciate the input from everyone - and I don't feel that it's "judgemental" really - this is a relatively new situation for me and not one that I thought I would be dealing with for a very long time (I'm 33 and my dad is 65). It is very hard for me to digest that he may not live much longer, and my efforts to help with diet etc. are in aid of him living a longer and more comfortable life if possible. A few things I didn't detail - he has bouts of diarrhea and nausea, which I suspect are either brought on or not helped by his dietary choices. I'm not harsh with him - it's not in my nature or my interest to be that way - he is my father and I respect him as an adult, but I do want to help as he lives in my home and eats the food I prepare. I make lots of diabetic-approved and heart healthy treats - chocolates, "sweets", healthy copy-cats of fast food items, but I have shared with him my worry about the take-out food (gently, I promise), and that I want him to feel good for as long as possible. I work all day, as does my husband, and I worry about him very much, that is where my question came from. I will try to take all the advice I've been given, to stress less about it and allow him to have what he likes and make the years he has with us happy and unrestricted - I just hoped that maybe I could make them healthier too. Thanks again everyone.
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This reminds me of a story about my Grandfather. Mom had him on a strict diet and he ate most meals with us. He lived alone next door to my parents so it was easy to walk across the lawn. Grandpa love to walk and loved kids, he'd spend hours at the local little league park watching all the games. Nearby was a Stewarts, one day my cousin & his wife went in for milk and saw Grandpa sitting in a booth so they joined him. The waitress brought him his lunch, a hot dog. Grandpa leaned forward and whispered "Don't tell your Aunt Ellen about this". Hot dogs were a big no no on his salt restricted diet. Yes Pat told my mother and we all had a little laugh, Grandpa thought he got away with it. It was a small town and there is not much that you can do with someone noticing. Mom figured as long as it was not an everyday event she'd let him have his little secret. He lived to 87 and was in his own house until the last 4 months.
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Living longer is not necessarily a great goal for people who have dementia. Living better with whatever time they have left was my goal for my demented husband and mother.
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