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My 90+ year old relative lives in an independent living facility where she pays for two meals in the dining room and eats breakfast on her own. A few years ago she fell a few times and was in rehab for a bit, apparently due to electrolyte imbalance. In my opinion, she was having short term memory issues and declining mentally. She also seemed depressed and sometimes talked about never leaving her room again.


When Covid hit, her facility closed the dining room, canceled activities, and delivered three meals a day to all residents. Overall, she seemed so much happier during this period. Instead of complaining about the place, she talked about how wonderful it was that they were being so careful. She also seemed more 'with it.'


Now that things are getting back to normal, she seems like she is slipping to me. The dining room has reopened and she's still getting two meals per day. She is more irritable and back to the relentless complaining. Is it possible that the full breakfast made a difference? It was an eggs/bacon/ toast type meal. She says she eats breakfast on her own, but I suspect she just drinks coffee.

The first place that a dip in glucose is felt (or not realized) is the brain. Alz & Neuro like diseases are often referred to as type 3 diabetes. Breakfast is just that, breaking the fast while sleeping. It is a challenge to keep my seniors glucose/blood sugar on a even level as we do not eat as much or as often as a person that is more active thus requiring the fuel for energy. However, I see the change cognitively and or by attitude/mood in the slightest dip and strive to avoid the dip. There was even a Snickers commercial where a person became “Hangry” and it is so very true. It could verrrrrry well be that your relative’s attitude IS due to skipping breakfast. I use all the tricks to keep a steady flow of “brain fuel” every two hours or a bit less. It just helps to make a better quality of day I think. And that is honestly all that I can hope for, daily quality with the time that is left.
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Reply to Warriorforthem
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I think the key is getting a good breakfast. My 91 yo mom eats 2 meals daily: breakfast & supper. Her breakfast is: fruit, 1 egg/bacon and either toast or oatmeal. Breakfast makes the biggest difference in her well-being IMO and she takes most of her meds at breakfast (the rest she takes at supper). If she’s feeling hungry mid-day, she eats some cheese.

If your relative can only afford to pay for 2 meals, breakfast should probably be one.
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Reply to InlandMeg
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After Mom moved to AL and was required to eat all meals in the dining room her health and weight improved.
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Reply to Frances73
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Imho, as the saying goes "Eat breakfast like a king, eat lunch like a prince and eat dinner like a pauper," that said, breakfast is the most important meal of the day. Three meals a day is best for your 90+ year old relative.
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Reply to Llamalover47
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Follow your intuition.

Can she order delivered breakfast like during Covid?

if she takes medication in the morning, it is even more important to have breakfast.
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Reply to ACaringDaughter
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Can she afford to pay for 3 meals (is that offered) and get breakfast delivered? If you're seeing a difference, it's worth a try. Otherwise, if she had smoothies in her fridge, or Ensure, would she have them?
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Reply to NancyIS
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As a newly retired Nutrition counselor for the geriatric nursing home population I can tell you poor nutrition adversely affects the elderly! My own mom…who lived in an independent apartment setting with 3 meals daily in a dining room…failed during Covid room lockdown…meals brought to her apartment were useless…she actually had a mental break and ended up in a memory care due to throwing the delivered foods away. She lost 15# in 8 weeks. She lost her ability to walk without falls. It took 8 months for her to regain weight and strength and now lives in an assisted living for closer monitoring of daily activities {she is 87}…If an elderly person loses 5% of their normal weight in 30 days or 10% loss in 6 months this can severely affect them…mental abilities will decline and irritability may occur.. I always started a liquid supplement between meals…even 4 ounces twice a day can help..like Ensure or even Carnation Instant breakfast mixed with whole milk..offer pudding snacks…ice cream even..Breakfast for most elderly is the best accepted meal..I advise she has breakfast in the dining room. They consume more when they eat in a social environment ..Good Luck!
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Reply to Sadinroanokeva
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I experienced a similar situation with my dad.

Eating nutritional meals, at the same time daily and getting his meds as needed was a life changer for him.

I think that the regular socialization helped a great deal as well.
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Reply to Isthisrealyreal
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Yes! Having regular meals helps to keep her blood sugar balanced and provide needed nutrients. Talk with her about having all her meals in the dining room.
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Reply to Taarna
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BeenThroughThis Jun 11, 2021
Taarna, it sounds like the lady loved having “room service” breakfast delivered daily so she didn’t need to get dressed and to the dining room early in the morning for breakfast.

Perhaps faranlee can arrange delivered-to-room breakfast each morning, and let her loved one continue with the lunch and dinner dining-room meals.

good luck, faranlee!
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I saw my mom’s appetite change over the years. She was never a ‘big’ eater but she ate adequately. In her final years of life she claimed that she never felt hungry. I asked her about it. She told me that she ate only because she knew that she had to.

My mom was skin and bones when she died. Some people get old and super skinny. She liked food but didn’t have much of an appetite. I cooked all of her favorite dishes for her. She couldn’t gain weight even though she tried to. She loved ice cream but even though she ate ice cream weekly she didn’t gain an ounce.
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Reply to NeedHelpWithMom
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Melora Jun 11, 2021
I sympathize, Needy! My mom is the same way! She goes thru periods where she’s “just not hungry” that will last for days sometimes weeks. I swear it seems that she can lose weight overnight! You’re doing all the right things, but I concur: it IS worrisome! Good luck!
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Here's a thought... could it be the concept of 'communal dining' doesn't appeal to her (not a 'people' person?) and the personal service received during covid allowed her to eat in peace and at her own pace? She may simply have felt more comfortable. I know I'm not a fan of eating in public - makes me all tense so I can't enjoy my meal!
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Reply to Kantankorus
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cwillie Jun 8, 2021
I used to hear a lot of stories about the cliques in the dining room from someone who worked there, if seating places are assigned or meal times are limited a pleasant dining experience is not always possible.
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Would she drink a breakfast smoothie with her coffee? There are some pretty decent ones available in cans and cartons- shake ‘em up, pop ‘em into a glass, fueled until lunch?
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Reply to AnnReid
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faranlee Jun 8, 2021
I don't think she would, but that would be another good solution.

She has someone pick up groceries for her every week or two but she doesn't seem to use the groceries she has - like you open the cabinet and there are ten boxes of the same cereal, six packages of the same cheese in the fridge. She always had a sort of stockpiling inclination (which I think must run in the family because I have it too), but it makes me think she is not actually eating unless it's something that's served to her.
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Your suspicions could be spot on.

Is it possible to 'add on' assisted living services? If so, having an Aide pop in to prompt breakfast every day would be ideal.
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Reply to Beatty
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faranlee Jun 8, 2021
It is, and it may even be possible to get breakfast delivered again. I saw her today and she mentioned how great the breakfast delivery was so I think I need to get this started. She also told me that the breakfast in the dining room is at 7:30 and she likes to lounge around in the morning and take her time getting ready for lunch. With the delivery, it's just there and she can eat in her nightgown.
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