He takes a long time to eat, and throws half his food away. Do I have to go the liquid route/baby food, or how wrong would it be just let nature take its course
To me, when the will/wish to eat is gone, the ability to swallow safely is gone, it is the bodies way. I would not interfer, myself.
If you are POA for this person, then you will know his or her wishes when he or she was able to express them. I so fear having tubes for feeding forced upon me that my advance directive is written so as to explicitly forbid feeding by tube either IV for NG/PEG. I also refuse dialysis and some few other things. I do not wish to live in that circumstance.
Yes you need to puree' all of his food and thicken his drinks with the product Thick It, so he can eat and drink easier. When the time comes that your husband is dying, he will let you know that he doesn't want any food or drink. But until then it's your duty to make sure that he's getting the proper nutrition in whatever form that looks like. Doing anything other than that would be you contributing to his early death. Could you really live with yourself if you were to do that?
I really disagree with this. It is not anyone's 'duty' to force food (in any form) into someone, particularly someone who is 85 and in the middle stages of dementia. He takes as much food as he wants, and then stops - his decision.
Get that swallow study done. Make sure his doctor is aware of reduced caloric intake. It sounds like it is hospice time. My concern is that food needs to be offered but not forced. However if you stop feeding him without the doctors knowledge and he passes with a major weight loss you don't want to be investigated for neglect.
My husband has dementia in about the stage before last... He is still eating most days but other days doesn't want to eat much. I just go with the flow..
My mother who did not have dementia died about 15 years ago - she had had a stroke and a heart attack previously. She was permanently in a wheelchair for many years. She fell and broke her hip so was hospitalized. She chose that as her opportunity to escape the miserable life she felt she had. She just refused food and medicine knocking it out of the nurse's hand. My father asked her if she was choosing this ...and she nodded yes she was. Why prolong a life that has lost all of its quality. Move your LO into a hospice facility if you can when he gets to that stage. It sounds like he is eating when he feels like it at the moment. My husband dropped 2 waist sizes initially but has now evened out and has stopped losing weight.
Has he had a swallow study, called a video fluoroscopy, to watch exactly what’s happening when he swallows? This is the guide to let caregivers know what’s appropriate in feeding. My mother was initially on a puréed diet, supplemented by a feeding tube, post stroke. After a year or so, this test indicated she was aspirating the puréed food into her lungs and all oral feeding was discontinued. The test gives the answers
Get your husband a hospice evaluation if he's already had a swallow study done. Starvation can be a painful way to pass, and hospice will make sure he's kept comfortable.
For me the ethical thing was to provide appropriate food that my mom was able to eat, she could then make the choice to eat or not (she could have turned her head, not opened her mouth, spat out the food or just refused to swallow). And a modified diet is not reduced to simply providing liquid or baby food, as I've mentioned hundreds of times on this forum there are is almost no food that can't be modified in a way that is both attractive and flavourful.
Atlasshrugged, My prayers and thoughts go out to you as you care for your husband. I thought I'd share my experience in case it helps. I currently care for my dad who has dysphagia caused by two issues - cancer treatment yrs ago & dementia. He didn't want speech therapy evaluation yrs ago, couldn't understand purpose despite repeated explanations that it was to help identify swallowing issues. As the dysphagia progressed because of the dementia, I did as much research and reading on the internet and upon discussion w/his Dr, decided not to pursue speech evaluation, not to put him through undue stress, and the doctor said I was already doing what they would do anyway - soft foods, pureed, etc. In caring for him, I've learned to tell when certain foods are harder for him to eat, when to thicken liquids and to what thickness works best for him, mince and puree meats, vegetables, and more. I've also learned at times when he doesn't want to eat that it is usually because his copd is acting up and he's coughing more, or just no longer likes or wants that particular food. His tastes have changed. He just doesn't want certain things any more. If he starts coughing more while eating, I make adjustments - maybe needs more moist, or more thick, or pureed better. Sometimes I just put the food away, give him a break from it and bring it to him later. There were also situations where something was affecting his appetite. For example, he was on a med short term that affected his appetite.
So with your husband, depending on his situation, maybe just try some more pureed foods. Could his appetite be good and he is just having trouble eating? You can start with things he normally likes. For example, if I make chicken, I will put some in a food processor and chop it up fine, like minced, then add something to it like gravy or thicken sauce or thickened broth, to make it moist to the thickness, like honey thick, that is safe and easy for him to swallow. He loves it. Talk to and work with his doctor. See if the doctor feels a hospice evaluation may be right or not. And read and learn all you can about dysphagia diet/foods here on the forum and the internet, youtube, etc. Hang in there and take care of youself. Best wishes.
As has already been said here... ask for a swallowing evaluation before making big changes.
MacinCt said: "It sounds like it is hospice time."
Swallowing issues do not necessarily mean hospice time!
My husband had a PEG tube inserted in 2016 when hospitalized for sepsis aspiration pneumonia . We had been advised in 2014 to consider a feeding tube but had also been told he could aspirate on his saliva, so we decided to wait until IF or WHEN he got pneumonia. Part of the time he has only needed it for medication and one tube fed meal for nutritional support beyond what he enjoyed eating.
You're asking if homicide by neglect is wrong?! Yes. Yes, it is. Of course, you should feed him pureed food! Next he will require IV nutrients (unless he signed a DNR/Living Will stating otherwise). May God bless your husband. And, may God help you!
My mother died at age 64 of complications related to Progressive Supranuclear Palsy. She and my father had been married to each other from the age of 16. Watching my mother refuse to eat was one of the most traumatic events of my dad's life, but that was her wish--no feeding tube. I say this because when responding to someone struggling with a loved one's care, it is better to keep your comments productive. You can get your message across just as clearly without belittling someone who is already in pain.
If you are POA for this person, then you will know his or her wishes when he or she was able to express them. I so fear having tubes for feeding forced upon me that my advance directive is written so as to explicitly forbid feeding by tube either IV for NG/PEG. I also refuse dialysis and some few other things. I do not wish to live in that circumstance.
When the time comes that your husband is dying, he will let you know that he doesn't want any food or drink.
But until then it's your duty to make sure that he's getting the proper nutrition in whatever form that looks like. Doing anything other than that would be you contributing to his early death.
Could you really live with yourself if you were to do that?
My mother who did not have dementia died about 15 years ago - she had had a stroke and a heart attack previously. She was permanently in a wheelchair for many years. She fell and broke her hip so was hospitalized. She chose that as her opportunity to escape the miserable life she felt she had. She just refused food and medicine knocking it out of the nurse's hand. My father asked her if she was choosing this ...and she nodded yes she was. Why prolong a life that has lost all of its quality.
Move your LO into a hospice facility if you can when he gets to that stage. It sounds like he is eating when he feels like it at the moment. My husband dropped 2 waist sizes initially but has now evened out and has stopped losing weight.
And a modified diet is not reduced to simply providing liquid or baby food, as I've mentioned hundreds of times on this forum there are is almost no food that can't be modified in a way that is both attractive and flavourful.
https://www.google.ca/imgres?imgurl=https%3A%2F%2Fdrb960u7vv58y.cloudfront.net%2Fcrop%2F208932%2F1200%2F627%2Fimage.jpg&tbnid=Dm_SUFt3BK-C5M&vet=12ahUKEwimv8L0kaaEAxW8M2IAHWYVDlUQMygMegUIARCPAQ..i&imgrefurl=https%3A%2F%2Fblog.thealzheimerssite.greatergood.com%2Fpuree-mold-steps%2F&docid=h7fPnBrSLJF_aM&w=1200&h=627&q=better%20pureed%20food&ved=2ahUKEwimv8L0kaaEAxW8M2IAHWYVDlUQMygMegUIARCPAQ
My prayers and thoughts go out to you as you care for your husband. I thought I'd share my experience in case it helps. I currently care for my dad who has dysphagia caused by two issues - cancer treatment yrs ago & dementia. He didn't want speech therapy evaluation yrs ago, couldn't understand purpose despite repeated explanations that it was to help identify swallowing issues. As the dysphagia progressed because of the dementia, I did as much research and reading on the internet and upon discussion w/his Dr, decided not to pursue speech evaluation, not to put him through undue stress, and the doctor said I was already doing what they would do anyway - soft foods, pureed, etc. In caring for him, I've learned to tell when certain foods are harder for him to eat, when to thicken liquids and to what thickness works best for him, mince and puree meats, vegetables, and more. I've also learned at times when he doesn't want to eat that it is usually because his copd is acting up and he's coughing more, or just no longer likes or wants that particular food. His tastes have changed. He just doesn't want certain things any more.
If he starts coughing more while eating, I make adjustments - maybe needs more moist, or more thick, or pureed better. Sometimes I just put the food away, give him a break from it and bring it to him later.
There were also situations where something was affecting his appetite. For example, he was on a med short term that affected his appetite.
So with your husband, depending on his situation, maybe just try some more pureed foods. Could his appetite be good and he is just having trouble eating? You can start with things he normally likes. For example, if I make chicken, I will put some in a food processor and chop it up fine, like minced, then add something to it like gravy or thicken sauce or thickened broth, to make it moist to the thickness, like honey thick, that is safe and easy for him to swallow. He
loves it.
Talk to and work with his doctor. See if the doctor feels a hospice evaluation may be right or not. And read and learn all you can about dysphagia diet/foods here on the forum and the internet, youtube, etc.
Hang in there and take care of youself. Best wishes.
MacinCt said: "It sounds like it is hospice time."
Swallowing issues do not necessarily mean hospice time!
My husband had a PEG tube inserted in 2016 when hospitalized for sepsis aspiration pneumonia . We had been advised in 2014 to consider a feeding tube but had also been told he could aspirate on his saliva, so we decided to wait until IF or WHEN he got pneumonia. Part of the time he has only needed it for medication and one tube fed meal for nutritional support beyond what he enjoyed eating.
Best wishes in moving forward.