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Dad is turning 87 this month And can still walk with walker, he loves his stuffed dog, is happy to see people.... But gets very angry and refuses to eat most meals. I can't see thriving on just ensure. Appreciate any suggestions....
This is common with dementia. Does the facility where he is ACTIVLY encourage him to eat? (another reason that I think people with dementia should be in MC not AL) With dementia there are a few things at work here. 1. He may forget how to eat. May forget that he has to lift the fork or spoon to his mouth. He may forget how to chew. 2. He may not be feeling hungry. 3. this might be part of his body shutting down there is a condition called "Failure to thrive" If this is what is happening he may qualify for Hospice.
He may have actually forgotten how to feed himself and needs someone to feed him. Has anyone tried that? Or could it be that he can no longer chew his food or swallow it properly and needs to have his foods pureed? And I agree with Grandma1954 below that your dad now belongs in a memory care facility and not an assisted living facility.
You would be utterly amazed at how long you can live weighing 65 pounds. My in-laws mom proved that. And so did Joan Didion. The body adapts around a starvation diet and on it goes.
You are describing an elderly and demented gentleman. I think it is time to discuss with doctor, and to discuss either palliative care or Hospice care. To be very honest, you have lucked out in having someone who is content in this last time of his life with dementia. Most are not. But what reason can you see to prolong a life lived in this manner? And why would you make him less happy by forcing food he doesn't want upon him?
I have a mantra that may not be popular with all, but I simply cannot feel another way. When I get to 80, I will not eat another thing simply because I should! By then, I will have spent 80 years following the rules and trying to "eat right" and protect my health. At that point, I don't want to worry about it.
My mom is 84 and has dementia. I do not try to push anything on her and neither does her facility. If she doesn't want a meal, we don't push. (They do ask more than once because 5 minutes can mean an entirely different perspective in her world). She has several health issues, all of which can end her life and she will not be improving. I am as prepared as a person can be to let her go when the time comes.
Because of this and my own personal mantra, I believe he should get to choose whether or not to eat and what to eat. You cannot make him better with good food so why not just keep him happy. He should be presented with appetizing choices and help if he needs it but he should not be pushed into eating if he doesn't feel hungry or want to eat what they are offering. I actually think ensure is a great choice if he likes it. Giving him ensure or other such products may keep him eating sometimes and that will be enough for his elderly body to continue.
My last suggestion is that perhaps mealtime is boring. My mom is in memory care and the room is silent during meals. Perhaps this is the best time for visitors to come, they can keep him engaged during mealtime. Every resident pays attention to the visitors in the room who are talking with loved ones. I go at mealtime whenever possible because mom cannot follow a conversation, so I can engage with her tablemates and keep the talk going. Two days ago, my daughter visited my mom during lunch and left before the meal was over. As she walked away, she heard mom's table mate saying, "Well, she was interesting". The woman hadn't spoken more than two words until then!
I absolutely agree with you. Let them eat when and if they want to. My aunt passed at 99 (no dementia). She basically only wanted Boost or Ensure that last year or so. Her doctor said those drinks provide complete nutrition. Another person existed on Ensure for more than 3 years. My cousin forced food on her mom, including appetite stimulant drug, to no avail. The body automatically starts the process of shutting down, they don’t feel hungry the way a healthy person does. I think we as the family of loved ones are hoping they will eat and get better.
Have you asked dad what he'd like you to bring him to eat, or what he prefers? My mother wanted sweets and ice cream, everything else was unappealing garbage to her. So I made sure she was stocked up on junk food and able to eat ice cream at each meal. Memory Care caters to each resident. Your dad's doctor can write him a prescription for an appetite stimulant also, which the AL should have mentioned to you, especially if they are "worried". If dad's doctor feels he's approaching end of life, a hospice evaluation can be ordered as well.
I'm glad to hear dad is happy though. My mother spent her days complaining and miserable which was tough to deal with.
I would consult a nutritionist and speak with staff about his diet. Talk with his doctor about his prognosis and if he has any swallowing problems or food aversion. He may need to be moved into memory care or another facility. My mom's MC is good about tracking what residents eat.
My mom is currently going through this. She loved mac snd cheese, vienna sausages. She loved milkshakes - add fresh fruit and a protein drink (i.e.: bananas with banana flavored protein drink, etc.). She loves honeybuns and little debbie’s. Our nurse said to add honey to her food and she will eat it.
Yes!! Find a volunteer or hire a CNA to sit with your dad...specifically during lunch. Many with dementia do not recognize hunger or thirst signals. He needs a meal buddy to gently encourage.
There is some great advice here. My MIL had Frontal Temporal Dementia and eventually forgot how to use a knife and fork. She did not know how to cut her food so while she still lived with us I would make casseroles that she didn’t need to cut. Eventually she wanted nothing but pasta, she was 100% Italian by the way! She only ate breakfast in MC, refused to eat anything else that they offered so I would make ravioli, lasagna (cut up), spaghetti, etc. and freeze them in single servings to give to the MC so that she could eat. She also loved her chocolate and we provided a large amount for her to snack on. Can you find some foods that your dad used to love and try offering them to him? Even if it’s junk food at least he’s getting calories.
My mother suffered from failure to thrive (no dementia) and I believe that she was just so tired of trying to hang on at 84 that she decided she didn’t want to eat anymore. The NH offered her food but she refused every time. We tried having someone feed her, but she became angry and cursed at the staff. Before she was in the NH though, she was complaining that she wanted a milkshake but didn’t want to “get fat”. My response was that she can barely walk, can’t see because of macular degeneration so the only joy she had left was food. I encouraged her to eat what she wanted instead of sticking to a boring and tasteless (to her) diet.
Whatever your family chooses to do, please do it with an open heart and love for your dad. With dementia life is so very hard on the patient, the caregiver, and the family. Look for his best interest and you will make the right choice.
Two things: As we age our taste buds diminish. Food that used to be tasty is now bland and gross. Some senior living centers put things like herbs and spices in shakers on the table to add more flavor to the food. If he likes certain foods, than like one of the other posters said, make sure he has some of those-even if they aren’t “healthy”-who cares! Hes 87! Time to live a little! Another issue is dental health-if he has ill fitting dentures-which happens as we age and lose bone and muscle mass-it may be uncomfortable to chew and eat. He may not have the words to describe what is happening. You could offer to let him take his dentures out and eat softer foods if that is more comfortable. It doesn’t make logistical or financial sense to get them refitted, but dentist can put pads in them to help some. Talk to your dentist about that. That became an issue with my MIL.
All the answers below are on good. My sister’s MIL is 97. She is now a very picky eater. She eats good for my sister on Monday evenings when she is there, in small amounts. My sister is an excellent cook and knows what she likes. Something sweet seems to be what early dementia seniors want, as well as company while they are eating. It is challenging to keep their calories up. Ensure mixed with milkshakes might be an option. My Dad forgot how to feed himself. Small tasty bites that they can pick up can attract them. Small meals every few hours sometimes works. Too, a persons appetite often does decrease as their body prepares for their final day. Food should be encouraged not forced. It could make them sick. A doctor can prescribe an appetite stimulant to try. Best of luck.
It's true that all these answers are good. Most seniors with dementia like things that they can grab and eat quickly. a sandwich cut in four... Fruit cut up... Bits of string cheese etc or cheese that's unwrapped and cut into pieces.
Having family arrive during meal time to encourage feeding. You may consider applesauce, scrambled eggs, protein drinks, favorite foods from his past if the living center will allow it. You can also get a consultation from a dietician at the facility if you have concerns as well.
Also ask if his stomach is upset when he eats -- that's why my FIL really avoided eating when he started going downhill. He was prescribed with a thick gel packet to ingest before each meal to coat his stomach (helped a bit), switched to little frequent meals/snacks instead of regular meals, and yep, catered to whatever on earth he wanted to eat plus trying to stuff in protein where possible.
What is he angry about? Is he stubborn and doesn't like someone prodding him to do something he doesn't want? Like trying to make him eat? Is the food quality not to his liking? Try bringing in something you know he likes.
And, yes, he can actually thrive on ensure, if that is all he wants.
My husband has dysphagia and after 2 years on a feeding tube, graduated to drinking thickened protein drinks on his own. For the last 8 years, he has survived, and thrived, on protein drinks daily. He is at home, so I mix up a batch every morning, which is a total of 10 cups of liquid; this includes 3 to 4 Boost, with Milk, water, juice, and a thickener added.
And, I would add everything that Grandma1954 says.
He may not be thriving, regardless of his diet. At some point, people eat very little, and then stop eating at all, as the body starts shutting down.
Is he refusing food for a reason? Have you observed him coughing up liquids or food or stating he feels as if the food is stuck and cannot go down. It may be that he avoids food because of this. I would suggest a swallow study to check for esophageal junction disorder. This can be very common in the elderly and a cause of lost weight. Your consults could also include suggestions from a licensed dietitian. This is very treatable. Read about it here: my.clevelandclinic.org/health/diseases/16976-esophageal-disorders I wish you the best
My mom was a happy dementia. She passed 3 years ago. I noticed her weight loss for about a year associated with eating very little and feeling full. You might be seeing the beginning of the end when the digestive system starts to shut down.here might also be a few suggestions on this thread to encourage him to take drinks like Ensure. My mom had them available until she lost her appetite for them as well. If he is not in discomfort or suffering then let him be. You can discuss with his doctor.
My husband has Parkinson’s no dementia but lost about 20% of his weight this year, went from around 180 to 140 pounds. And eats well. Drs don’t know why. Some say progression of disease.
Sweet foods or sweet àlternative to savoury foods tend to be more acceptable eg egg nog or egg custard instead of omelettes. Soft, pureed or strained foods may be easier to swallow. Try feeding him or assist by scooping the food on the spoon or fork and resting it on the plate with gentle reminders. I have found that engaging with them at mealtimes e.g. telling a funny story helps sometimes.Natural essences or flavourings help , I can tell you finding rum essence has been a lifesaver with some patients lol .
Yes, dad is now on pureed foods....proteins, vegetables and carbs are given in separate bowls. He is eating a bit better. He is in a facility an hour away and I bring my mother to visit as much as I can. She insists we visit during a meal time so she can feed him. He gets upset cause she pushes him to eat all his food. That's when he gets angry and yells that he's done or not hungry.......this upsets me and ruins my visit with dad. I ask mom to stop, but she keeps pushing.
You would be amazed how little we elders need to stay alive. AMAZED. My own partner is down to weighing a whisper. What does his doc say? "This guy's got better balance than I do. He can stand on one leg with his eyes closed!" He isn't worried about the weight at all.
Now as to this "anger". That's another subject. If your Dad needs to see doc about a mild anti-anxiety med or a mild anti-depressant, that may help him enjoy food more. But be assured, as we approach the end of our lives we eat less and sleep more.
If the doctor isn't worried, I wouldn't worry. If you are MPOA discuss with medical. And do know, people DO in fact live on liquid ensure and other drink given through tubes and etc--in fact they live for the most part much longer than they WANT to.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Does the facility where he is ACTIVLY encourage him to eat? (another reason that I think people with dementia should be in MC not AL)
With dementia there are a few things at work here.
1. He may forget how to eat. May forget that he has to lift the fork or spoon to his mouth. He may forget how to chew.
2. He may not be feeling hungry.
3. this might be part of his body shutting down
there is a condition called "Failure to thrive" If this is what is happening he may qualify for Hospice.
Or could it be that he can no longer chew his food or swallow it properly and needs to have his foods pureed?
And I agree with Grandma1954 below that your dad now belongs in a memory care facility and not an assisted living facility.
You are describing an elderly and demented gentleman. I think it is time to discuss with doctor, and to discuss either palliative care or Hospice care. To be very honest, you have lucked out in having someone who is content in this last time of his life with dementia. Most are not. But what reason can you see to prolong a life lived in this manner? And why would you make him less happy by forcing food he doesn't want upon him?
My mom is 84 and has dementia. I do not try to push anything on her and neither does her facility. If she doesn't want a meal, we don't push. (They do ask more than once because 5 minutes can mean an entirely different perspective in her world). She has several health issues, all of which can end her life and she will not be improving. I am as prepared as a person can be to let her go when the time comes.
Because of this and my own personal mantra, I believe he should get to choose whether or not to eat and what to eat. You cannot make him better with good food so why not just keep him happy. He should be presented with appetizing choices and help if he needs it but he should not be pushed into eating if he doesn't feel hungry or want to eat what they are offering. I actually think ensure is a great choice if he likes it. Giving him ensure or other such products may keep him eating sometimes and that will be enough for his elderly body to continue.
My last suggestion is that perhaps mealtime is boring. My mom is in memory care and the room is silent during meals. Perhaps this is the best time for visitors to come, they can keep him engaged during mealtime. Every resident pays attention to the visitors in the room who are talking with loved ones. I go at mealtime whenever possible because mom cannot follow a conversation, so I can engage with her tablemates and keep the talk going. Two days ago, my daughter visited my mom during lunch and left before the meal was over. As she walked away, she heard mom's table mate saying, "Well, she was interesting". The woman hadn't spoken more than two words until then!
I'm glad to hear dad is happy though. My mother spent her days complaining and miserable which was tough to deal with.
Many with dementia do not recognize hunger or thirst signals. He needs a meal buddy to gently encourage.
My mother suffered from failure to thrive (no dementia) and I believe that she was just so tired of trying to hang on at 84 that she decided she didn’t want to eat anymore. The NH offered her food but she refused every time. We tried having someone feed her, but she became angry and cursed at the staff. Before she was in the NH though, she was complaining that she wanted a milkshake but didn’t want to “get fat”. My response was that she can barely walk, can’t see because of macular degeneration so the only joy she had left was food. I encouraged her to eat what she wanted instead of sticking to a boring and tasteless (to her) diet.
Whatever your family chooses to do, please do it with an open heart and love for your dad. With dementia life is so very hard on the patient, the caregiver, and the family. Look for his best interest and you will make the right choice.
Another issue is dental health-if he has ill fitting dentures-which happens as we age and lose bone and muscle mass-it may be uncomfortable to chew and eat. He may not have the words to describe what is happening. You could offer to let him take his dentures out and eat softer foods if that is more comfortable. It doesn’t make logistical or financial sense to get them refitted, but dentist can put pads in them to help some. Talk to your dentist about that. That became an issue with my MIL.
Is he stubborn and doesn't like someone prodding him to do something he doesn't want? Like trying to make him eat?
Is the food quality not to his liking? Try bringing in something you know he likes.
And, yes, he can actually thrive on ensure, if that is all he wants.
My husband has dysphagia and after 2 years on a feeding tube, graduated to drinking thickened protein drinks on his own. For the last 8 years, he has survived, and thrived, on protein drinks daily. He is at home, so I mix up a batch every morning, which is a total of 10 cups of liquid; this includes 3 to 4 Boost, with Milk, water, juice, and a thickener added.
And, I would add everything that Grandma1954 says.
He may not be thriving, regardless of his diet. At some point, people eat very little, and then stop eating at all, as the body starts shutting down.
I wish you the best
.
Now as to this "anger". That's another subject. If your Dad needs to see doc about a mild anti-anxiety med or a mild anti-depressant, that may help him enjoy food more.
But be assured, as we approach the end of our lives we eat less and sleep more.
If the doctor isn't worried, I wouldn't worry. If you are MPOA discuss with medical. And do know, people DO in fact live on liquid ensure and other drink given through tubes and etc--in fact they live for the most part much longer than they WANT to.