Why will my Mom open her mouth and accept food when her aides spoon feed her but she won't feed herself?

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Let me start by saying that my mother has moderate dementia (probably vascular) but has no trouble swallowing. But she has shown absolutely no interest in food - well, except sweets, she will always take sweets. I have noticed that she will open her mouth and accept food when her aides spoon feed her but she won't usually pick up her utensils and feed herself.


I have seen her feed herself lately but then, the other night, she acted as if she had no idea what a spoon was.


I am about to bring in all new caregivers and I am wondering what instruction I should give them regarding feeding her.


a) spoon feed her - at least we are getting food in her (but, she may completely lose the skill of feeding herself)


b) coach her through the process of eating but don't spoon feed - she will eat if she is hungry.

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Hugs, Mom2mom. It made me want to weep, too.
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I think that you all are correct in your various points. I do have to readjust my thinking. She has been very manipulative my whole life and still is. She can turn on and off her dementia at time... being unable to speak to me then suddenly remembering how to communicate when someone else walks in.

But, I can't shake the feeling that if you don't use it, you will lose it and I hate to see her decline even more.

Mom does not have an actual diagnosis and, according to her doctor, is still only suffering from mild dementia - she showtimes for him. He does keep on ordering carotid artery dopplers on her but nothing has ever shown up. I think the chronic UTI's have finally destroyed her brain.

I think I have to deal with my emotions on tis matter. I feel less resentful wiping her butt than I do spoon feeding her because that, in my head, is the ultimate sign of helplessness. I resent that she declined so fast and I wonder what the point of living is when you get pleasure from absolutely nothing anymore.

Thank you all for talking me down.
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Oh dear oh dear, excuse me laughing, but I've just re-read the bit about the lift chair - and the reason it makes me laugh (looking back, obviously) is the memory of just how many permutations a riser recliner can go through. My mother managed more positions than the karma sutra. Carol was probably fearful that left to her own devices your mother might drop herself on her head.
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Mom2mom, you may inadvertently be being too harsh. If the vascular dementia diagnosis is correct, your mother may have lost the ability to "initiate" - her lunch is in front of her, she knows what to do, but the neural link from thinking "pick up fork" to her hand actually picking up the fork is broken. She can't do it.

Starting her off helped my mother - putting the cup in her hand, placing the sandwich in her hand. Literally doing that bit for her. Reminding or prompting didn't work.
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I would read more about dementia and how it effects the brain. I'd try to let go of the mindset that she's being spoiled or somehow waited on improperly.

Dementia creates disabilities, because the brain does not allow the person to do certain things. The ability to function may fluctuate, but, it's not the person being lazy or manipulative. Sometimes, my cousin can pick up her food. Other times, she just looks at it and has to have the food placed in her hands.

People with dementia actually lose the ability to do things like press buttons, pull levers, lift a spoon, etc. It's not one of those things where tough love is appropriate. Only kindness, compassion and care matter. Holding on to the idea that she's being manipulative doesn't really serve any purpose, except to frustrate you. I'd do what is needed, let the staff do what is needed to make her day as comfortable as possible and not fret about it. I'd tell the staff that hand feeding is sometimes necessary. They can respond as the need requires.
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I think you are having a hard time coming to terms with the fact she is losing ability due to her disease because she has a past history of manipulation. In my experience with my mom the disease process related to vascular dementia doesn't follow any of the guidebooks. Of course encourage her to do things for herself, but remember she is gradually losing those abilities.And it will fluctuate day to day and even hour to hour, she may be able to feed herself breakfast but unable to manage lunch. With my own mom (admittedly much farther along than yours) she can sometimes get stuck halfway through a task, such as forgetting how to get the juice up the straw after she has already finished most of it.
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you are right, I may be overthinking this. But, one of the things contributing to her decline has been that her caregiver has spoiled her to the point where she is either too lazy to do things for herself or has lost the skill. For example, Two years ago, when she was living on her own, she could make her own coffee, breakfast, lunch etc. After a few months of Carol waiting on her hand a foot during the week, the weekends became a pain in the butt for me because Mom would suddenly be unable to perform these tasks for herself. and would expect me to wait on her. I know she could do it because when she realized that coffee wasn't going to magically appear before her, she would eventually get up and make it. Same with breakfast and lunch.

Then, we got to the point where she either wouldn't or couldn't do anything for herself. She can't even consistently remember how to push the button on her lift chair because Carol would always run over and push it for her.

I guess I am afraid that eating will be the same and she will eventually become an immobile lump who has to be spoon fed and have everything else done for her.
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Wow, you are making this too complicated. Provide a variety of foods she can eat without a spoon - crackers, cut up fruit, bite sized veggies, sandwiches. Leave the difficult stuff to the aides.
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