My 90-year-old mom had an emergency ileostomy last November, and now has no appetite. What can I do? - AgingCare.com

My 90-year-old mom had an emergency ileostomy last November, and now has no appetite. What can I do?

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She's still very sharp--only a little memory loss (remembering words for things--she works crossword puzzles!), and she's competent to use the bathroom. But she hates the damned bag and is depressed by it. She's sarcastic and witty and so damned funny, but I worry so much about her!


She's always been tiny, and not much of an eater. I'm currently going broke (well, not really, but it's expensive) trying to supply her with Glucerna and Ensure Hi-Protein drinks which she loves (she must drink six a day).


I make her breakfast (instant Cream O' Wheat--maple flavored, yogurt, apple sauce or diced peaches, and a half a banana) and dinner (often a "Lean Cuisine" or other frozen entree, half a banana and bread or crackers). She makes her own lunch which she writes down for me: little bits of Spam, crackers, yogurt, and a half a banana.


Her ostomy nurse (who we saw once) said she can now eat anything--even though she has a short history of high blood pressure--I guess because she can't absorb as much now.


Mom also has "urge incontenence" which also dehydrates her. I make sure she has a steady supply of water available and she knows the symptoms of dehydration.


Anyway, she started out eating most of what I gave her, but lately she just doesn't get hungry. She says she gets hungry when the food is in front of her and when she takes her first bite. But she only eats about a third of it all now.


Am I doing something wrong? Bringing her too much/wrong food? I've read everything I can find on diet for ostomy patients (there isn't anything specific for tiny, aged ostomy patients). Maybe she just doesn't need as much as I give her? She's never been a big eater.


Any advice would be welcome.


Thanks.

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People with ileostomies require special diets - as someone stated above. The biggest issue with ileostomy management is keeping the person hydrated. As long as you have that down and as you said you are giving her 6 ensure/glycerna a day continue that and back it up with plenty of fluids. She should not have seeds or high fiber,as stated above. And really vegetables are great but don 't provide a lot of carb or proteins that she needs to keep up to prevent muscle loss.
The caregiver sounds like she knows what the person needs just has seen a decrease in appetite.
Protein sources - maybe chicken salad, turkey bits, hamburger meat, meatloaf...she needs a special RD. Contact her ostomy nurse and ask her to connect you with a nutritionist for a review. I commend you for taking such good care of her, and she sounds like a wonderful mom. Good luck!
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continued from above....she eats 1/2 to 1/3 of her meals for lunch or dinner, has a snack in between when she is hungry. occasionally has a desert. If you are in doubt have a full blood screen. This will tell you if she is anemic, pre or diabetic, high cholestreal, etc. Mother is 99 1/2 years old. This should be at least 2 x a year. Fluids are very important too. Ask the Dr. what he recommends. Around 32 oz is usually good, 28 oz is ok for my Mom. Check with the Dr.
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How is her weight? If her weight is ok and she hasn't dropped too much, she may be getting enough food. My Mom is tiny. She has weighed the same since high school and hardly varies but for a few ponds, Mom eats eggs and toast w butter and jelly for lunch with coffee and OJ.
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I just read an article concerning insure. Not good. I would ask her doctor if six a day is too much. You can get too many vitamins and protein. My daughter can't drink these drinks because of the thickening agent that is used in them. Does a real number on her, if u know what I mean.
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Had the same issue with my mom. She was prescribed medication and helped with appetite a lot.. Couldn't get her to stop eating. I would speak to her physician and see about getting medication for her appetite.
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Agree with person who suggested consulting a dietician or nutritionist. That said, if she is not restricted from eating anything, consider some other factors. My father has a much better appetite with a dinner companion than if his food is prepared by someone who isn't eating with him. He has dementia and now likes food a kid might like. He's also a nibbler, so we keep several healthy things around in small packages that he can forage (nuts, for example). When his mother was at that stage without hunger, she did well with a McDonald's shake and M&Ms. His sister liked cheese and crackers. My mother gave up bread and would eat 4 triscuits with ham/cheese.
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Seek out a geriatric doctor for her.
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Keep in mind, at 90, her caloric intake doesn't need to be what is was years ago. Quality of food and nutrition are more important. It sounds like you are both doing very well. I am in a similar circumstance, my mom is 89 and physically doing very well. However, she has dementia but so long as I keep her engaged in some busy physical activity, she is doing OK.
I think you can make your own protein drinks which she will like. There are so many ideas and recipes online and if you need to "fool" her, you can save one of the cans she likes and fill it with your own concoction. I have done some research on these supplemental drinks available, such as Ensure, and have learned that they have too much sugar and unnecessary additives. But, all things considered, she is 90 after all and you are doing buyout very best to take care of her. People always tell me I have earned my angel wings. I'm sure you have too!
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Be aware that an ileostomy diet excludes all seeds/skins/high fiber fruits and vegetables ( ie tomato skins apple skins, cabbage and on and on)
There are 2 issues here. One is the lack of appetite and one is the need for a diet compatible for an ileostomy .
My personal dislike of the ensure-like products is mainly because they market to the idea that this will "ensure" health and so on. To me you are just as well off with some water corn syrup, and a vitamin pill mushed up . One can get this nutrition from ice cream and a vitamin, which might not be a bad idea.
The first thing is to make a list of the allowed foods for an ileostomy diet. ( which you may have already done). The next is to make them as palatable as possible and use the power of added ingredients to enrich the nutrition. You can add rice cereal to scrambled eggs, or dried milk powder to anything you blend. These will add nutrition. No chia seeds, nuts or high fiber foods. She cannot digest them. There are liquid vitamins to add if you would like.
Yes, my 90 year old parents' appetite has decreased dramatically over the years. My father who never ate sweets, now does. My mother who was always a tad overweight , now isn't . I know my mom will not eat unless food is put in front of her or I remind her. Peanut butter is her go to easy to eat thing. Peanut (smooth)butter and banana sandwiches are good, and usually can be followed by lots of liquid to "wash it down" . Gelatins and ice pops are nice alternatives for hydration when that glass of water or whatever juice isn't hitting the spot. Yogurt is a great choice for in between snacks. Also it is more advantageous to have 6 small meals a day than trying to get all one's nutrition in 3 larger meals. There is nothing wrong with it and it maintains the body's constant energy level. And if she " grazes " all day that's ok too.

Manufacturers add salt to their frozen foods for shelf life longevity and palatability. When sugar is removed from a product the food manufacturers add fats. When fat is removed from a product, they add sugars. These products are not necessarily " nutrition friendly". But on the other hand they may be calorically helpful.
Exercise of any kind- including gentle chair exercise ( tape or CD is fine) or a neighborhood class at the library or local "Y" increases appetite and if she goes out, she can meet new acquaintances .
A registered dietician who specializes in ostomy diets is a resource. But like with any other care giver it is the particular person doing the advising that makes the difference. A degree doesn't bestow caring or personality on the professional. Find someone who will be " a partner " with your mother in her quest for health. There are medications that increase appetite that you can discuss with your Mom's gastroenterologist as well.
I understand your concern totally. I hope some of these suggestions are helpful and help her to have a sense of humor about the absurdity of what our bodies do to us as we age .Sometimes all we can do is laugh at the ridiculousness of the things that happen to us, that we were never prepared for, nor had anything to do in causing them. ( Because crying is exhausting)
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@RayLinStephens--You mentioned V8 Juice and then made a comment about watching sodium, so I wondered if you are using the reduced sodium V8 Juice (which still has plenty but less than the "original" type). For some reason unknown to me, food manufacturers (at least in the US) tend to load any processed food with exorbitant quantities of salt (and often sugar as well).
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