My mother (88) with COPD, diabetes, & dementia is ravenously hungry and demanding of food whenever she's not sleeping. Any ideas? - AgingCare.com

My mother (88) with COPD, diabetes, & dementia is ravenously hungry and demanding of food whenever she's not sleeping. Any ideas?

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She's on metformin for the diabetes, an anti-depressant, blood pressure med, baby aspirin, and vitamins, as well as oxygen almost around the clock. When not eating she's in bed. Her diet's pretty good thanks to a high-protein, sugar-free shake mix, but my father gives in to her demands for goodies such as fruit, bread, & potato chips. Don't know if that's enough to create cravings; her fasting blood sugar level is between 136 and 160 lately. She forgets what just happened and often argues after a full meal that no one gave her anything to eat. Could it be part of the dementia - has anyone else experienced this?

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My mom and grand mom were always hungry, it comes with our genes and insulin alone made it worse for them. If you rarely feel full and have no short term memory, this is a common result! Try non food distractions, see if meds can be changed (my mom's appetite got quite a bit better on Januvia) try cranberry juice, apple juice, fruits instead of candy (effects on blood sugar vary, check that out a little) and *maybe* avoid wheat if you can. MCT foods like coconut maybe even sugar free macaroons or chocolate covered candies might be satiating and are theoretically helpful for Alzheimer's brain too. There is a theory that insulin resistance in the brain is part of the picture and that would be guaranteed to make you hungry too.

There is a big tendency to not control diabetes very closely and just let people eat what they want, but be careful with that; if there is pain from neuropathy or poor wound healing, that could result in really poor quality of life. Sometimes it is absolutely the right thing to do, but other times it could worsen vision, lead to limb
pain or even limb loss and might need to be curbed.

Before they got my mom on Januvia, she would stash sugar packets to eat, and we could never convince her to actually check the blood sugar first. High or low I think felt about the same to her, maybe because insulin resistance means glucose is not getting into your cells where it's needed? It's tough stuff and can be a vicious cycle because weight gain makes insulin resistance worse, which makes excess appetite worse, and on and on. Add pain and inactivity to that mess and...well, it's a mess.
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I just want to add one thing, in response to your question about forgetting that she just ate. My Mom does that all the time. We'll have a great meal, some of her favorite foods, and she eats every morsel and says how delicious it is. Then we have dessert. Then she goes in her place for awhile, and shortly thereafter, she wanders out and asks when we're going to eat!! She does this breakfast, lunch, and dinner. AND, she has little snacks in between. She's tiny, so God only knows where she puts it all, but it's quite funny how she completely forgets the delicious meals she's just scarfed down. When I remind her (as I'm still in the process of cleaning up the dishes) she looks incredulous, and says, REALLY? (like I'm trying to pull one over on her.) LOL!! So, I think that forgetting about eating, and thinking they're still hungry is fairly common.
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I think a good guideline is to observe whether she seems more settled or satisfied by giving her a little of what she wants. At age 88 she still should have some of what she wants because she has no potential for recovery and needs to experience moments of pleasure - to whatever extent that is possible. We have to realize, in this process, that we are also treating the family, so it has to be manageable. At the end of the day the family needs to be confident they did all they could to limit the misery of the family member with dementia. They also need to do something that helps alleviate the stress the family experiences. Have that cookie or cake still matters because it may trigger a sense of fairness or satisfaction that is rooted in a survival mode rather than a mental awareness. If having that cake or cookie is the difference between a few fleeting moments of pleasure or misery, we need to err on the side of pleasantness because the person is 88. Witnessing her experience a few moments of pleasure probably does the family good. At 88, her comfort matters the most and families can be proud they worked to relieve some of the stress experienced by all of her loved ones. Every ones comfort and stress is on the line.
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My idea is to give her what she wants to eat. Maybe keep the portions small. What are you trying to protect her from? How much longer is she likely to live if she eats the "correct" amounts of the "correct" foods? And how much longer is she likely to live if she indulges in food that gives her pleasure? She is 88. She has dementia. Would extending her life really be a good thing?

I was on prednisone once, and my blood sugars were sky-high, no matter what I ate or didn't eat. My doctor increased by insulin dose for the duration of that med. If my fasting blood sugar were routinely over 110 now I would work with my doctor to control it, through drugs and diet and exercise. In 20 years if I have dementia and my fasting blood sugar is 160, so what? Please, please, no one try to make me eat "right" at that point!

You asked for ideas. Those are mine.
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People with Dementia/Alzheimer's eat a lot of sugar because the Alzheimer's brain craves it. You can find information on this on the internet.

My Mom has to have cookies after every single meal and sometimes in between.
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My dad loves sweets, I have Diabetes 2. To protect myself from myself, I buy him single serving sweets once a day, and have plenty of cut up fruit in the frig for both of us. I buy the precut, more expensive but more variety and usually a whole watermelon etc will go bad. He loves strawberry slimfast, Power Crunch bars from Trader Joes (15 g protein, 8 g carbs) I have sugar free fruity drinks or Crystal Light to keep him hydrated. They make good no sugar added ice cream, and no sugar added fruit-cicles. We have no sugar Swiss Miss hot coco mix (which by the way is good blended as powder into ice). You might also try veggies cut to be dipped into plain yogurt with dill weed. One apple for a minute in the micro wave is pretty yummy. So is oatmeal with chopped up fruits. Good luck.
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Often people who have COPD are on prednisone. This will make hungry and raise blood sugars..... is she on prednisone?
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Your father needs to be discouraged from shopping. If you can do the grocery shopping, it may limit the amount of sweet stuff that gets into the house. When deprived of anything they enjoy, it sets up or increases the craving. My obese husband who is diabetic, has high blood pressure, neuropathy, and is developing dementia. He gets up at night and eats, or worse, drives to Denny's. I now hide the keys at night. I give him small amounts of cookies or cake once a week to help control the cravings. Around the holidays, he can have a piece of pie or eggnog. There are some reduced- sugar deserts and eggnogs. I limit, but don't exclude, carbs from the diet. I hide food at night - not easy. He likes milk when he gets up at night, so I've got him to drink the 1% vs. whole milk. I leave the jar of peanut butter out, but hide the bread at night. I told him he can eat a spoonful of peanut butter, but no toast at night. (I buy the lowest sugar version of peanut butter. Some brands have considerably more sugars and fats than others). It's a process of limiting the availability of the food. If your father enjoys the sweets or chips and other type foods your mom should not eat, is he willing to go out once a week to have a hamburger with chips or fries? Or, a piece of cake or pie with coffee? Or, an ice cream? Part of the problem, is without some goodies at home, your father is being deprived too. I go out with friends a couple times monthly to get a desert and coffee. Would he be agreeable to you setting the serving size? Maybe a small piece of cake and 1 or 2 cookies with coffee? If store bought cookies, there are some lower sugar types, so offer your mom two. If you bake the cookies they will likely have more sugar, so offer her one cookie. What about a fruit dish to their house once or twice a week? Would your parents split a piece of fruit? There are fresh fruit, quick to bake, cereal topped cobblers very easy to bake. These go well with coffee. Cool Whip is sometimes desired with this. Or, maybe you and your father could make an appointment with a nutritionist or dietician but not have your mom present at the meeting? In my husband's case, nutritional education for the family is available 1 or 2 times yearly at no cost to the family if it's a part of the care plan. You likely have a much better understanding of your mom's needs than your father has of her needs. That's why it helps to take him to a class. He doesn't have to embrace the class, but this experience may help him understand he needs to work with you. If your father is able to process information this may help him understand what efforts YOU have to expend in order to make things work. I've also done progressive meals - serve a main dish and vegetable at one time of the day, a soup and desert at another time. Sometimes a fruit salad before serving the meat. I switch things around in such a way that I too can manage. Time, money, and patience are not always on our side. My husband sometimes forgets he ate already, so that's why I sometimes do meals in a progressive style. It helps keep his consumption about the same, and sometimes I think it actually helps keep the blood sugar on a more even level, because he's not eating a lot at one time.
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This blood sugar reading is way too high! Even with med, her doctor needs to be consulted and her husband needs to stop "giving" in.
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I went through a similar experience with my mom, who is not in an alzheimer's nursing home. Prior to the nursing home, she wanted to eat everything sweet and not much nutritional food. If we attempted to keep the sweets away from her, we would find cookies, candy etc. stuffed in her pockets, or under her pillow in bed. We tried to ration the amount of food that was available and that helped. But, what I really want to emphasize is "does it really matter at this point in their lives." I don't mean to sound crass, but who are we trying to protect. I've watched my mom deteriorate this past year with dementia and at the end of the day I say just give them what they want - if that is what makes them happy.
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