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My dad has been in the hospital for 3 weeks he has sudden onset dementia he has not eaten much for 3 weeks. He thinks he has eaten and is full so won’t eat or drink. I’m afraid he will starve to death. Any suggestions appreciated.

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I am having the same situation with my 90-year-old mother who has dementia. However, I found out she was constipated so she took milk of magnesia for 2 days. She has started to eat more. I bring her some of her favorite foods (although she only nibbles at them now) and an Ensure each time I visit (the 350-calorie ones with high protein). I leave another one for her to drink when I leave. She loves them. I also bought prune juice and have started bringing one small can for her to drink as well. I have called her doctor about this and everything the other people have posted is true. As people get older, they start to eat less until they hardly eat anything at all. I just wanted to make sure that I was doing all I could to make my mother's days the best they can be until the time comes and she passes away. Good Luck!
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My grandfather drank Ensure for most of his nourishment. He was just too tired to eat. I thought he would live to be 100 but he grew tired. The body just starts to wear out. My goal was 100 but now I see to live to 80 is good. Stay strong. You are not alone. (((Hugs)))
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You should direct this question to the Hospitalist, who is the dr. at the hospital.
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just in case, if grapefruit is being consumed often, check with the pharmacy to make sure no meds will be useless or potency will be altered or interact with the grapefruit.
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Many good suggestions. If he has an advanced directive and is relatively old and not a lot of joy in life, choosing not to eat may be a way of his body/mind shutting down and ready to let go of this life. Are you ready to let him go if that is what he choose in his advanced directive. Often people stop wanting to eat when it is their time to let go.
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I also agree with Grandma1954. I just lost my mother who also had dementia, but was still pretty functional. All us children helped, and took turns to keep her at home so I'm telling you this from an up close, personal perspective. It was a huge learning curb. No one talks about dying so we're all clueless about what to expect. The first thing we noticed that told us something was wrong was her loss of appetite, which occurred after a heart procedure closely followed by a hospital admitting UTI from which she never recovered.

Unbeknownst to us, along with her end stage appetite, taste buds also start to go. We'd cook her favorite things in a desperate attempt to get her to eat, but she would say it didn't taste as good as before. We were all hurt by her complaints. My brother was the worst as he associated her lack of appetite to not getting better so would get mad at her, and force food. Lots of protein! It was terrible, but done out of misguided love.

After doing research, I stumbled on what Grandma1954 stated. My siblings didn't believe me even though I showed them the research, and only came around late in the game. Poor Mom. Admitting your loved one is dying is so difficult. Her lack of appetite was just the beginning of a natural decline. A change in taste buds coincide with this symptom. She wasn't trying to insult our cooking when we cooked her favorite things, what we cooked really didn't taste the same. At this stage, eating does not equate to maintaining strength. As the body starts shutting down, it requires less and less. We stopped forcing her to eat, and everyone was much happier, especially her since we were actually making her sick with food her body could no longer process. Instead, we kept it as healthy as possible, and gave her all the foods SHE wanted: fruits, ice cream floats, chocolate, seafood salad... Gravitating towards sweets is common because this is the last taste bud to go. The doctor gave her an appetite stimulant, but it had no real effect. Her change in appetite began in March 2017, and was never the same no matter what we did. We started in home Palliative care in April 2017. She passed 2 February this year. I guess the bottom line is find out the cause, but do not force him to eat. Let him guide you. As we discovered, as usual, Mom really did know best. Respect what his body tells you. Don't be afraid if his change in appetite is related to the end. The end is just a new beginning. Embrace the time you have left.
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YES! Immediately a good probiotic and some Gas Relief medicine.

When gas fills the stomach, they won't eat. Learned this raising baby calves, but it is the same for us humans.

I put DH onto a good probiotic (you can ask your dr to recommend but I am using Healthy Origins Natural Probiotic 30 Billion CFU's)
NOW Candida Support
and Gas-X (but I use the Walmart brand chewable: Equate Gas Relief)

It got DH eating again last year and he takes them daily. The Candida Support is 2 capsules so I give morning & night.
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My mother seldom eats much for supper, but I've been told she sometimes eats much more for lunch. In her case I suspect part of the problem is that the supper comes too early for her--she would do better if it came at, let's say, 7 or 7:30 PM rather than at 5 or 5:30, but the system isn't set up that way. So much of the food is "breaded and fried" and, at least to me, not appetizing--and my mother asks "what IS this?"--and I have to tell her I don't know. Sometimes I can get her to eat part of a banana. I think a lot of the food resembles what I saw in my elementary school cafeteria or maybe something rejected by a fast food place. If I ever end up living in one of these places (and assuming I still have a functional brain!), I'm going to maintain a big stash of fresh fruits and vegetables, yogurt, bananas, nuts, oatmeal and sardines (foods I've been eating for years so I'm in good health), or at least pay someone to bring me these things so I'm not forced to live on their junk food full of sugar, salt and fat.
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I give my Aunt CBD oil which in most cases increases the appetite. In addition to helping with her appetite, she has also become less paranoid, sun-downs less at night and is more calm.

She recently broke her hip and required a partial hip replacement and I am appalled at the nurses in the Neuro recovery area who just push in her tray and do nothing else. I have had to practically live at the hospital and she is not getting her CBD oil which is making her hunger less and less every day.

I meet with the hospital patient advocate today and will discuss encourage to eat verse force to eat. Every nurse says they cannot force her to eat but I have seen absolutely no encouragement to eat and not a single nurse willing to just sit with her to get her started. Hoping she comes home today and I may be doing PT here in the home or bring her to a facility. After visiting those places I realize she will just be left in a bed all day with minimal actual therapy. She is better off at home.
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Are you making foods that he enjoys and that he absolutely loves? Sometimes it's hard to make meals for yourself and your family and then a special one for your Dad but I have the same problem at times and I try to feed him what I know he won't refuse. And also being a nurse, we use to give our patients a glass of wine before meals in the nursing home which increases the appetite. Of course, if he is not a wine drinker, scratch that idea. They have a lot of liquid protein drinks in the market like Ensure and they are pretty good. I also use to make my husband milkshakes with chocolate ice cream, milk, peanut butter, banana which he loved until he couldn't tolerate dairy anymore. Hope this helps.
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Agree wholeheartedly with Grandma 1954. I am only hoping and praying that I lose my appetite when (if) I develop dementia. When my husband had a stroke he could not swallow, and we had documents stating that he didn't want a feeding tube. He did not appear to be hungry, and he received mouth care in hospice. We might not have chosen this path if we had not watched my stepfather on a feeding tube slowly lose his mind and his eyes got wild (he could not speak). If all life has to offer is lying in bed making your loved ones miserable and using all of your resources and theirs just to keep alive, it doesn't seem worth it to me. Let nature decide.
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I would caution you the subject of a feeding tube may come up.
Please resist the idea of one.
There are several problems with them.
Dementia patients may pull them out. Many Long Term Care Facilities or Re-Hab facilities will not take a dementia patient with a feeding tube.
As he declines and is closer to end of life he will stop eating. The body does not need food at a certain point and it can not digest it so to continue giving food can create more problems.

It can be very difficult seeing a loved one decline food. All our lives we are told.."eat this it will make you feel better" "drink this soup it will help your cold, or flu" Even our medicine is sweetened either with a coating, corn syrup in syrups, or as many of you recall the drops for polio were put on sugar cubes. We show our love with big family meals, we give chocolate for special days I could go on....
So when a loved one begins to refuse food we do not know how to accept it.
It is just part of the natural course as the body shuts down. It is not painful and there is no feeling of hunger.
So as long as your Dad is eating now and I do hope he continues to improve when it does come time and he refuses food if he truly is at end of life resist the urge to do a feeding tube.
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Very good suggestions in this thread. As a retired registered dietitian, I want to contribute my experience working with geriatric patients experiencing anorexia coupled with dementia, post-stroke, or Alzheimer's disease. We would try prescription appetite stimulants. Sometimes the patient would refuse the stimulant, and it would have to be hidden in a supplemental beverage or food such as mashed potatoes or cream soup. But we had marginal success in achieving increased food intake through the stimulants. I agree in exploring dental (or denture) comfort--especially check for denture fit in patients who have lost weight. Watch for pocketing of food between gums and cheeks instead of swallowing. Watch for persistent throat clearing and even light coughing, a potential sign of swallowing issues that may indicate the need for a swallowing study. Feed them favorite foods but don't serve great big portions which may overwhelm patients--so more small, frequent meals/snacks may be more appropriate. Favorite foods are a good idea except in patients who experience nausea. Try a change of setting for mealtime if possible, unless that seems to bring on anxiety for the patient as some don't do well with changes. We tried moving to foods and drinks that were portable for patients in the Alzheimer's unit, things they could easily and safely carry and consume since many of them paced around, but my concern was that they would set down their foods/drinks, walk away, and another patient might pick up and begin consuming--didn't want to spread germs between patients, didn't want food/drinks to spoil, and couldn't really track what the patients were consuming. Poor appetite is such a difficult problem to contend with in facilities and at home. I wish you good luck and peace of mind.
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Had 2 LO's with dementia go through this in the last couple years, and in both cases they each only wanted, of all things, canned peaches... couldn't get enough of them. Someone commented that foods with syrup are often appetizing, maybe this is why. And sweets are what my in-laws (late 80s, early 90s) both crave... when I make dessert and take it to them they eat it immediately. Don't despair, you'll find something, and when you do just let him eat as much as he wants. At this point, whatever makes him happy.
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Try giving him some fresh pineapple (be sure it's not sour - can sweeten with sugar if necessary). My mother's appetite increased when I gave her fresh pineapple with dinner one night (it was an accidental find), so I made a habit of including it. It worked like a charm, and she gained a little weight, too.
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My dad passed in November .. didn't have dementia .. undiagnosed pancreatic cancer (misdiagnosed) but he had ascites .. where the belly fills up with fluid and needs to get drained periodically. It made him so full .. he couldn't eat .. but also, it turns out, his esophagus was inflamed. He wasn't a complainer of "pain", just kept saying he was too full! So I second getting doctors to check him out and make sure there's nothing more going on medically. As for the dementia and thinking he's eaten already: that's my mom! It's hard to get her to eat if she imagines she's full but we don't talk or argue with her about it, we just sit her down and put food in front of her. Eventually, out of habit, she'll start to eat and since she grew up in an era of "clean your plate", she does.
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need to find something they really love my mom eats Belgian mini cream puffs ..she has stopped eating almost ..for a shake or malt ..i found out the best way is get edy's slow churned ice cream chocolate & chocolate ensure &then hershey chocolate suryup combine in mixer enough ensure to cover ice cream to mix then bout it various to hide the flavor blend mix with some blender we have a hamilton beach for shakes & malts cant do strawberry cause they put chunks of strawberries in unless he will drink without a straw ..it hide the flavor real good my mom is picky .. seems like she wont eat much at all like maybe now 4 oz of malt ..she is 82 how old is your dad ??
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Lioness, what kind of dementia does he have? Does he have any other problems, like depression? When my LO was first diagnosed with dementia, she hardly ever wanted to eat. She had lost about 100 pounds. Before the dementia, she loved to eat. But, after she went on meds for anxiety/depression, her appetite picked back up and she still has a good appetite. I'd discuss it with her doctor. Sometimes, the appetite might not return though. I wish you and your dad the best. Does he have an Advance Medical directive?
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Thank you everyone for your suggestions, I did find something he likes and will eat mostly fresh fruits especially grapefruits. Since he's lost about 40 lbs. drs said to feed him anything he wants. He took his pills with applesauce and he ate a full magic cup. I was so happy I cried, I'm hoping he starts eating a little more. I got an update on him today he ate a few bites of his lunch. :) I'm praying this keeps up.
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My grandma was in the hospital and the drugs she was on made her not hungry. I have noticed, UTI meds, pain meds, dementia drugs, diabetic drugs, etc have changed the taste of things and make her not hungry. Through trial and error, the doctor and I have found a combination that works and doesn't upset her stomach too much. I agree constipation causes my grandma not to be hungry, when she's sick and her sugar is high (she's a diabetic) she won't eat and isn't hungry and sometimes she just doesn't like what I fix. She is so used to be able to fix what she wants when she wants it that honestly she just doesn't like what I fix sometimes and cannot express herself.

I agree about finding something that was a favorite for him or something soft and sweet. Offer ice cream or pudding or even mash potatoes or whatever the comfort food was when he was eating. Sometimes time of day makes a different. Talk to his doctor and make sure it's not a medication change that's causing it or it's not sickness that's causing it. UTI's are brutal. Hopefully it's a change that can fix things.

For my grandma, when in the hospital she won't eat and she didn't eat much in rehab. She said the food was bland and was gross. In fact she lost 40 pounds in 2 months while healing at a rehab facility because she refused to eat even while doing her PT 3 times a day. When she came home she put back on 10 pounds which the doctor was happy to see. You can even try those shakes. They aren't ideal but it will help with the nutrition. Good luck. Hope you find the answer.
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Can you, when you visit him eat a chocolate pudding (or similar sweet). Say yummy and mmm lovely then offer him a mouthful?

Good luck, hope it works out soon.
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In addition to what ff said I have heard that putting syrup on the food helps for some people. Are you trying to hand feed him? My mom started having issues controlling her hands fairly early on. Much luck
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Lioness, when was the last time your Dad saw a dentist? A tooth that is hurting will make someone not want to eat, and it could be that Dad doesn't want to complain about the tooth ache.

Plus as we age, we tend to lose our sense of taste except for really sweet items. My parents use to load up on ice cream, pies, cakes, cupcakes, cookies, etc.
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He’s in the hospital. Drs don’t know what else to do. Being transferred today to a rehab/long term facility. He appears to not be hungry cause he believes he has eaten already. And whatever is going on in his head is apparently not letting him feel hungry or thirsty. Hopefully the geriatric specialist will be able to help
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Why does he feel full if he hasn't eaten? Is he still in the hospital? Get in touch with one of his doctor's and inquire about this.

Sometimes constipation can make someone feel full. Or gas.

Try to figure out why he won't eat or drink. In the meantime try giving him protein shakes like Boost and Ensure. Encourage fluids. Try something other than water like Gatorade or Sprite.

Don't try to force him to eat. Think how you would feel if you weren't hungry and someone tried to force you to eat. It's very unpleasant and it doesn't help. Offer him a cracker and see if he'll take it. Maybe some jello. But if he still refuses, take the food away and try not to chastise him. Still, I understand your concern and frustration.
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