My father has end-stage dementia and sometimes does not want to eat. He gets angry if I wake him to eat. How do I get him to eat?

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My parents live with me (both in their 90s). My father has severe dementia and alternates between sleeping a lot or being up all day and night. He is on Atavan for agitation because he fights us when changing him or trying to give him something to eat. My mother cannot stand watching him not eat and she will insist that the aide or I wake him up to eat. If we wake him he is so angry and will knock the food out of our hands. I asked his nurse and she said not to wake him. I told the doctor but he never said what I should do. The nurse says don't wake him to eat, my mother says make him eat, and the doctor is noncommittal. Does anyone know what to do in this situation? Sometimes he does eat three meals a day, sometimes two, sometimes one; each day is different.

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Top Answer
Definitely do NOT wake him to eat. Let him sleep; he probably needs that rest. Time his meals to coincide with periods when he's awake, and have smaller meals if necessary.

Don't push to eat a solid 3 meals a day either; sometimes people (and not just older ones) just don't need to eat on that kind of regular basis. Plan meals according to his waking and sleeping patterns.

And explain to your mother that it's best if he eats when he's fully awake and in the mood to eat. No one wants to be forced to eat, although that's not a problem I've ever had.
End stage dementia. Stand up to mom. Don’t make this poor guy wake up and eat. It’s pointless.
Poor Mom. She has always seen to it that he had food. It was her job and her way of showing love. It is especially hard on her to this decline.

So, poor Mom. But Dad is the one that needs you to advocate for him now. Don't wake him up. Don't offer him large meals.

Is he on hospice? Would that be appropriate?
Get him some ensure or boost let him drink that ..rather than eat is his swallowing? Have you notified hospice they can help
Definitely don't wake him up. I keep snack plates ready in the fridge for when mom's awake - she never wants a meal anyway.
The others are basing their answers on the assumption that your words "severe dementia" means end stage, but in my experience reading on this forum severe a relative term, so...
Although I agree that eating on a strict schedule is not helpful, other concerns of excessive sleeping is the timing of medications & toileting schedules, loss of muscle tone leading to frailty, and skin breakdown. I would want to work with the doctor on sorting out his excessive sleep/wake cycles, ativan doesn't work for everyone and there are other medications such as antidepressants and anti psychotics that help some people. Is his doctor a specialist or just a GP?
Agree with others. Have small snacks available, healthy small milkshakes or other -- you can buy protein powder and add to applesauce or icecream or BOOST shake, etc. Make it small. I find a full plate or even half a sandwich is overwhelming to an elder. Just a spoonful of this or that on a plate is plenty. Foods often don't appeal to an elder and they trend towards sweets. So a small (6 oz) smoothie or similar where you all enjoy one together with him when he's awake will be best shot.

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