My mother, 87, with Parkinsons and moderate dementia, has been in a NH just over a year and increasingly refuses to eat. She'll go for breakfast as she likes oatmeal, refuses lunch and I suspect is now refusing dinner as well. Yesterday I picked up things she had asked for which included two types of cookies and assorted chocolate bars. I used to take her a little fruit but, in the last couple of months (since having a stroke) she won't eat it and only wants cookies and chocolate. I didn't go to her room but left the shopping at the desk as I have a cold.
I called her just before dinner time (when I knew she'd be awake as the staff try to get her to go eat) and she told me she wasn't going to dinner. She also said the last time she was weighed she was 80lb. As you can imagine, she's skin and bone and due to taking blood thinners (has for many years) is covered in bruises. After her stroke she was returned from hospital to the NH deemed palliative and sleeps most of the time.
Is her body starting to shut down? Are we nearing the end? Deep down I think I know the answer to my question.
Candy and cookies are not ideal choices for people with dementia, they bring on the problem of the mind scattering to much at least that is what we notice here, we use that stuff only if she eats and has regular food, so far it has worked, she has been home now for 1 and a half years, she has an afternoon treat and one after dinner, they are usually home made to be in charge of the ingredients.
A person starving themselves to eat chocolate and goodies does not do anything for their muscles, and would be prone to falling, but it us a proven fact, that people often crave what they shouldn't eat, we do limit her intake...so far...is she any worse in the year and a half??? OCD's are really kicking in and of course they do not make sense to us or her...
As we age our taste buds do alter and we crave sweet things. can you add peanut butter to the cookies? or even eggs. Food needs to be of a soft texture and moist without things like nuts in them. Is she a real vegan? I assume not so make your own mayo for the salads with real eggs and her favorite seasonings.
if she appears to be able to swallow soft foods and salads I would not put her through a barium swallow. I have just done that and managed to inhale some. I am not going back for the food challenges. I know what I can swallow! The staff should be checking on her bowel habits if she can't stand she must be getting help. She needs a stool softener regularily start with half a tab. I doubt she could manage Metamucil because of the volume. Plenty of apple juice helps too. Everyone says make drinks cold but sometimes room temperature is easier to swallow. By all means have a hospice consult and consider a higher level of care and talk to mom to see how she feels about things herself and follow her wishes
More important however is that you start a conversation with your Mother, as best you can, about her diet and the fact that she wants to limit her food intake to cookies and chocolate. Ask if she's even aware of this. Her response might surprise you. I wish and will pray that you and she will work this out together because talking about shutting down seems to be jumping the gun as far as your Mother is concerned.
While he was on hospice, I gave my husband what he wanted to eat. Some days that was only popsicles. Some days he wanted breakfast. Some days he ate almost normally. He ate small portions of a traditional thanksgiving meal, including wine and pumpkin pie. The day he died (two weeks after thanksgiving) he enjoyed breakfast.
If professionals think that your mom is actively in her final stage, it may be best to relax about the food and let her set her pace and preferences. That is why I ask about the NH staff opinion, and an evaluation by hospice. Always make food available to her, but don't try to figure out how to get her to eat it. Don't let the poor dear think she has to hide her protein shakes! On the other hand, if it is not close to her time yet, it makes more sense to try to coax some nutrition into her.
Hugs to you. This is a very difficult time in the caregiving journey. I felt privileged to be there for my husband on the last leg of his life journey, but it was also a painful time.
Here once you go into a nursing home you don't keep your own doctor - her previous doctor is now 85km away from her in any event. Even if she were able to have a doctor locally I can't lift her into my truck and the nursing home staff are not allowed to do so.
As far as meals are concerned she can feed herself but for those that can't there is a separate dining room where residents are fed by staff one on one. Believe me, if her teeth were giving her trouble she'd be all over me like a dirty shirt.
She's given protein shakes several times a day but mostly refuses to drink them. She likes apple juice drinking boxes and I make sure she always has plenty on hand. She often refuses to go for meals but the staff insist and make her sit at table even if she only has a juice. You can't force her to eat.
What she did on Christmas Day was what she does every day, mostly watch tv and sleep. There are a lot of activities at the nursing home but she's always been something of a hermit and has never joined in. I call her every day, though she has a habit of answering then, confused, putting it down and leaving it off the hook for hours. I haven't visited for over a week as I've a bad cold and, as you may be aware, there's a virulent strain of the N1H1 flu virus sweeping across Canada.
I did read an article that said that dementia/Alzheimer's patients crave sugar....their brains need the sugar. At 85 I do not care if Mom eats sugar, but I would like to get a bit of eggs or meat and veggies into her every day.
Constipation is often caused by narcotic medication - is she on something for pain?
Taste, buds wane as humans age, even more so with dementia. My aunt lost your ability to taste and enjoy food almost overnight when she had three little strokes, which were in no way obvious by the way, and they affected the area of her brain that controlled her taste buds.
She's always been constipated, going #2 only every 3 days, and that was while I cooked/cared for her and she ate well. Now she tells the staff she goes every day, lying so they don't give her a laxative as those make her explode. She just tells staff stories to get out of things and they know it.