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She's in good general health aside from the AD. Shes 91, and depressed, but doesn't do well at all on anti-depression meds. She just recently started to take her Seroquel and thyroid meds; she refused for a while and that sure wasn't helpful with her behavior.

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Thanks again for the valuable insight! We have had two clinical meetings; one with full staff (as you suggested Igloo), and most recently with Charge RN with full reports from all other related staff. We've read up on and discussed Comfort Care, & will soon be in place; Mom signed a DNR years ago and is on file.

The staff is always cheerfully willing to keep me informed on mom's meds, behavior, daily intake, output, and everything in between. I've only missed visiting her four days since she's been there, so feel like we're seeing regular staff/resident activites and interaction.

Mom has a triple whammy as she is very hard of hearing with an aid, and has dry mac degen on top of the AD. We're blessed that she still knows us, but do expect that to change one day. She thankfully sleeps well which is great since a bad reaction to Remeron. Good report today with food AND liquids! :-)
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Yes. I have operated personal care homes for persons with dementia for years. I have found Megace to be a lifesaver. My itty bitty ladies, who pcik at their food, at best, start eating large portions. I have found that some elderly do not need a very regular dosage; rather, just a "jump start every few days. This is especially helpful for those elderly that experience diarrhea with this medication.
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My mom is tiny & petite, about 4'10 and 85 lbs wet. 20 years ago was 5' and 125 lbs. She's mid 90's & in a NH. Lewy Body Dementia so know's who's who and still can do ADL's most of the time. She was on Megace when she was still in IL and it did add about 10 lbs to her, but she would have intense dry mouth especially at night. Then she read that Megace is given to AIDs and cancer patients and convinced herself that her MD told her she had cancer and that was why Megace and she stopped taking it and lost 15 lbs. Her doc put her on Remeron and it was great in that she would actually sleep through the night and it also increased her appetite and she gained about 12 lbs. Then the last 6 mos of IL, she got increasingly paranoid and hallucinations & not take any of her meds, so went into NH from IL as the weight loss was considered critical level of care needed.

She is still on Remeron and it's a great med for her (along with Exelon patch and a vertigo drug). But it seems she has entered the last phase of Lewy and is starting to have difficulty in "connecting the dots" in eating and other ADL's. She will go to the dining room at the correct time in her walker or wheelchair to eat, will sit happily at a table and will be hungry but she cannot figure out which utensil to use to start eating and so just sits there. The staff will put a fork in her hand and then into the food and then she is good and eats almost everything but if they didn't do that, it wouldn't happen. Her NH medical director really tries not to give them Boost or other food supplement, as they feel it makes them feel full and they will loose the rhythm in eating/chewing/etc as they aren't hungry.

How has her care plan conference gone? Has there been a rep from all NH services - dietary, social, activities and nursing? The DON may even stop by (Director of Nursing and the god or goddess in the NH). This is a good time to find out how she is adjusting, how she is feeding and what she is joining in and if she should be considered for hospice or if they have other suggestions that they need for you to ask for. If you have issues or ?'s, I'd start writing them down and take this list to the meeting EVEN IF you have discussed any of this with staff prior. Make sure that whatever they have on file for her advance directives is correct so that there is not feeding tubes or transfusions or whatever her wishes are, are in her file. My mom's AD clearly states no transfusions but this wasn't written in the front cover of her chart. You just have to double check stuff. Good luck.
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Appreciate the encouragement, thanks much! I guess I could've given more details: she had lost the 10# because of too high TSH. She'd been fine with taking pills, vitamins, & stool softeners at home, but since her move to the NH in Aug. she began refusing most! Her specialist recently DCd many of the "extras", now she's willingly back on the few most important meds. She's ambulatory, continent, and is still adjusting to the move. Comfort Care will be in place soon and she's already responding to Megace; it's not like forced tube feeding...won't go that route at all.
Thanks again for all your care & concern. ♥
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It appears over and over again that many elderly do not want to eat - they are losing their appetite. It is a common occurence - often the person;especially with demential is losing their appetite. Other than giving them energy drinks ( I forget the name) - I don't think they should be forced to eat. This is a natural process - let nature take its course - I would not want to be forced to eat it not wanting to. The body it trying to say something. A loss of appetite is a sign. Let the elderly person do what feels comfortable to them at this stage of their life; especially with dementia. I wouldn't want any food forced on me. The elderly person should feel comfortable - whether that is eating or not eating. Aging is depressing for many - things will take care of themselves.
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There might be something else physically that is preventing her from gaining weight. In my experience people with dementia would usually get an increase in appetite from using Megace but everyone is different. There is always the good old milkshake for calories! Seems so unfair to me as I would love to be able to shed some of this stress weight that has accumulated around my belly since I became a caregiver. My Mom keeps getting smaller as I enlarge - where is the justice - haha - hang in there.
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I don't think it has done much for my mom. She weighs 90 and last year she weigh 105 she is only 72yr old. She has been on it for 2 months and hasn't gained but 3 pounds. Still no appetite. She had Dementia. The home health nurse said she didn't think it was doing any good Friday and was going to tell Dr. so I don't know what Dr. is going to do. This is just my own experience. The Nurse couldn't believe it wasn't doing her any good. So I don't know.
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Megace is a terrific drug for stimulating appetite in elderly patients. We used it numerous times in the hospital for elderly patients with little appetite. It worked like a charm. Good luck
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Yes. Mom had been on megace and she had gained weight. My mom was 125 before admiration to the hospital. when she lost 25 pounds she was too weak to stand up. Megace for my mom did help gain her 10 pounds over a period of time. She looked better and looked stronger.
Equinox
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