My 87 year old mother, who is under home hospice care, with myself as her full-time caretaker, has suddenly lost all interest in eating. Up until about a week ago she had what I'd call a normal, very light, appetite but took an interest in her mealtimes. Now I'm lucky if she'll have one snack-sized meal a day.

Her only diagnosed medical problem is congestive heart failure although she doesn't have any symptoms except becoming out of breath if she moves around more than a trip to the kitchen or the bathroom. I suspect some of her problem is depression, and the case nurse has prescribed an anti-depressant, but she refuses to take it.

She has a great deal of anger, and much of it is directed towards me which I think is a common reaction to her lack of control over the aging process. She hates the thought that she's dependent upon anyone, much less someone as imperfect as one of her children. :(

The anger, the frustration, and the depression, I believe have more to do with her refusal to eat than anything specific of a physical nature. She can swallow, and has no obvious digestive problems. Her doctor was by last week and seems to think she's declining, but also seems to think it's a natural progression of events. I think he's also frustrated by her refusal to accept medication for depression.

Should I keep encouraging her to eat, or hope that eventually she'll come around to an interest in food again? I don't want to push food on her if she's not able to digest it properly and cause more problems. She refuses liquid supplements like Ensure or Boost as well. I'm afraid she's just making herself weaker, but could this be nature taking its course?

I feel meddlesome if I try to get her to eat and guilty if I don't. However trying to get her to eat doesn't work anyway—it just makes her more rebellious. What to do?

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Yes, the instinct is to feed her, isn't it?

I guess I'd try simply making small snacks available on a regular schedule, without encouraging her to eat. If she does, fine. If not, try not to take it personally.

Since she is in Hospice, I assume that she is likely to die within a matter of months (although obviously no one knows the timetable!) She is weak, and she will probably get weaker. This is very, very hard to see. Fussing at her to eat more won't really change the outcome. She is not going to get well if she eats a bowl of soup. I think I'd provide food, but not let it be a source of conflict between us, if it were my parent.

Hugs to you!
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Thanks jeannegibbs, I did speak to the nurse today and she seemed to think that the little bit my mother eats is enough. The nurse suggested small snacks like grapes and cheese, which was funny since I had just given her grapes and cheese as a snack yesterday. :)

I guess I'm concerned because she's getting so weak. She dropped the remote control in her chair cushions this afternoon and couldn't even stand up for the minute-and-a-half it took me to fish it out.

In this situation you want to do something to help, and all I can think of is to feed her! :(
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I am so sorry for what you are facing, Paula.

I suggest that you talk this over with the Hospice personnel. They have had much experience with this situation and they can help you understand it and think through the options you have, and their consequences.
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