84 year old sister has lost 20lbs in 6 mos. No cognitive problems. Has had a complete physical, endoscopy, colonoscopy, mammogram/sonogram, chest C/T nothing explains the weight loss. She eats pretty well. Any ideas?
It can be dangerous for an elderly person to loose a lot of weight in a short period of time, even if they are overweight to begin with. As other's have noted, rapid weight loose may be muscle loss and that can be dangerous.
My mom lost a lot of weight in a short time about 2 years ago, after a 2 week hospital stay (after a bad fall and lung collaspe). She went to a rehab hospital after for 8 weeks (needed IV antibiotics for 2 different infections, one in the blood; and needed 4 LT of ox to start until the lung issue improved). She was permanently placed at the long term nursing home wing of that facility, where she remains (has dementia and a myriad of other conditions).
The dietician and geriatrician (an internal med MD) at the NH worked on a weight stabilization plan that worked and she gained a little bit back. One thing they explained, is sometimes there is a "malabsorption" issue with the elderly that is not necessarily something all of the tests your loved one (LO) had would pick up. Just like many things may decline (hearing, ability to walk/move, cognitive, overall strength with the elderly), the GI system may slow or decline in function too; including the ability to adequately absorb nutrients. My mom is almost 86.
So the geriatrician put her on a few "anemia Rx" meds, iron supplements, and an Rx form of high protein drink (not the type bought in the grocery store). And they allow her to pick anything she wants to eat. She gets a menu the week prior and picks out her meals for the week and they do NOT bother with redirection; so she'll eat most of what is provided. If she wants a hamberger for dinner every night, she can have it. They are not so worried -- at her age and condition -- about "balanced meals" but more about calories and protein.
Perhaps having you LO see a geriatrician (board certified) and a similarly trained (focused on the elderly) dietician would help?
My Moms doctor chalked it up to muscle loss. Muscle is where the weight is. Are you with her 24/7? She maybe eating well but less than she used to. Thats not even a pound a week. Cutting back 500 cal a day is 3500 a week = lb.
My mom with mild dementia had rather significant weight loss over the coarse of a year, I think she vainly like being slim.
She would like to eat, but wouldn’t finish much and we in the family just thought perhaps her appetite was decreasing or maybe she’d forget to eat occasionally.
Looking back, she would complain of constipation or general malaise in a joking way from time to time. She got regular check ups and colonoscopies over the years…
Turned out that she ended up in the ER with a twisted stomach that nearly killed her. Docs thought it was her heart till I mentioned she sometimes has constipation and nausea. They reluctantly ordered a scan and finally saw the issue. Apparently, it’s a difficult to figure out diagnoses even for those without dementia.
JoAnn29 is right. And also Sohenc's answer is equally correct. If she has had bloodwork and the many tests you listed and nothing is found, then she may need to eat higher calorie foods. It's a fact that elderly people seem to eat less as they get up in years. My Mom and MIL definitely ate less as they got older. They just weren't as active or hungry. I, myself, at 63 find I'm not eating as much as I did when I was 40. I don't need the same amount of food to "feel full".
Sometimes people who carry extra weight, as they get older, they start losing weight because their not as active and their muscles are losing strength. Muscle mass gives you more weight. Hight protein shakes and more frequent meals may help. Is your Mom worried about it?
Let’s not jump to wild conclusions. Most cancer, dimentia, Alzheimer’s, and same old boring food all the time cause weight loss also.
A psychologist isn’t required at all. If patient is suffering so badly from depression or anxiety as the cause for not eating, thst can also be determined by general primary doctor. It will be that obvious. Let that doc refer her or him to mental health if they feel it is warranted by their professional, expert knowledge. The also prescribe anti depression and anti anxiety meds to seniors m, so you don’t have to have so many appts and higher medical expensive. You need a referral anyway.
Some seniors loss appetite, bc they have to eat alone. In USA, eating is very social. So if you eat with him or her while chatting about their life, a TV show, a President they are more inclined to eat also if the food isn’t the same old food. Chatting and eating really works.
Give high caloric weight gain smoothies, ice cream, breads, anythibg Me too Mum’s doctor says. Who cares if it’s heart healthy or not when starving to death is the alternative.
Reality, if a person isn’t eating, that it decision to die. Hard to hear but true. My Mum is 75 lbs and 76 years old and been 75lbs sover a year since 77lbs. She just keeps going and going and she has no depression or anxiety. She’s very vibrant. . She had kidney cancer. Surgeon cut it out but she never regained weight.
She actually eats but never gains weight. Her doctor said to give high protein diet and eat anything she wants anytime, even with her heart issue. If you don’t eat you can’t live even to have a bad heart.
Your parent’s situation may be for many other or combination of reasons. But if underweight make video appt ASAP with doctor. Doc will request blood tests. Then you have better idea why the weight loss.
It can take a very long time to pass from weight loss unless it’s related to Pancreatic cancer which is only months. Hospice or palliative care will need to be ordered at a specifics point with weigh loss patients. It’s a serious physical medical matter where blood tests are required.
If your parent has a medical power of attorney for no life preserving acts, then you can’t hand feed her by hand. Just FYI. My Mum eats lots now when I am there eating w her, and when she doesn’t have the same boring food. Just food for thought.
I was thinking of malabsorption, too, as Sohenc mentioned. Your sister may have food sensitivities and intolerances that even she does not know about. Some of the usual calorie supplements that involve dairy or soy or eggs or nuts may actually be counter-productive.
Also some medications, like Digoxin and Diltiazem, have loss of appetite as a side effect. Just went through this with my 86 year old mom. Lost 20-30 pounds since May and recently hospitalized with Digoxin toxicity. Look into medication side effects.
Has her thyroid TSH been checked? (hyperthyroidism) Does she have elevated calcium levels in her bloodwork? (Hyperparathyroidism) Parkinson's Disease can also cause weight loss, even before diagnosis.
My mom lost a lot of weight in a short time about 2 years ago, after a 2 week hospital stay (after a bad fall and lung collaspe). She went to a rehab hospital after for 8 weeks (needed IV antibiotics for 2 different infections, one in the blood; and needed 4 LT of ox to start until the lung issue improved). She was permanently placed at the long term nursing home wing of that facility, where she remains (has dementia and a myriad of other conditions).
The dietician and geriatrician (an internal med MD) at the NH worked on a weight stabilization plan that worked and she gained a little bit back. One thing they explained, is sometimes there is a "malabsorption" issue with the elderly that is not necessarily something all of the tests your loved one (LO) had would pick up. Just like many things may decline (hearing, ability to walk/move, cognitive, overall strength with the elderly), the GI system may slow or decline in function too; including the ability to adequately absorb nutrients. My mom is almost 86.
So the geriatrician put her on a few "anemia Rx" meds, iron supplements, and an Rx form of high protein drink (not the type bought in the grocery store). And they allow her to pick anything she wants to eat. She gets a menu the week prior and picks out her meals for the week and they do NOT bother with redirection; so she'll eat most of what is provided. If she wants a hamberger for dinner every night, she can have it. They are not so worried -- at her age and condition -- about "balanced meals" but more about calories and protein.
Perhaps having you LO see a geriatrician (board certified) and a similarly trained (focused on the elderly) dietician would help?
She would like to eat, but wouldn’t finish much and we in the family just thought perhaps her appetite was decreasing or maybe she’d forget to eat occasionally.
Looking back, she would complain of constipation or general malaise in a joking way from time to time. She got regular check ups and colonoscopies over the years…
Turned out that she ended up in the ER with a twisted stomach that nearly killed her. Docs thought it was her heart till I mentioned she sometimes has constipation and nausea. They reluctantly ordered a scan and finally saw the issue.
Apparently, it’s a difficult to figure out diagnoses even for those without dementia.
Sometimes people who carry extra weight, as they get older, they start losing weight because their not as active and their muscles are losing strength. Muscle mass gives you more weight. Hight protein shakes and more frequent meals may help. Is your Mom worried about it?
A psychologist isn’t required at all. If patient is suffering so badly from depression or anxiety as the cause for not eating, thst can also be determined by general primary doctor. It will be that obvious. Let that doc refer her or him to mental health if they feel it is warranted by their professional, expert knowledge. The also prescribe anti depression and anti anxiety meds to seniors m, so you don’t have to have so many appts and higher medical expensive. You need a referral anyway.
Some seniors loss appetite, bc they have to eat alone. In USA, eating is very social. So if you eat with him or her while chatting about their life, a TV show, a President they are more inclined to eat also if the food isn’t the same old food. Chatting and eating really works.
Give high caloric weight gain smoothies, ice cream, breads, anythibg Me too Mum’s doctor says. Who cares if it’s heart healthy or not when starving to death is the alternative.
Reality, if a person isn’t eating, that it decision to die. Hard to hear but true. My Mum is 75 lbs and 76 years old and been 75lbs sover a year since 77lbs. She just keeps going and going and she has no depression or anxiety. She’s very vibrant. . She had kidney cancer. Surgeon cut it out but she never regained weight.
She actually eats but never gains weight. Her doctor said to give high protein diet and eat anything she wants anytime, even with her heart issue. If you don’t eat you can’t live even to have a bad heart.
Your parent’s situation may be for many other or combination of reasons. But if underweight make video appt ASAP with doctor. Doc will request blood tests. Then you have better idea why the weight loss.
It can take a very long time to pass from weight loss unless it’s related to Pancreatic cancer which is only months. Hospice or palliative care will need to be ordered at a specifics point with weigh loss patients. It’s a serious physical medical matter where blood tests are required.
If your parent has a medical power of attorney for no life preserving acts, then you can’t hand feed her by hand. Just FYI. My Mum eats lots now when I am there eating w her, and when she doesn’t have the same boring food. Just food for thought.
Does she have elevated calcium levels in her bloodwork? (Hyperparathyroidism)
Parkinson's Disease can also cause weight loss, even before diagnosis.
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