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My poor Mom has been in advanced Alzheimer’s for over 3 years. She is 95-1/2. She is just surviving and living in a wonderful board and care. Bed ridden and mostly nonverbal. Not sure she knows me anymore. She would be horrified to live like this. She is pumped full of anti-psychotics to control her extreme agitation, anxiety, yelling. It is heartbreaking. For the past year or so, she has had trouble swallowing and starting to aspirate. The caregivers have me purchase “Thick-it” powder to aid her swallowing so she can eat. Now they say she’s eating less and want to put her on Ensure. Gosh, I feel like, “Let her be!” If she doesn’t want to eat, so be it. If she goes, it will be a blessing for her! She is not currently on hospice and she was in for a few years before and then went off as she stabilized and her vitals were fine. I think I am going to try again. Anyone have this situation? Thank you!!!

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I would like to sincerely thank all of you for your heartfelt answers. Surprisingly, my mother passed a few hours after I wrote the above. Blessedly, I had gone over to discuss her feeding issues, and I like to think, she was waiting for me, and she passed on as I was signing her up for hospice. She went peacefully, somewhat, as passings are, and swiftly. I thank God I was there to hold her and be with her in her final moments. Bless all of you for taking the time to reply and help me. I wish you all love and peace with your loved ones. Thank you again!
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Centone,  I'm sorry to learn of your mother's swallowing issues, on top of everything else that's going on.

Ensure, though is one of the go-to substitutes to real food, and allegedly contains a variety of nutrients which could substitute for food that would be too challenging to swallow.   My father was prescribed it when he developed dysphagia in his later years.    (And BTW, it used to be available in chocolate, strawberry and vanilla).  

I understand the reason for Ensure in addition to Thik-it products.   The staff is trying to provide her with sufficient nutrients, if that's possible in that stage of life.

If she begins to lose nutrients, it could complicate her dietary intake and cause other issues.   However, if she qualifies for palliative care or hospice, the situation might dictate a different method of keeping her as comfortable as possible.  

My father actually began liquid feeding over a decade before needing it again as he aged, but that initial situation was a complex one during which he hovered near death for a few weeks.   Thanks to a few determined doctors and nurses, he survived to live another 15 years or so, but the circumstances were different from those of your mother.

Did she ever execute a Living Will, with directions on how she wants to have her declining years spent, i.e., hospice, or continue to try to keep her alive?   If so, it might be time to consider it, although I also wonder how experienced a Board & Care facility is.   I don't have any experience with them; we've always used larger facilities with well known reputations.

What were/are your mother's wishes for her declining days and declining health?   You mentioned hospice; are you familiar with palliative care, which is kind of  a step up from hospice?

I hope you're able to come to a resolution, and path which is appropriate for you and your mother.
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If she is aspirating even Ensure will need to be thickened.
You can thicken from "nectar thick to pudding thick" And when I was thickening liquids for my Husband I went the full range.
As her body shuts down she will stop eating as she will not process food as "we" do when we are healthy and need the calories to function.
To "force" someone to eat by either forcing it in their mouth or tube feeding can do more harm than good.
I would encourage you to contact Hospice again and get her back on both for support and help now.
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So sorry to hear of your mom's passing, but glad you were there when she went.
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Thickeners aren't because she doesn't want to drink, it's that she chokes and possibly aspirates when she does, which besides being uncomfortable will lead to aspiration pneumonia. My mom lived many years on a modified diet, first at level 5 minced and moist foods and by the end of her life purées, and she needed thin fluids thickened long before that. By the end of her life she needed to be fed like a baby, and though I vowed to myself that I would never force her to eat it never came to that, when food was presented she always opened her mouth and swallowed, sometimes with obvious enjoyment.
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