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She has lost over 20 lbs. the past year. She has been taking very tiny bites and very tiny sips of anything to drink. They haven't been able to find a reason. she was dehydrated and malnourished, went to hospital. then on to a rehab and has just continued to decline. she is 88 1/2 yrs. old.

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Although this is horrible having to watch one's loved one during this kind of decline it is not unusual and does not cause discomfort for the loved one. At a time likie this forget about healthy eating just provide small amounts of anything she is willing to try,
Especially important if any medication is still being given.
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I'm sorry about your mother. I hate to say this, but it could be the beginning of the end.

It also could be the side effect of a medicine, ill fitting teeth, unexplained pain somewhere, change in taste buds - just about anything. Have you asked her why, does she say she's not hungry or does she say nothing tastes good? Do they have her on a feeding tube at rehab? Will she eat ice cream or pudding? You can make protein shakes or fruit shakes or Jell-O. Unjury protein powder can be added to just about anything.

I know this is very frustrating for you. Hope someone else has some ideas for you.
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You may want to consider hospice for your mom. If she isn't eating and perhaps has some dementia or other disease state it may be an indication she is in the last stages of her life. Hospice will continue to support her symptoms by providing care for her while making sure she is comfortable. I would suggest getting a Hospice evaluation. The costs are covered by medicare and she can be home where she probably wants to be.
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I think how you handle this depends on your mother. Is she ready to give up, or is she as frustrated as you about her decline? My mom started losing weight a couple of years ago but I failed to notice and it lead to loss of strength and a sudden decline. I too looked hard for reasons but without success. I did however become very proactive in regards to the amount of calories she eats by making sure everything she ate had added calories and by adding nutritional drinks like ensure, and I was able to stabilize and even increase her weight. She still has no desire for food and it is a struggle to get her to drink enough. I often wonder if it would have been kinder to just allow her to fade away.
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Give her anything to eat that she loves, whether its good for her or not. My father loved Burger King cheeseburgers and brownies and would eat them, in small amounts, but better than nothing.
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You describe my mother exactly. She resided in memory care unit then on to the hospital and finally rehab then hospice. She started with eating and drinking little then finally nothing. Her decline was 3 months. She was thin to begin with and 96 1/2 years old. It was a horrible thing to watch.
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As a dietitian, I know it is a medical fact that as the aging process continues, our taste buds decline or fade. So it is a normal reaction to aging, when food stops tasting good or loses its flavor altogether. Remember the last time you had a bad cold and couldn't taste anything? It was like eating cardboard to try to get food down and at her age, it may seem like that to her. One thing to try would be high calorie milk shakes with protein powder added. Sometimes the soothing texture and ease of drinking will encourage intake and add the nutrition that she needs.
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Let her eat anything she likes. At this stage forget about a balanced diet. My wife, a dozen years into Parkinson's, eats less and less. She has lost 25 pounds over the last three years. Most days she will eat an ice cream bar, and a couple of Godiva chocolates in addition to nibbling at her other meals. Recently, her doctor told her to drink a supplement (like Boost or Ensure). Most days she will drink a supplement because "the doctor" said to.
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My daughter is an RN and says the brain stops telling the body that it's hungry and thirsty. With dementia they don't remember. Forgive me but ur mothers are 88 and over 90. They are dying of old age. As much as we would love having them forever their bodies are giving out. And what kind of life do they have. I agree with the hospice thing.
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With Mom it was a combination of depression (she was bipolar) and just plain giving up. I found out later she had been diagnosed with Alzheimers, and from there it was just a matter of time.

I tried giving her bites of my home cooking (a lot better than the frozen prepackaged rations she was living on), and learned how to make good smoothies. Toward the end her doc prescribed her with an antidepressant that increases appetite, but she was determined to shut things down and there was nothing a caregiver could really do except keep her comfortable. At that point she probably needed hospice care. Under the circumstances, she went out under her own terms.
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