How to help elderly mil who won't eat?

[Sonshine]

My mother-in-law is losing weight and eats very little. She claims she feels full. She had gone to the cancer hospital emergency room twice (where she was treated for cancer 5 years ago) and her cancer doctor once in the last two months trying to figure out what the problem is. They have ruled out cancer and heart disease. I almost got her to go to an internist but she is now saying she wants to stick with the cancer hospital. Obviously, they are not doing anything for her, nor should they since she doesn't have cancer.

 

Whenever she is sick she eats very little and won't budge an inch in that area, even to the point of getting rude if you push food. She is currently below 95 pounds, which is way too thin for her.

 

I don't need ideas of how to sneak calories into her, but ideas of how to get her to go to a different doctor or get help some other way. Or any ideas of what kind of help to get.

 

Also, I am wondering if this is a common problem in the elderly. The way she is going she may have to be put on a feeding tube. She goes to church, etc., can eat, but won't. We have tried to explain to her that she needs to eat even if she feels full, but get nowhere. I'm afraid she is going to end up on a feeding tube, and that it will be downhill from there.

[TravelingChris]

Yes, it is a common problem in elderly. I remember once being in an ER with my broken hand (I was gesturing and accidently gestured right in the side of a table:tongue_smilie:). There was on one side of me an elderly lady who was being examined since she wasn't eating and was losing weight. She described what she ate in one day and it was something like a bowl of cereal and that's it. I don't know what they did for her but I would search on the internet for potential causes and ways to help.

[KJsMom]

My grandmother had to drink lots of shakes. They were high calorie and at that point, we were desperate.

[Sonshine]

We've tried the high calorie shakes. She will drink some, but not enough to keep her weight up.

[EKS]

I know that not eating can a part of the dying process. My grandmother did this in the month or two before she died. But if your MIL is fairly young (my grandmother was 96 when this was happening) and otherwise healthy, I wouldn't think that this would be the issue.

[Dobela]

It is common in the elderly. Sometimes it is even an early sign of dementia or other mental health problems. For my grandmother it was an early sign of Alzheimers. For her we started making her milk shakes with high calorie milks like Ensure and whole milk ice cream. She loved them and considered it a treat. Sometimes she would drink a can or 2 of the ensure and it would give her more calories than she consummed. When we were with her we would also sneak calories in her meals by using whole milk, lots of butter on her vegetables, and so on just to add calories.

 

You can also buy a powder called scandical and scandi-shake to add calories to food. The Scandical will change the consistency of food some but melt in clear. The Scandi shake you add to milk to make a milkshake drink and increase calories. When I worked with a child with special needs we would even add it to pediasure for a super high calorie boost. I think they are both available OTC but you can usually get them free with an Rx.

[SailorMom]

Is there any possibility that this could be tied to depression? I know that depression is highly un-diagnosed in older folks, and a huge detriment to their health.

[TravelingChris]

CHecking the internet the three biggest reasons for anorexia even of drinks is depression (by far the biggest cause), dementia, and certain gastrological disorders (which I think they would have checked at the cancer hospital). I think the most likely causes are the depression and getting her to a psychiatrist that has expertise in the geriatric population or maybe just a geriatric specialist would be the way to go. Either of these should be able to advise you whether you are dealing with depression or with early dementia or with both (unfortunately, patients with dementia often have depression as part of the symptoms apart from knowing about the diagnosis). Depression medications work well even in the elderly population so I guess my prayers for you is that this is the diagnosis and you can get her proper help.

[Sonshine]

I will look into the Scandical.

 

She is asking for help with the eating problem - mainly with the uncomfortable ness of her stomach. I don't think she would be asking for help if she wanted to shrivel up and die. She is very particular about accepting help. People in her family don't like change and that may be part of why she insists on returning to the cancer hospital. It's possible it's depression and/or dementia. She does get things mixed up, but not to an alarming degree. That issue is there however, so it could be the start of deeper dementia.

 

I'm wondering, if I found the name of a good doctor who specializes in the elderly, if she ended up in the emergency room of the hospital where he practiced if he could be brought in to the case upon request. Anyone know how this works at the hospital?

[Oakblossoms]

My Grandmother was a nurse in nursing homes. She has told me that they will often just start to shut down and stop eating. It's like their body is just done and doesn't want to eat anymore. I know that's hard to hear though.

 

But, if she does really want to eat and get help. I would look into Celiac. It does show up in the older generation. It's no surprise really because it's an auto-immune disease.

[Joanne]

Also, I am wondering if this is a common problem in the elderly. The way she is going she may have to be put on a feeding tube. She goes to church, etc., can eat, but won't. We have tried to explain to her that she needs to eat even if she feels full, but get nowhere. I'm afraid she is going to end up on a feeding tube, and that it will be downhill from there.

 

It is common and even, to a degree, expected. As we age, our biological functions slow. The gastro-system also slows and it takes less food to feel full and more time to process the food.

 

Depression is also common and can exacerbate the problem.

 

It's also a power grab; the elderly experience diminishing power. Like children, (who eventually experience increasing power), the elderly can grab onto eating (or not) as a way to assert that they are still independent, autonomous, adult human beings.

 

Allow access to nutritional shakes at any time, complete access to any food she'd like and leave it alone. She's an adult - "encouraging", "educating" or "reminding" her to eat is counter productive, it just reinforces her frustration.

[OLG]

 

I'm wondering, if I found the name of a good doctor who specializes in the elderly, if she ended up in the emergency room of the hospital where he practiced if he could be brought in to the case upon request. Anyone know how this works at the hospital?

 

My Dad was like this when he was dying at 93 but would go from being concerned for himself to just giving up. Sweets appealed to him though!

 

The quoted part above leads me to ask if you have a medical power of attorney for her? If so, you can handle the doctor's requests altho I do not know if this can be done when she is in the hospital. Depends on the set up of the hospital...

 

Depression is running rampant with our elderly - my Dad surely had it but it went undiagnosed. God bless you for caring and staying on top of it all!

 

Mary

[4kiddies]

 

My mil just had surgery for a "full" feeling and it was determined to be a hernia. She said it felt like a baby's leg was pushing on her ribs and she would only be able to eat small amounts at a time or she would get uncomfortable. Not sure if this is it but might be worth looking into.

 

 

 

[GraceinMD]

PMing you right now. Let me know if you can't read the link that I'm sending you, please.

[MeanestMomInMidwest]

is she regular with bowel movements? As Joanne said, part of the aging process is the slowing down of bodily functions. This is why many older people are practically obsessed with their bowels. If they don't move (the bowels) the elderly person will end up feeling full. Infrequent bowel movements can also result in impaction and other issues. So, if you have the kind of relationship that allows you to talk with her about her bowel movements, I'd ask if she was regular. If not perhaps she needs something mild every day so she can have a BM every day.

 

Hernia may also be an option.

 

Instead of going to the ER, it would be better to make an appointment with her regular doctor, if she has one. If she doesn't have one, it is a good time to get one. An office visit will allow her to voice all her complaints and look for the small things, where an ER visit is focused on emergent, life threatening things and major things.

[Sonshine]

We don't have power of attorney. That ball of wax hasn't been thrown yet.

 

This all started when she had a stomach flu and was treated with antibiotics. She loses her appetite with antibiotics. That was 5 months ago. It's highly possible that her stomach and appetite and energy level have just progressively shrunk since then. However to get it all back, she would have to push herself to eat more and she's not willing to do that.

 

Oh, I know I can't push her to eat - that has never worked with her - through two bouts with cancer over the last 20 years. It may be that is her way of keeping some control, like you said Joanne. She also has always pointed out people who are overweight, which is one of the few negative things she says about people. So maybe what she eats and weighs are even more important to her than most people.

 

This is not so much about how to get her to eat more as it is what kind of medical help to get her, as I think this is a medical problem, compounded by her personality and aging. She is somewhere around 80, which is old but not ancient. I have not seen any signs of her wanting to die and frankly am tired of hearing that suggested, not so much by people here but by my dh. My dh says that and I think it's sometimes a copout from dealing with the uncomfortableness of hospitals and doctors and from pushing his mother to get proper medical help. He's a great guy, but avoids conflict. It's a valid suggestion, but I don't see it in her case.

[Sonshine]

Sorry, I didn't mean to be so emotional in my last post. I appreciate everyone's suggestions.

 

In one of the emergency room visits, they actually diagnosed her with constipation and prescribed a laxative and more fruits, vegetables, and other foods with fiber. They also said that if she is not drinking enough, that leads to constipation. I will speak with her tonight about her follow through on this.

 

She said she is willing to go to an internist at the cancer hospital, so maybe that will be helpful.

[OLG]

You mentioned antibiotics...that really can mess with your immune system balance. Ultimate Flora Critical Care could just do the trick and would not be harmful.

http://www.amazon.com/Renew-Life-Ultimate-Critical-Billion/dp/B000CMKC5Y

 

Mary

[Alyce]

I would express your concerns that she might need to see a geriatric specialist. Ask him if he can recommend someone and then ask him if he will tell her he's referring her to someone else. If she only wants to go to the cancer center then perhaps she'll listen better to them about seeing someone else. They may be feeling that she needs to see someone else but are hesitant to refer. Sometimes having a heart to heart talk with the Dr can make a huge difference in how he treats her. In my father's case we found out he was leaving huge details out about how he was doing when he talked to the Dr so we stepped in and started talking to the Dr ourselves. It gave him a much better picture of what was really going on and made a huge difference in his treatment.

[Marylou]

Is she on a lot of medications?

 

I live with my 85 y.o. dmil and she is on at lease two anti-Alzheimers meds. My dsil just took Mom to the doctor this past Monday for the same thing you are experiencing. Mom weighed 93 with clothes on. The only thing she'll ingest is chocolate Ensure and cookies! The doc said that he thinks the meds are slowing down the bowels and she really does feel full all the time.

 

And she is definitely obsessed with going the bathroom.

 

ie you can find some answers soon.

[Sonshine]

These are all good ideas and suggestions. I'll ask my sil to look over the meds- she is a whiz at that. I'll also ask her about the antibiotic issue.

 

I will probably be the one taking her to the cancer center internist, so I think i will implement Alyce's suggestions. Thank you.

[Dobela]

You have had some great suggestions. I want to add something else. My other grandmother (age 87) began having eating issues and not wanting to eat a few years ago. She also hates going to the doctor so it was a real struggle. Finally she went, had an upper GI performed, and her problem was reflux. She had silent reflux and didn't realize her body was building scar tissue near her stomach and in her espophagus. It made eating difficult and slower, which means she felt full sooner. All it took for her was GERD medication and some time to heal.

[kalanamak]

 

The quoted part above leads me to ask if you have a medical power of attorney for her?

 

How about a living will, so it is clear what she does and doesn't want. My parents would have NOT wanted a feeding tube, never, never, never.

[Mom0012]

My grandmother stopped eating about a year before she died. She got very, very tiny. When my parents moved her up here into an assisted living facility, they put her on a medication to stimulate her appetite and she gained quite a bit and then became overweight. I honestly wished they hadn't done that (put her on the medication), but I know they meant well.

 

She died a couple of months later even with the weight gain. And she did have dementia. She really had very little left to live for since she could no longer consistently remember the people she knew all her life, she couldn't concentrate to read or even watch television. She couldn't even really sleep. She was ready to go, but I miss her terribly.

 

Lisa

[KidsHappen]

This is actually one of those conditions that legalized marajuana would be the perfect treatment for. My grandmother's doctor recommended it to her way back in the 80s. He said if she didn't want to try that then have a glass of wine each night as that can also stimulate the appetite. When I lost 30 lbs after my mom died my doctor told me that they would put me on a med to gain weight if I didn't gain some in a certain amount of time. There aren't any meds that are specifically made for that purpose but there are a lot that have that as a side effect.

[Lawana]

My mil lives with us and, at 83, is down to less than 90 lbs. She has lost most of her sense of smell, which translates into loss of taste. Things she thinks will taste good just don't. She doesn't have any desire to extend her life at this point, so eating something that doesn't taste good to her is, in her view, pointless.

[MeanestMomInMidwest]

This is actually one of those conditions that legalized marajuana would be the perfect treatment for. My grandmother's doctor recommended it to her way back in the 80s. He said if she didn't want to try that then have a glass of wine each night as that can also stimulate the appetite. When I lost 30 lbs after my mom died my doctor told me that they would put me on a med to gain weight if I didn't gain some in a certain amount of time. There aren't any meds that are specifically made for that purpose but there are a lot that have that as a side effect.

 

Marinol is a prescription drug used to treat nausea and vomiting in chemo patients and loss of appetite in certain groups of patients (including elderly). The active ingredient is synthetic THC.

[Sonshine]

Even though she doesn't normally drink I will suggest the wine.

 

I made her dinner tonight. My daughter ate with her and cleaned her house. According to my daughter she actually ate a decent amount. She also raved about how good it was. She also got out of the house today and worked a few hours. Maybe she has more of an appetite when she is out and moving about?

 

I really think she has an undiagnosed medical problem. I am going to research the medical suggestions given here. She can eat a decent breakfast, but has no room in her stomach the rest of the day. This makes me think her food isn't passing through the system until the night has passed, which is way too slowly of course.

[Guest Amy in MS]

didn't mean to post here. sorry :(

[StephanieZ]

 

I didn't have a chance to read the other posts, so please forgive me if you've already covered this. . .

 

But, have you tried "Ensure" drinks? When my dad and grandma were fragile and needed extra calories, both would happily drink those drinks. They really cram in the calories and seem easier to get down than "real food." There are many favorites. Grandma and Dad each had their favorite flavors, so you can try an assortment to see what she might like.

 

HTH

 

 

[Sonshine]

She already drinks Ensure. She is not about to starve any day now, but is steadily losing weight which she can't afford to lose.

 

This morning her daughter suggested a gastroenterologist and my mil liked that idea. Someone my sil knew had a kinked up intestine, which was causing the same problem. We are going to check into that.

[MotherGoose]

My grandmother was put on prednisone (low dose) to increase appetite. She must have a relationship with someone at the cancer hosptial, maybe they can refer her to an appropriate internist or talk to her or something.