Getting an older person to buy in to diet changes

[Emba]

My husband’s grandma broke a hip a couple of months ago and while in the hospital started having problems with retaining fluid (extreme swelling, fluid buildup around the lungs, wet cough). Due to conflicting things we were told, I’m not sure if it is congestive heart failure or something else.  At any rate, she is supposed to be on a as low sodium diet.  She’s supposed to have been on a low sodium diet for years, but has never really done it. She’ll say she is, but to her that means not using salt at the table and getting fries with her Whopper ( 1100+ mg itself, when she’s supposed to be keeping under 1500 mg per day).

 I’m providing them with a lot of food since she got back from the hospital and is in a wheelchair.  I’ve been sending cooking low sodium for my family and then sending them a few servings.  This helps, but they still fix a bit of food for themselves, send family members out for fast food and groceries and have other people provide occasional meals.

 I’m trying to help her find low sodium varieties of things they like, and gave her a cookbook to choose recipes she wants me to try making, and she is trying a bit harder than before to actually do low sodium. But she still insists that she needs things like almost-weekly fast food and more frequent sausage for breakfast (though in limited quantities that wouldn’t be that bad IF she was actually doing well with other meals).

 It’sa little frustrating for me though, because I want to help but she doesn’t do the most basic things like read labels.  My FlL brought them a box of pancake mix, and she mentioned that they didn’t care for it. I looked at the label and was like “that’s okay, it had 480 mg of sodium per serving, you probably shouldn’t eat it anyway,” and she was just shocked. It was clear she hadn’t looked at the label at all.

i don’t want her to feel like I’m trying to boss her around, and i I realize she’s an adult who can make her own decisions. Her mind is still good.  I realize also that food preferences/habits are hard to change after a lifetime and sometimes tired up in emotions. Does anyone have any experience getting an older person to buy in and really try to change habits?

 She and her husband are almost 90. I realize there is a bit of “Let them eat what they want and be happy in their last years” attitude out there, but if she just eats what she wants, she’s going to be back in the hospital and in physical pain, and her husband’s quality of life will suffer as well, because his mind is slipping a bit, and he can’t take care of himself as well as he ought.  But when she was in the hospital/rehab he insisted on staying home alone and wouldn’t go to live temporarily in the nursing home she was at for rehab.

[bolt.]

As someone who did my best to lower my sodium intake while trying to live a normal life, enjoy my food, and have at least some low-effort cooking options... I really wasn't able to do a great job. My doctor was fine with that and it seems like they always ask people to try to change things with diet before they offer them a prescription. I accepted the prescription with great relief.

I don't mean to imply that your GMiL's problems could be fixed with a simple prescription. It seems to me that if that was the case, it would probably have been offered already. (But it might be worth asking anyways.)

What I'm trying to emphasize more, is that it's really hard to willingly give up such a *huge* component of taste and enjoyment in your life. It's a sacrifice that's hard to describe. You get kind of used to having some pleasure from eating a few times every day. When eating becomes a chore, you really can start to feel like life sucks. It's not something you just get used to.

It's also worth wondering: "What's low sodium?" -- Do you have her recommendation in mg? Do you know if it has to be adhered to daily, or if it can be balanced weekly?

From your reaction to pancakes at 480mg per serving, I'm concerned that you might be misinformed as to how much sodium she can safely have, and even possibly how much she minimally needs. Anything below 2000mg per day is considered lower sodium, with 1500mg per day being a common recommendation. That's 500mg per meal, if you spread it evenly -- or more for some meals if other meals are less. (Even if she is down to 1000mg per day, the lowest recommendation I've seen, that's still around 330mg per meal. So the pancakes, if she had liked them, did not need to be off the table if she did something to compensate in her other meals.)

So, some actual recommendations:

- Encourage a sweet tooth: I would say get her hooked on a number of treats that are low in sodium because they are full of sugar. Start buying her these kinds of snacks and making them available in her fridge and pantry. Be careful because not all sweets are actually lacking in salt -- but if it's on you, you can choose what to try to get her hooked on.

- Buy MSG: Usually under the brand name 'Accent' the flavour enhancer MSG has less considerably less sodium than table salt, and it's probably behind a lot of what draws her to fast food. Put it liberally in your own offerings, and encourage her to keep a shaker on the table.

- Let her have what matters most to her: Don't touch the things that are really important, but do things like get the products that she is more passive about out of her pantry. For example, shrink or remove her supply of crackers -- if she wants cheese, encourage her to have it, but no crackers. If she loves chips, buy her an individual serving size, but only one bag. She's right about not getting fries at fast food: see if you can move her towards a 'junior' burger too.

- Find some low or no sodium meals that can compensate for indulgence: Design at least one of each type of meal for her that works that way. Then, if she does have a whopper, she can make a good choice like having a yogurt and fruit breakfast to 'make up for it'.

- Blame the doctor, not her, and not you. Say things like, "The doctor won't let you have that." -- without saying it's your opinion too, and without adding how she should or shouldn't respond to her doctor's instructions.

[MEmama]

We've tried with the in-laws, but despite what they tell us they just aren't interested. We've given up; it's their lives and we can't force them. 

[Arcadia]

24 minutes ago, Emba said:

 It’s a little frustrating for me though, because I want to help but she doesn’t do the most basic things like read labels.

Reading labels is physically harder once bifocals come into play. My MIL prefers not to wear glasses and she would ask her children to read labels if they are around. My FIL and my dad would just take off their glasses and read the labels. I have food sensitivities to artificial sugars and msg so I read labels and my husband has gotten into the habit because of buying groceries for me. My husband now needs bifocals but reading labels has already become an ingrained habit for him so he would still make the effort.

I have aunts with geriatric diabetes. The most helpful thing to them was getting them snacks they could eat. They are like me eating many small meals per day instead of three meals. So snacks are very useful. My husband likes saltine crackers and we have bought those with lower sodium content. My husband doesn’t need to avoid sodium but we eat fast food probably once a week so we try to go for less sodium daily food.

[kbutton]

Would they eat homemade mixes? For instance, if you whipped up pancake mix or batter that was low sodium, would they eat it?

Cooking from scratch helps tons. You can make homemade breakfast sausage (ground vs. links). Making a whopper at home is always an option too.

Also, I wonder if mixing low-sodium options with “regular” options with the ratio slowly moving toward low sodium would help.

I don’t know what amount of time you have to commit to helping change palates vs. changing minds.

I also agree about meds—I would ask about a water pill.

I easily retain water (have for decades) and do not really like salty food. I tend to eat pretty low sodium, but once in a while I crave salt and assume I’m out of balance. I can confidently say that while salt can make you swell up, it’s not a 1:1 correspondence every time.

Also, pushing fluids (while making sure electrolytes are good) is a sure-fire way to get fluid to move even though it’s counterintuitive.

[Emba]

1 hour ago, bolt. said:

As someone who did my best to lower my sodium intake while trying to live a normal life, enjoy my food, and have at least some low-effort cooking options... I really wasn't able to do a great job. My doctor was fine with that and it seems like they always ask people to try to change things with diet before they offer them a prescription. I accepted the prescription with great relief.

I don't mean to imply that your GMiL's problems could be fixed with a simple prescription. It seems to me that if that was the case, it would probably have been offered already. (But it might be worth asking anyways.)

What I'm trying to emphasize more, is that it's really hard to willingly give up such a *huge* component of taste and enjoyment in your life. It's a sacrifice that's hard to describe. You get kind of used to having some pleasure from eating a few times every day. When eating becomes a chore, you really can start to feel like life sucks. It's not something you just get used to.

It's also worth wondering: "What's low sodium?" -- Do you have her recommendation in mg? Do you know if it has to be adhered to daily, or if it can be balanced weekly?

From your reaction to pancakes at 480mg per serving, I'm concerned that you might be misinformed as to how much sodium she can safely have, and even possibly how much she minimally needs. Anything below 2000mg per day is considered lower sodium, with 1500mg per day being a common recommendation. That's 500mg per meal, if you spread it evenly -- or more for some meals if other meals are less. (Even if she is down to 1000mg per day, the lowest recommendation I've seen, that's still around 330mg per meal. So the pancakes, if she had liked them, did not need to be off the table if she did something to compensate in her other meals.)

So, some actual recommendations:

- Encourage a sweet tooth: I would say get her hooked on a number of treats that are low in sodium because they are full of sugar. Start buying her these kinds of snacks and making them available in her fridge and pantry. Be careful because not all sweets are actually lacking in salt -- but if it's on you, you can choose what to try to get her hooked on.

- Buy MSG: Usually under the brand name 'Accent' the flavour enhancer MSG has less considerably less sodium than table salt, and it's probably behind a lot of what draws her to fast food. Put it liberally in your own offerings, and encourage her to keep a shaker on the table.

- Let her have what matters most to her: Don't touch the things that are really important, but do things like get the products that she is more passive about out of her pantry. For example, shrink or remove her supply of crackers -- if she wants cheese, encourage her to have it, but no crackers. If she loves chips, buy her an individual serving size, but only one bag. She's right about not getting fries at fast food: see if you can move her towards a 'junior' burger too.

- Find some low or no sodium meals that can compensate for indulgence: Design at least one of each type of meal for her that works that way. Then, if she does have a whopper, she can make a good choice like having a yogurt and fruit breakfast to 'make up for it'.

- Blame the doctor, not her, and not you. Say things like, "The doctor won't let you have that." -- without saying it's your opinion too, and without adding how she should or shouldn't respond to her doctor's instructions.

She is on some prescribed medicines, one of which is for the fluid buildup. 1500 is what her dr wants, so 500 mg a meal. So yes, 480 mg for one serving of pancakes at a meal that also likely includes an egg or sausage, and with two others meals and also possibly some snacks left in the day, isn’t really a good option in my mind.

They do already buy cookies all the time. I haven’t looked at the labels on those yet.  I know they usually have chips and crackers on hand.  
 

like, I’m all for having indulgences. They help you not feel deprived and keep you willing to continue the diet.  But indulgences are oily goods so long as you know what you’re doing and how to make up for it. She doesn’t. I looked up the info on various fast food options for her. She didn’t seem to be like the idea of a whopper jr, even though it is MUCH more reasonable given the number we’re aiming for. 
 

Thank you for the ideas. I do think that having a few meals to go to for days she indulges is a good idea.  Maybe oatmeal for breakfast, I know they like that once in awhile and I C found a good slow cooker recipe with no added salt that she might like. It’s one from the low salt cookbook that I added to my family’s breakfast rotation and no one even noticed it was low sodium.

[Emba]

1 hour ago, kbutton said:

Would they eat homemade mixes? For instance, if you whipped up pancake mix or batter that was low sodium, would they eat it?

Cooking from scratch helps tons. You can make homemade breakfast sausage (ground vs. links). Making a whopper at home is always an option too.

Also, I wonder if mixing low-sodium options with “regular” options with the ratio slowly moving toward low sodium would help.

I don’t know what amount of time you have to commit to helping change palates vs. changing minds.

I also agree about meds—I would ask about a water pill.

I easily retain water (have for decades) and do not really like salty food. I tend to eat pretty low sodium, but once in a while I crave salt and assume I’m out of balance. I can confidently say that while salt can make you swell up, it’s not a 1:1 correspondence every time.

Also, pushing fluids (while making sure electrolytes are good) is a sure-fire way to get fluid to move even though it’s counterintuitive.

She is on a pretty heavy dose of something already to reduce fluid retention.

 Thank you for the suggestions.

i have considered doing dry mixes for pancakes And maybe some other things. I think they might use them, and probably prefer the taste over the store bought pancake mix.

i am hoping that if I send over enough low sodium foods and shop for things for then that are lower sodium options, that their palates will change to not need so much salt. I know my palate changed after my mom started cooking low sodium for my dad after his heart attack. Lo these 20 years later I still don’t use all the salt most recipes call for, and the low sodium recipes I’m using now don’t bother me. My kids and husband are adding lots of salt to them, though. 
 

as far as time, well, if I send over things I’m making for us, the extra time is minimal. If I make crackers from scratch and other specialty stuff often, it gets more burdensome, but probably not as burdensome as the tone required for caregiving if her health gets worse out she’s hospitalized again, so.  I’m trying to find as happy medium.

 As far as pushing fluids, I think that’s a no. Her doctors also have her on a limited fluid intake.

[Pawz4me]

This is a people thing, not (only) an older people thing.

You can't make someone else change their diet. They have to want to do it. I commend you for trying, but . . don't stress yourself out about it.

[Annie G]

Our experience with our elderly parents is that even when they want to make changes, it’s difficult. They almost have to cook things from scratch and that can be hard for folks nearing 90. (Or for anyone used to relying on convenience/processed foods and fast food) Our folks had difficulty translating what they read on the label to their actual intake- they didn’t do well figuring out how many servings they were eating, or didn’t take into account anything added to the food, such as the sodium in ketchup, butter, syrup, etc.    My 92 year old dad can read and comprehend nonfiction books with ease but I know he couldn’t figure out how much sodium is in the breakfast he cooks every day- 2 slices bacon, 2 eggs, toast w butter, and fruit. 
Any small changes will help, and sometimes you have to take that as a win. After MIL died I taught FIL how to cook a few things and it was the perfect time to teach him how to do it the healthiest way possible since he had no bad cooking habits to break. 
 

[73349]

I think the idea that "Better drives out worse" could work in your favor, if you can make sure they have on hand...

- fruits like blueberries, sliced melon, and bananas

- a salt substitute (I like Stardust, which is only sold online)

- lower-sodium canned goods to the extent possible (Here's a soup that's only 270mg per half-can serving.); frozen vegetables if possible, because they usually don't have anything added; or frozen things you've made for them

- veggie burger patties (This page compares nutrition labels so you can choose one low in sodium) and suitable buns so they can have a burger at home.

[Emba]

1 hour ago, Pawz4me said:

This is a people thing, not (only) an older people thing.

You can't make someone else change their diet. They have to want to do it. I commend you for trying, but . . don't stress yourself out about it.

Yeah, my Dad was much younger when he had his heart attack and he never had done well on keeping to a heart-healthy diet when my mom isn’t cooking for him.  

i think if nothing else this thread has made me realize that in part, I’m stressing out about it so much because I am worried that if she gets as bad as she was before, we’re the ones who will end up doing the bulk of the caregiving for both of them.  My husband is the nearest grandchild, as well as the most willing to help out, and both of their children are dead.  

I do also care about her health and well-being but  I think that fear is a large part of why I feel so internally stressed and frustrated about it. My dad makes diet changes that negatively affect him and I’m much calmer and accepting of it (not happy about it, mind you but I can accept that he makes his own choices).  

[Emba]

1 hour ago, 73349 said:

I think the idea that "Better drives out worse" could work in your favor, if you can make sure they have on hand...

- fruits like blueberries, sliced melon, and bananas

- a salt substitute (I like Stardust, which is only sold online)

- lower-sodium canned goods to the extent possible (Here's a soup that's only 270mg per half-can serving.); frozen vegetables if possible, because they usually don't have anything added; or frozen things you've made for them

- veggie burger patties (This page compares nutrition labels so you can choose one low in sodium) and suitable buns so they can have a burger at home.

Thanks for all of these suggestions. I haven’t tried any salt substitutes because the one my mom bought was so bad. Is Stardust better than average? Have improvements been made over the years in salt substitutes?

[Emba]

1 hour ago, Annie G said:

Our experience with our elderly parents is that even when they want to make changes, it’s difficult. They almost have to cook things from scratch and that can be hard for folks nearing 90. (Or for anyone used to relying on convenience/processed foods and fast food) Our folks had difficulty translating what they read on the label to their actual intake- they didn’t do well figuring out how many servings they were eating, or didn’t take into account anything added to the food, such as the sodium in ketchup, butter, syrup, etc.    My 92 year old dad can read and comprehend nonfiction books with ease but I know he couldn’t figure out how much sodium is in the breakfast he cooks every day- 2 slices bacon, 2 eggs, toast w butter, and fruit. 
Any small changes will help, and sometimes you have to take that as a win. After MIL died I taught FIL how to cook a few things and it was the perfect time to teach him how to do it the healthiest way possible since he had no bad cooking habits to break. 
 

Yes, like I said, her mind is good but the numbers aspect of this just seems too hard for her, which is probably part of why she hasn’t really been good about doing it before. I’m willing to help work up some menus and do the number crunching and cooking for her, but I also want to let them keep what independence they have and cook what they can. They want to make breakfast, partly because as lot of things they like are things they can do themselves, and have actively resisted me coming over to cook breakfast. 

[bolt.]

If it's the numbers, make it a little simpler by saying: "500mg per meal -- Anything more means you have to do less next meal."

Maybe make a large-print short list of the foods they eat often (especially breakfast) with "mg - per - whatever makes actual sense" rounded to 10s or 5s. You can also do the calculations for some of their favorite combinations.

Another shorthand is that they should watch out for: "1. Cans, 2. All the parts of sandwiches, including bread, 3. Things where the flavour comes from a powder, and 4. Anything you buy hot (or ready to heat)."

[kbutton]

1 hour ago, Emba said:

As far as pushing fluids, I think that’s a no. Her doctors also have her on a limited fluid intake.

Oh, that’s interesting! I was told with fluid retention to drink more. That makes me think this is on the more serious side (sodium intake seems to be a catch all recommendation, so you never know). Has a work up been done for pulmonary embolism/pulmonary hypertension? You don’t have to answer, but that would not be uncommon after surgery.

35 minutes ago, bolt. said:

If it's the numbers, make it a little simpler by saying: "500mg per meal -- Anything more means you have to do less next meal."

Maybe make a large-print short list of the foods they eat often (especially breakfast) with "mg - per - whatever makes actual sense" rounded to 10s or 5s. You can also do the calculations for some of their favorite combinations.

Another shorthand is that they should watch out for: "1. Cans, 2. All the parts of sandwiches, including bread, 3. Things where the flavour comes from a powder, and 4. Anything you buy hot (or ready to heat)."

I would even maybe list out the items by relative amounts of sodium, so that they know which items are interchangeable when building a meal. Maybe a card listing favorites in various sodium ranges would be a good cheat sheet. And some “free” items that have trivial amounts. 

[Clarita]

3 hours ago, Emba said:

It’sa little frustrating for me though, because I want to help but she doesn’t do the most basic things like read labels.  

Reading labels is hard. It's deliberately made to be hard. Personally I wouldn't push the label reading, I might read the labels myself figure out which snacks (including brand) are OK then just tell them buy these only.

 You can work with her to build some specific menu options. So she can have input as to what is easy for her to make and what she likes the taste of. If money isn't too tight she can try one of those meal kit subscriptions, some of them do have healthy options.  Blue Apron has the nutrition information labeled for their meals, I'm sure other ones do too. It makes expanding what she can cook more painless for her (everything is purchased and portioned out). I don't know if it would be more restrictive because of her dietary needs but perhaps she could still chose from several options each week. 

[Clemsondana]

Older people also often don't have as strong of a sense of taste, so they tend to need more salt or seasoning to make food have flavor.  For anything that you make, can you go heavy on other seasoning - lots of garlic, onion, pepper, paprika, cayenne or whatever would work for them?  For foods like mashed potatoes or popcorn, go heavy on butter, sour cream, cheese, chives, or garlic powder to add non-salt flavor.  Do they actually eat full servings of most foods?  Many of my relatives no longer eat a full serving as they get older, so her amount of sodium may be less than the serving size.  I've also seen older relatives not eat 3 meals - by the end of the day they are happy with just a snack - maybe you could encourage something like a dish of ice cream or sorbet - not ideal if you are diabetic, but it doesn't have salt.  Fruit would be better, but I think with diet, and especially with older people and diet, you sometimes just have to go with what will keep them happy and not in pain.

Edited May 4 by Clemsondana

[sassenach]

2 hours ago, Emba said:

i think if nothing else this thread has made me realize that in part, I’m stressing out about it so much because I am worried that if she gets as bad as she was before, we’re the ones who will end up doing the bulk of the caregiving for both of them.  My husband is the nearest grandchild, as well as the most willing to help out, and both of their children are dead.  

I do also care about her health and well-being but  I think that fear is a large part of why I feel so internally stressed and frustrated about it. My dad makes diet changes that negatively affect him and I’m much calmer and accepting of it (not happy about it, mind you but I can accept that he makes his own choices).  

I very much relate to this, as I spent the last 2 years of my FIL's life being his main caregiver. I carried the knowledge that we were all he had and that the majority fell onto me. Please receive this will all gentleness- her decline is inevitable. She will definitely end up back in the hospital at some point. This type of end of life care is hard, because the changes that can be made are bandaids but don't stop the overall disease progression. I think at this point, there is nothing more you can do about the diet. You're making meals and editing their purchases. The only more controlled version of this is nursing facility care. This is a lull between escalations of her disease. Try to use your energy to come up with a game plan. What will the next steps be? How can you make the next hospitalization more manageable? What are your options locally if she needs a skilled nursing facility? Do they have DNRs in place (called a POLST)? If not, I would highly suggest an appointment with a palliative care doctor to talk through those decisions. Those are the things I would turn your energy toward now. 

For my FIL, he was in end stage kidney failure and was also a diabetic. He had many things he wasn't supposed to eat. I did his grocery shopping but he ate in a cafeteria (he lived in a senior apartment complex) and despite my coaching, he pretty much just ate what he wanted. We met with a palliative doctor and FIL was clear on not wanting life sustaining treatments (which was a relief to me). When he had his final decline, it was a stroke, followed by covid, and then rapidly declining kidney function. He went from the hospital to a facility, which he lived in for about 2 months. He spent the last 3 weeks on hospice, and passed peacefully. I'm sharing this not to be a downer, but to give you just one version of how things can progress. 

Wishing you the best. There's an Elder Care board in the clubs section and I found the insight super helpful; come join us.

[Eos]

43 minutes ago, Clemsondana said:

Older people also often don't have as strong of a sense of taste, so they tend to need more salt or seasoning to make food have flavor.  For anything that you make, can you go heavy on other seasoning - lots of garlic, onion, pepper, paprika, cayenne or whatever would work for them?  For foods like mashed potatoes or popcorn, go heavy on butter, sour cream, cheese, chives, or garlic powder to add non-salt flavor. 

I agree, lots of flavor really hides the lack of salt. Garlic powder, celery seed, cumin, cinnamon (even in savory foods,) lemon zest, lemon and lime juice, grated ginger, smoked paprika, and chili flakes all add zing and salty-seeming flavor.

[marbel]

12 hours ago, kbutton said:

I would even maybe list out the items by relative amounts of sodium, so that they know which items are interchangeable when building a meal. Maybe a card listing favorites in various sodium ranges would be a good cheat sheet. And some “free” items that have trivial amounts. 

In addition to this, they need to know what a serving is and have a way to measure their food. 

When I was told to go low sodium, I downloaded a food tracking app and started using my kitchen scale daily.  I know not everyone can access tools like that, but they make it much easier - though it is still tedious.  Sodium per serving size is easy to read on a label, but if a serving size is 1/2 cup, you have to measure it. People are very bad at estimating serving sizes. And if a person regularly eats out, it's even harder because servings are huge in most places. (Though most big chain restaurants/fast foods have nutrition information available either on site or online.) 

It's very hard. I am old - I was 65 when told to reduce my sodium - but it would have been just as hard in my 40s and probably even harder in my 30s when I ate out a lot.  

I'm sorry you are dealing with this. I get the concern about caregiving. 💗

[73349]

13 hours ago, Emba said:

Thanks for all of these suggestions. I haven’t tried any salt substitutes because the one my mom bought was so bad. Is Stardust better than average? Have improvements been made over the years in salt substitutes?

I like the flavor of Stardust enough to have greatly reduced how much salt I use in cooking. It's not potassium chloride or anything; it's a mix of powdered dried veggies and actual spices. I think salt is used so widely because it's cheaper than other spices more than because of its addition to flavor. I also add a little powdered mushroom seasoning to a lot of soups/casseroles/etc. for more depth.

[DawnM]

15 hours ago, MEmama said:

We've tried with the in-laws, but despite what they tell us they just aren't interested. We've given up; it's their lives and we can't force them. 

This is my friend with his parents.   His dad is diabetic and has high blood pressure.   They have given up after arguing, fighting, etc.....just not worth it.   

[Tenaj]

Does she have physical symptoms that decrease the quality of her life?  The only way I've been able to help my Aunt understand sodium restrictions is that she hates the compression socks she needs to wear.  She also hates the potassium supplements she has to be taken because of to the lasix she is on.  

So, when she is making poor food choices I remind her of those two things and explain that the only way she is going to get away from them is to keep her sodium in check. Sometimes it works - sometimes it doesn't.

[Arcadia]

2 hours ago, marbel said:

It's very hard. I am old - I was 65 when told to reduce my sodium - but it would have been just as hard in my 40s and probably even harder in my 30s when I ate out a lot.  

I have asked for unsalted fries at In-N-Out burger. My relatives have asked for unsalted fries at McDonalds. We rarely ate fries at other fast food places but they could probably do that, you just wait longer for your serving of fries. 

I think what is harder is figuring out the sodium in condiments. When I was a school kid, my schoolmates and I have definitely used up a lot of condiments to dip our fries, way more than one serving per person.

[TechWife]

20 hours ago, Emba said:

Edited May 4 by TechWife

[Faith-manor]

I wish I had advice. My mom, a type 2 diabetic, has refused to change her diet for 30 years since her diagnosis. She just figures "pop pills". Everyday a piece of white bread toast or a bagel to start the morning. Sigh. And my mother in law has terrible BP issues, and is now taking five meds to keep it down to borderline high. She is a former nurse! 😠 She eats a crap ton of lunch meats, salts everything like salt is a food group in and of itself, and also has renal problems (down to 34% function) and won't lay off the salt nor the high potassium foods. Absolutely refuses to do a damn thing about her diet.

We have given up. 81 and 87 respectively. They can do what they want and take the consequences. I can't make an adult so anything. Sigh. All I can do is learn from this experience and try to be a LOT better as I age on behalf of my own kids and grandkids.

[Laura Corin]

7 minutes ago, Faith-manor said:

I wish I had advice. My mom, a type 2 diabetic, has refused to change her diet for 30 years since her diagnosis. She just figures "pop pills". Everyday a piece of white bread toast or a bagel to start the morning. Sigh. And my mother in law has terrible BP issues, and is now taking five meds to keep it down to borderline high. She is a former nurse! 😠 She eats a crap ton of lunch meats, salts everything like salt is a food group in and of itself, and also has renal problems (down to 34% function) and won't lay off the salt nor the high potassium foods. Absolutely refuses to do a damn thing about her diet.

We have given up. 81 and 87 respectively. They can do what they want and take the consequences. I can't make an adult so anything. Sigh. All I can do is learn from this experience and try to be a LOT better as I age on behalf of my own kids and grandkids.

They may have subconsciously decided that - at this point in their lives - they would rather continue in their familiar ways, come what may.

[Faith-manor]

16 minutes ago, Laura Corin said:

They may have subconsciously decided that - at this point in their lives - they would rather continue in their familiar ways, come what may.

Right. And I can't really change that. But I will say when it comes to these two women, they were diagnosed with these conditions at a far younger age, far younger. Mother in law began having BP issues while still teaching nursing school in a BSN program, and still kept up the sodium like crazy. So I think there is extreme resistance to change with her. Sort of like when Avian BirdFlu was going around a few years ago and bird feeders and bird baths were banned for 90 days in our township in order to slow the spread. She refused to comply even when commenting about the plethora of dead birds she kept finding! "I have always fed the birds." Sigh.

It is so very hard. And I hope that I can maintain my mental well enough to do better on behalf of my kids.

[Innisfree]

44 minutes ago, Laura Corin said:

They may have subconsciously decided that - at this point in their lives - they would rather continue in their familiar ways, come what may.

This: or even consciously decided.

[Heartstrings]

2 hours ago, Laura Corin said:

They may have subconsciously decided that - at this point in their lives - they would rather continue in their familiar ways, come what may.

And I think that is their right.  They may not feel comfortable or be able to fully articulate that to their children though.  
 

 

We have a tendency to infantilize the elderly people in our lives.  We really have to work hard to preserve their dignity and treat them as adults, even if we disagree. 

[PeterPan]

If you get to 90 without reading labels, why start now? 😉

I would go low sodium for anything you send them. I would IGNORE everything else going on. If you shop for her (hint hint) then you can pick the low sodium options. Good luck though. You can run yourself ragged on this.

You need to release yourself from some guilt here. They're going to have declining heart, kidney, and lung function because that's what happens. Do what you can for the part you do and absolve yourself of the rest. 

[Laura Corin]

44 minutes ago, Heartstrings said:

And I think that is their right.  They may not feel comfortable or be able to fully articulate that to their children though.  
 

 

We have a tendency to infantilize the elderly people in our lives.  We really have to work hard to preserve their dignity and treat them as adults, even if we disagree. 

It's hard though when you know that the poor choices they make will increase your labour.  I remember my mum - in her early 70s and very fit - looking around her chaotic house and telling me I'd have to tidy it up when she died. Infuriating. 

[Faith-manor]

2 minutes ago, Laura Corin said:

It's hard though when you know that the poor choices they make will increase your labour.  I remember my mum - in her early 70s and very fit - looking around her chaotic house and telling me I'd have to tidy it up when she died. Infuriating. 

Yes. My mother in law and mother make a lot of choices that have profound negative effects on my husband and me, and then laugh about it, acknowledge that they are making things difficult, and then announce we have to "respect our elders". It isn't funny.

We have been taking some steps back, and reducing our work load with them. They will either figure it out, hire someone, or do without. Mark is going to kill himself young if we don't. It is a balancing act of respecting them and giving reasonable assistance and still surviving here. Mark hasn't retired yet, and I have grandchildren and adult kids also wanting to spend time with me. But they don't have an ounce of respect for us, nor care what happens to us. That makes it very hard to keep going. If I infantalize them, if is because they act like petulant toddlers, especially mother in law who is literally vengeful.

But, the reality is they can't be forced to change, and there is no use trying. All you can do is do you which is IF you are in charge of the food or the activity or whatever, do it the way you believe is best and won't leave you feeling guilt riddled. So for us that means if I am cooking, it is low sodium, low protein, high fiber, complex carbs, and no dessert though I do provide a nice fruit bowl with things like mango, grapes, and blueberries.

[bolt.]

2 hours ago, Laura Corin said:

It's hard though when you know that the poor choices they make will increase your labour. 

I'm really sorry to put this in such a macabre way... but logic tells me that most elderly folks' "poor choices" with diet aren't going to increase the labour they need from family. It's just going to promote the same amount (or less) labour into earlier/sooner years.

I mean, doing the final decline and end of life care: this year, next year, in 5 years, or in 10 years -- it will still be generally the same amount of work for that type of decline. If it happens sooner it will be less work (overall, total) than if it happens later.

Now, making chaos in the house, or generating other work other than simply having needs because of ill health -- that's a different kettle of fish. But longevity itself is not labour-saving. If anything a quick decline is labour-saving: but I know none of us genuinely want that for our loved ones.

[Jaybee]

3 hours ago, Laura Corin said:

It's hard though when you know that the poor choices they make will increase your labour. 

I have struggled with my weight all my life. But I am really working on it and trying to improve my health in other ways as well, in part for this reason. I certainly can't control everything, and who knows what the future holds, but if I can work on things along the way now, I want to, to help my loved ones later. Not patting myself on the back, just trying to do better.

[Laura Corin]

1 hour ago, bolt. said:

I'm really sorry to put this in such a macabre way... but logic tells me that most elderly folks' "poor choices" with diet aren't going to increase the labour they need from family. It's just going to promote the same amount (or less) labour into earlier/sooner years.

I mean, doing the final decline and end of life care: this year, next year, in 5 years, or in 10 years -- it will still be generally the same amount of work for that type of decline. If it happens sooner it will be less work (overall, total) than if it happens later.

Yes and no. Again, to be brutal - lifestyle changes have an effect on health-span, not just lifespan. A long period of debility brought on by someone choosing not to make changes is hard on a potential carer. 

[Faith-manor]

1 hour ago, Laura Corin said:

Yes and no. Again, to be brutal - lifestyle changes have an effect on health-span, not just lifespan. A long period of debility brought on by someone choosing not to make changes is hard on a potential carer. 

Yes. We are experiencing this. 

[Eos]

23 minutes ago, Faith-manor said:

 

Nvm

Edited May 5 by Eos

[Laura Corin]

3 hours ago, Faith-manor said:

Yes. We are experiencing this. 

I'm sorry.

As a counter example for the general conversation - my mum adopted a roughly Mediterranean diet in the 1960s, never learned to drive so rode a motorbike until she was 85, and otherwise walked and bused for transport. She read a serious newspaper cover to cover and kept a flower garden. She was also undoubtedly lucky in her genes.

I was only her caregiver for six years after she reached 92, and for part of those last years she also used her money to buy full-time care. I emerged from the experience diminished. I was in therapy for a while. Longer debility would have had even more of an effect on my own health, retirement and the possible burden placed by my state of health on my own children.

[PeterPan]

2 hours ago, Laura Corin said:

Longer debility would have had even more of an effect on my own health, retirement and the possible burden placed by my state of health on my own children.

The older I get (old, haha), the most I start to figure wonder how we actually live. It's like our childhood goes quickly and then we get into this rut people die and we prepare to die. And the more I'm in this phase, the more I'm like what happened to MIDDLE AGE FUN?? It's more like care for the dying and get old and die yourself. 

It sounds like your mom had a great time.

[Laura Corin]

22 minutes ago, PeterPan said:

The older I get (old, haha), the most I start to figure wonder how we actually live. It's like our childhood goes quickly and then we get into this rut people die and we prepare to die. And the more I'm in this phase, the more I'm like what happened to MIDDLE AGE FUN?? It's more like care for the dying and get old and die yourself. 

It sounds like your mom had a great time.

Long lifespan and short healthspan is particularly hard if people have children young. I am lucky that my mum had me when she was 38.

[Emba]

23 hours ago, Tenaj said:

Does she have physical symptoms that decrease the quality of her life?  The only way I've been able to help my Aunt understand sodium restrictions is that she hates the compression socks she needs to wear.  She also hates the potassium supplements she has to be taken because of to the lasix she is on.  

So, when she is making poor food choices I remind her of those two things and explain that the only way she is going to get away from them is to keep her sodium in check. Sometimes it works - sometimes it doesn't.

I mean, going to the hospital specifically because of the fluid buildup, and the lingering wet cough and leg swelling seem like they should be enough motivation, to me, even if I don’t remind her. It’s frustrating. She wants badly to be at home, not in the hospital or nursing home.

[Emba]

23 hours ago, Arcadia said:

I have asked for unsalted fries at In-N-Out burger. My relatives have asked for unsalted fries at McDonalds. We rarely ate fries at other fast food places but they could probably do that, you just wait longer for your serving of fries. 

I think what is harder is figuring out the sodium in condiments. When I was a school kid, my schoolmates and I have definitely used up a lot of condiments to dip our fries, way more than one serving per person.

Yes, she knows that. But she doesn’t want to make a fuss and would rather go without fries than put in a special order.

 Condiments are an issue, for sure. Not just ketchup but ranch dressing.

[PeterPan]

25 minutes ago, Emba said:

I mean, going to the hospital specifically because of the fluid buildup, and the lingering wet cough and leg swelling seem like they should be enough motivation, to me, even if I don’t remind her. It’s frustrating. She wants badly to be at home, not in the hospital or nursing home.

It’s easy to underestimate the amount of support your loved one needs. What you’re describing is common and it’s when the POA steps in to gently get them where they need to be.

[Faith-manor]

1 hour ago, PeterPan said:

It’s easy to underestimate the amount of support your loved one needs. What you’re describing is common and it’s when the POA steps in to gently get them where they need to be.

Neither of our elderly mothers is willing to give anyone POA. They are determined not to let anyone have that kind of power or influence. It is very frustrating. 

[PeterPan]

45 minutes ago, Faith-manor said:

Neither of our elderly mothers is willing to give anyone POA. They are determined not to let anyone have that kind of power or influence. It is very frustrating. 

If you can get them to allow you to go to the doc with them the doc can do the paperwork for guardianship. If they have impaired judgment due to decline, that’s the path.

Edited May 5 by PeterPan

[Faith-manor]

1 hour ago, PeterPan said:

If you can get them to allow you to go to the doc with them the doc can do the paperwork for guardianship. If they have impaired judgment due to decline, that’s the path.

They do not allow this. The only way we know what is going on with mother in law is she leaves lab test paperwork and results laying around so he sees it. They have to be driven to their medical appointments, but tell the staff that I have to remain in the car or the waiting room. It is their legal right, and in my state getting a POA or guardianship only happens with a dementia diagnosis or something like schizoephrenia, and often only when police get involved. Our neighbor just went through this. Her husband was never willing to give her POA, and he has Alzheimer's, wouldn't do it before he was diagnosed, wouldn't do it after, and doctors do not interfere here because it is so easy to get into legal trouble. Last week he ran away because he was mad at her for not taking him to church even though it was Tuesday and not Sunday. He ran into the woods, and she couldn't get him back, then he got lost. Police, sheriff, and EMS came with a tracking dog to find him. Only then, could a social worker get a judge to give her guardianship. He did not want to go to the hospital though he was injured and dehydrated, but the medics declared him "altered mental status" which was what the police needed to force him onto the stretcher and restrain him. Now he is in the dementia wing of our county medical home which is actually a very good place that does an excellent job. But it took this level of horror to get guardianship of him. We would never get it over either of our mothers in their current conditions.

[Laura Corin]

1 hour ago, Faith-manor said:

They do not allow this. The only way we know what is going on with mother in law is she leaves lab test paperwork and results laying around so he sees it. They have to be driven to their medical appointments, but tell the staff that I have to remain in the car or the waiting room. It is their legal right, and in my state getting a POA or guardianship only happens with a dementia diagnosis or something like schizoephrenia, and often only when police get involved. Our neighbor just went through this. Her husband was never willing to give her POA, and he has Alzheimer's, wouldn't do it before he was diagnosed, wouldn't do it after, and doctors do not interfere here because it is so easy to get into legal trouble. Last week he ran away because he was mad at her for not taking him to church even though it was Tuesday and not Sunday. He ran into the woods, and she couldn't get him back, then he got lost. Police, sheriff, and EMS came with a tracking dog to find him. Only then, could a social worker get a judge to give her guardianship. He did not want to go to the hospital though he was injured and dehydrated, but the medics declared him "altered mental status" which was what the police needed to force him onto the stretcher and restrain him. Now he is in the dementia wing of our county medical home which is actually a very good place that does an excellent job. But it took this level of horror to get guardianship of him. We would never get it over either of our mothers in their current conditions.

This is similar to the UK I think. In addition you can have capacity for some things and not others. Many people lose capacity to deal with finances while they are still able to choose whether to accept medical treatment. 

[Emba]

On 5/3/2024 at 3:53 PM, Arcadia said:

Reading labels is physically harder once bifocals come into play. My MIL prefers not to wear glasses and she would ask her children to read labels if they are around. My FIL and my dad would just take off their glasses and read the labels. I have food sensitivities to artificial sugars and msg so I read labels and my husband has gotten into the habit because of buying groceries for me. My husband now needs bifocals but reading labels has already become an ingrained habit for him so he would still make the effort.

I have aunts with geriatric diabetes. The most helpful thing to them was getting them snacks they could eat. They are like me eating many small meals per day instead of three meals. So snacks are very useful. My husband likes saltine crackers and we have bought those with lower sodium content. My husband doesn’t need to avoid sodium but we eat fast food probably once a week so we try to go for less sodium daily food.

Coming back to say thank you for this reminder. Her vision is poor and finding the sodium in a label is hard for me, with all the competing info and small print. I sometimes forget to look at the whole picture