Not Eating - But Not End of Life

MrsAnnabelLee

Hi all,

We've noticed recently mom is barely touching her food. Even with prompting she's started leaving most of her food on her plate at each meal. 

She's solidly at the end of stage 6 and I've wondered if we aren't in stage 7. It's sometimes hard to tell because her language skills are always more advanced than they "should" be for any given stage she's in. But, she needs assistance with all ADLs, her communication skills are much lower, she's incontinent, and she's about to be getting a walker. 

Still - she's not sleeping most of the day, or having lots of trips to the hospital or anything like what I've read signals that you're nearing the end. So I feel confused about what to expect from this point. I'd love to hear any insight you may have.

terei

She must be losing weight.  This is an example of what I mean when I say to call hospice for an evaluation

CanyonGal

I just spent the last year trying to get my mother to eat. She might eat about 3 bites and then push the plate away. I can't eat that, or that type of food I can't eat, or some other excuse to why she is unable to eat what is in front of her. We would often ask what she was interested in eating, and if you brought that to her, she might taste it but not eat it. I was really frustrated and upset about the food issue. There was no reasoning with her.

She went on a tomato soup diet for several months. Ensure and the other weight gain products were a definite "no" for her to try but bring on the soup!  Her teeth were fine (dentist checked) and she didn't have any swallowing issues. 

She had surgery in Feb - but the not eating started before surgery, so not related. It appeared to be a dementia related issue. While in rehab, the doctor requested she be treated for depression. They started an antidepressant in April. 

By the end of June, she went from 109 weight in January to 85 lbs. We requested a Hospice evaluation and due to the weight loss, she qualified for Hospice. She mentally declined after surgery as well, not unexpected. 

We moved her from AL to Memory Care in August, and suddenly she started eating again. She hasn't gained much weight back, but she is eating. 

NO ONE knows why she went on this not eating phase, but we were happy she turned the corner. She was very constipated, and I have to think if that caused some of the problem.

(My mom was at stage 5- leaning towards stage 6 now.)

WhatNow?

This sounds very familiar to me and reminds me so much of how my mom was about a month ago.  She wasn't eating very much, she was getting harder to understand, and her mobility was very slow.  She started having falls, which then led to ER visits.  Jump forward about a month and now she isn't walking, still not eating very much, and she is on hospice.  Even though she is on hospice I still would say it doesn't seem like death is at the door yet, but we all know it is heading that way; slowly for now.  It can still be a very long journey from here from what I understand.  Within a month she had lost a significant amount of weight (12/15 lbs) and then with the loss of ability to walk I think that placed her firmly in stage 7.  

We had placed her in MC earlier and with this progress she is now in a nursing home.  A couple of weeks after she started hospice we thought she was going to pass due to an issue with her breathing, but somehow she stabilized and here we are.  

If you think she may qualify for hospice you might as well call and talk to them or her Dr for a referral.  That was actually a pretty quick process once we got it initiated.  Since mom was already at a facility we worked with the DON and social workers to get the evaluation schedule.  Even though we had already placed mom, we use hospice for a 2nd set of eyes and ears for her and they provide her a broda chair, fall mats for around her bed since she falls out and incontinence products.  They also help manage her medicine, give her baths, and make sure we have constant communication about her status.  It is really nice since this is not a strong point of the facility that she is in.  

Best wishes for you and your mom.  

LaurenB

When I was working in nursing homes we would explain that hospice is usually a service for people who are expected to live less than 6 months.  We’d ask ourselves, would you be surprised if this person died in the next 6 months?  If the answer was “no”, then hospice may be an appropriate option for them.

CanyonGal

I am going to add that my mother could not walk with her walker very far and was unstable BUT once she started eating again, she regained enough strength to be mobile again. It makes sense that if you don't have enough food, your body becomes weak. Weakness means more falls.

At my mother's facility there are many people who are on and off Hospice. If they regain their strength, weight, etc. they may not be eligible to stay on Hospice. There is one lady there who has been on and off Hospice for two years. I think my mother has been evaluated twice, if not more, since June, and still qualifies due to the increased dementia and other morbidity issues.

When she first qualified for Hospice a hospital bed arrived, morphine, oxygen....and I had to say, WAIT we are not at death's door yet! Hospice said it is standard procedure to have those things available because they don't know where the person is when they are first arriving and begin treatment. It is better to have them available. So, except for the hospital bed, the other things are stored in the closet.