No Appetite

dougmelissa · April 19

My mom hasn’t been eating or drinking for a few weeks. We brought her to ER for IV fluids and the PT recommended a rehab facility to get her eating, drinking, and moving again. Great plan except that she has no appetite and everything tastes bad to her. Even foods she loves. She is excited to eat it and then stops after a couple bites because it doesn’t taste good. She doesn’t feel hungry either. She’s lost about 40 lbs in a little over a month and won’t get out of rehab unless she starts eating. He doctor prescribed Mirtazapine to stimulate appetite. She’s only been on that for 2 days and so far it hasn’t helped. Looking for ways to try to get her to enjoy eating and drinking again. She seems to understand that she needs to eat before she can go home but isn’t interested in eating. We don’t know what to do.

H1235 · April 19

Welcome. Could you offer food more often. My thought is if she takes only two bites at each meal (3 times a day) that’s not much, bit if she were offered food every hour (maybe just a couple sips of ensure) that might get her the nutrition she needs. If her memory is poor she may not remember that you even offered her something an hour ago and she didn’t like it. The dementia may have effected affect the part of the brain that processes taste and hunger. There may be nothing you can do to get her to truly enjoy food.

Quilting brings calm · April 19

@dougmelissa

Mirtrazipine takes a little while to kick in, just like any other medication of that type. You are going to have to give that some time. In the meantime … go with whatever she likes, rather than what’s good for her. She likes ice cream? Well then, a sundae and a milkshake everyday, etc.

I do need to ask- are you sure it’s just low appetite or depression? Is she forgetting how to use utensils and needs to be steered toward finger foods like chicken nuggets, shrimp, sandwiches, etc?

Is she forgetting how to eat - or having trouble swallowing? Have you asked for a swallow test?

How old is your mom and how long has she had dementia? Could she be reaching the end of life stage?

Regardless of the cause, a 40 pound weight loss would be a good reason to ask for a hospice evaluation - if you are ready to put her on comfort care rather than invasive treatments for any other conditions she has. Hospice for dementia has different qualifications than hospice for other terminal conditions. There’s not a firm ‘x number of months life expectancy’. It’s about the decline in ADLs, mobility, weight, etc.

dougmelissa · April 21

thanks for the feedback. She’s 79 and has had Alz for about 4 years. We’ve tried all those strategies mentioned and offer her bites of food and sips of liquid frequently. Everything tastes bad, even foods she loves, her diet Mt. Dew, and water too. She keeps saying my brain likes it but my mouth doesn’t. She can still use utensils, no issues chewing/swallowing, and knows how to eat. Maybe the medicine will stimulate an appetite soon. Right now she doesn’t feel hungry and hates everything she tastes.

Victoriaredux · April 22

Did they test her for COVID? That can impact the taste of things. One of my PWDs lived on Ensure for months.

Farther out there they could look for things like Dr House would - tumors or some such but if found would you treat some major condition at this point, maybe the part of her brain that impacts taste etc has been damaged by the disease progress. Hospice follow-up seems like a gentler approach.

Generaluser26 · April 28

Hi there, I could recommend switching to possible tasty soups with veggies and cooked pastas, soft breads with spreads/butter, jellies, and we give my husband many shakes and natural fruit drinks. The shakes contain ensure, but we add in frozen fruit, oatmeal, aloe vera (frozen), and eggs. He seems to enjoy them and has enough energy throughout the day for everyday necessities. He's in mid stage Alzheimer's. This also gives him some nutrients that he's missing out on as he also stopped wanting regular foods. I can send you a recipe offline via email if you'd like!
I hope this works. His Dr. seemed to think it was a great alternative.

No Appetite

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