When do you stop offering food and just offer liquid nutrition?

JanJon, my mom has been in the nursing home for 13 weeks and in that time has gone from eating a minced diet with occasional finger foods to a totally pureed diet, and very little of that. Her first few weeks there it broke my heart to observe all the people in the dining room seemingly surviving on one or two bites of food, those eating the least generally have their "meals" topped up with nutritional supplements. My mom doesn't spit out her food, but has reached a point where I sometimes need to remind her to "chew chew chew swallow" or she will simply hold the food in her mouth, so I try to be there for at least one meal a day because I'm guessing that nobody else can take the time to actually get her to eat. Some of these folks are still on a regular diet but just don't eat, even when the aides coax. The point of my ramble is that the NH has at least a dozen folks living on minimal calories, but nobody appears to be imminently dying as the result of it. Frail, immobile, mentally absent, but not dying. (sigh)

I care for my 95 year old mom who has late stage dementia and in last month has starting ?chewing food and not swallowing it , spits it out on floor and also spits over side of wheel chair. I realize each patient is different, but has anyone had this happen for long length of time Without sounding morbid, is my mother heading toward the end of her life? She also morns and cries like she has pain but when I ask her if she has pain, she rattles on about something that is not coherent. Help!!!!

mrsribit,
How lond has your mom been doing the "chewing up and spitting out" ? Mine just started this about a month ago.

I am going through the exact same thing with my mother. She is also in hospice but at home with me and has been chewing up and spitting out food. I have done a few things so far to encourage her to eat:

Morning: sunny side up eggs on top of toast. The eggs soak into the toast and make it soft. soft fruit with a bit of sugar...for some reason the sweet foods she will eat more of and spit out less.

Nutrition shake: Orgain (organic nutrition shake she loves the taste.)
Organic vitamin suppement: 1/2 a packet : Oxylent seems to give her energy

Soup with the veggies and meat overcooked to soften them: kale, carrots, potatoes, parsnips, onion celery,chicken, low soduim organic chicken broth. She will chew up the solid stuff and spit it out....but the broth has all of the nutrients and she will drink that.

Pudding, cream of wheat, ice cream, fruit cocktail she will eat.

Macaroni and cheese, pasta with sauce, noodles with cottage cheese ok. (I over cook the noodles)

I will also make a shake with coconut milk or yogurt in the blender add spinach, peanut butter, frozen berries, banana and blend. I also add a protien power...I use Vega One nutritional shakes.

Both Vega One and Orgain can be found at healthfood stores or organic markets.

I sneak high nutrition foods in whereever I can.
It is so hard to watch her eat less and less.

I have an appointment with a renal dietician to discuss the food intake further and have also looked into meal services that supply meals to individuals with terminal illnesses. "Food and Friends" is one that I have recently contacted...they have a "soft food" selection and dieticians on staff. Hoping this will give more variety.

As long as she will eat the puréed foods we will keep that up. She gets boost on ice as she likes drinks to be cold. She also can't use a straw correctly anymore.

My mom has problems with regularity too. I have been increasing her stool softener and still occasionally give her a suppository to aid this. So are you going to change to liquid nutritional supplements or are you going to continue to give pureed food?

My MIL has vascular dementia. The first sign we had of her digestive system slowing down was impacted bowels. Next she began eating smaller amounts of food and spitting out chewy items. After choking and aspirating at lunch, she was tested and now has a delayed swallow. Also, her digestive system has slowed down a great deal. She has to have puréed foods and tends to eat at breakfast. If she eats too much, the food backs up in her esophagus. The back up causes great discomfort. As you can imagine the stomach has room at breakfast but not the rest of the day. She is currently hospitalized and her issues are piling up. Poor thing, the nurses want to stuff food down her thinking they are helping her get better. Instead they are setting her up for a long day of pain.

I have finally completely switched over to boost. I just wanted to know if anyone went through this to know what made them make the final decision. You don't want to stop giving them the option but eventually it's what they need. I feel ok with this decision now it was just hard to decide when to do it.

this must be really hard for you. it gets to a point we don't know what to do, doesn't it? at the end my mil stopped eating completely, but by then she was in hospital and was on a naso-gastric tube. Maybe speak to your doctor or her hospice carers of what they suggest is the best way to make sure she eats. much love to you today, xxx

Mom never would eat pureed food. It seems like her not eating is more rejection of food rather than inability. She spits out food that she's chewed so well she should be able to swallow and does to a very small degree. She drinks/eats milkshakes that I make with boost and ice cream but recently she's even refused those occasionally. She's had such a slow decline that it's gotten hard to determine when to make changes. Last summer I'd cut up mango and she loved it. I just got some and she's doing the chewing and spitting out thing with that too. I'm only giving her the really ripe mango. It should be really easy to eat. I gave her pudding the other day and she seemed to enjoy it but I can't give that alone. It just seems like I'm giving up by not giving her food when she says yes even though she doesn't really eat it.

when my mil had late stage senile dementia, we used to mince her food or mash it very fne, as she could also no longer chew. everything was chopped, diced, mashed to the conistancy of the second stage of feeding a baby solid food. she would eat then, eg, mash and pumpkin and gravy went down well, but rice or pasta got spat out because of the texture of it. in the beginning of this stage, she could feed herself, towards the end, she had to be spoon fed. in this way at least she ate. she also loved yoghurt., and milky puddings.

Sorry It's late. forgive the duplicate info.

Mom has severe memory loss and has been on hospice for a while. She at times refuses to eat and I give her liquid nutritional supplements, boost, ensure. Lately she's been eating a bite or 2 and refusing to eat more. On other days she will continue to put food in her mouth and not swallow. Or she'll chew and then hold it in her mouth. There are times when she ends up with little piles of chewed food that she spits out on the plate. Ultimately she doesn't eat more than a bite or 2 of any meal. I feel guilty when I think of just transitioning to just providing her boost or ensure only. She has lost the thought process to understand the options. When I ask her what she wants for lunch or dinner she can't think of any food items or she says something she hasn't been able to eat in a long time like steak. If I give her food it's just a sandwich. I think I'm rambling but I need clarity. Anyone with experience? If you've made the transition with someone you care for what made it clear for you that it was time?