ALZ and eating disorder. Do we stop buying mom's groceries? Force her to eat at the dining hall?

Lolo, I’m not certain if you were asking me about what I observed with my mom, but keep in mind that all people are different.

My mom was very paranoid. She spoke for at least a year about a man at her apartment she swore was stalking her. In her mind, he was. If she got a hang up call, it was him. If he walked past her apartment, he was spying on her. If something went missing in her apartment, he stole it. She called 911 three times in 2 weeks. Finally, she contracted a UTI that was so bad she had to be hospitalized. She was so combative and off the wall, they had her evaluated and told me they felt she could no longer live on her own. She was in the regular skilled nursing section for about two years and then became really paranoid, combative and did start to wander. They put a wander guard ankle bracelet on her but she cut it off, twice. We had a Care Conference meeting and decided she would get the next bed to become available in the Alzheimer’s unit. Oddly enough, when she became a resident in that unit, she never tried to leave. Stay in close contact with the people who care for your mom. They can advise you about when it’s time.

My mom ate nothing but frozen meals, even with their sky high sodium counts. I’d bring her leftovers from our dinners and when I cleaned out her fridge, I found most of them shoved in the back. She told me it was just easier for her, and buying food in tiny amounts, especially meat, was impossible. When my hubby was hospitalized last year and gone for four months, I did the same thing. I also brought Mom snacks, candy and once a week, her favorite fast food. It was ok. She was 92 when she went into the facility. I doubt if the stuff I brought her was very detrimental at all.

You know, LoLo, she just might be forgetting to eat. She has food in her room that she picked out herself. Does she eat that sometimes and not other times? If she is not losing weight, she must be eating something, some time!

Some residents require hand feeding every meal. An aide does that. Of course it costs more for this service. (I know this is available in nursing homes, but I'm not sure about all ALFs.) What if an aide came in for at least one meal a day and "reminded" Mother to eat. "I think it is close to snack time. Would you like me to make a pbj sandwich for you, or would you rather do it yourself?" "Well, it is my job to check off a box on my list that says I saw you eat something. I hope you won't get me in trouble with my boss." "The bananas in the kitchen look especially good today -- no brown spots at all. Should I bring you one?" Your mom doesn't need to be hand fed, but she might need some mealtime attention. It may be available for a fee.

If she isn't losing weight, I'm not sure I would make an issue of this, though. She has had a bad relationship with food for a very long time, and she has somehow managed to keep going, so perhaps she is smarter than we are giving her credit for. It doesn't take a lot of calories to watch television, after all.

It might give you a little different perspective to read "Being Mortal" by Atul Gawande. It is about quality of life as we reach the end.

Your next visit take her scales. Notice what she has on and weigh her. Put a calendar near the scales and jot it down. Next visit repeat. If she isn’t losing weight she probably is eating enough.
How long has she been in ALF?
Will she eat with you? When you take her to buy groceries?
Have you had a meal with her at the ALF? In her room or in the dining hall?
Have you tried favorites?
Milk shake, ice cream?
Peanut butter?
There is a medication that will stimulate her appetite if her blood work shows she is malnourished.
Does she drink liquids?
If she has original Medicare you could ask her doctor to order Home Health to check on her vitals. Do you think she should be on hospice? When you say she has always had a problem with food I am assuming she is very thin
Let us know if you find a solution.

Lolo, I can tell you from experience that if she’s a picky eater, the staff will come to retrieve a full tray during the after-meal cleanup. That’s what happened with my mom. I commented on another post that my mom and I, when we had lunch together at her facility would play “guess the meat”. There are some facilities that have chefs and onsite dietitians, but those are not the norm. Now, my mom, when Alzheimer’s took hold, claimed no one brought her a tray when her tray was sitting right there.

Just a thought, but needing Memory Care is more than just wandering. My mom didn’t try to leave her facility until after she was in MC. You will see little signs that become big signs. Thinking back on it, the signs were there months and months before I decided to admit Mom to skilled nursing. Keep close contact with the people who care for her to get their observations.

If there's food served in the dining hall, there's no good reason to buy your mom food for her room. You are enabling her reclusiveness. If she's hungry, she can go find food if she is mobile. If not, someone can bring it to her from the facility. If she chooses not to eat, perhaps she's given up hope. That's ok too - there comes a time when people are ready to go and some stop eating. It's a valid choice.

When a person has Alzheimer’s, there is no forcing them to do anything they don’t want. You can’t “teach them a lesson” so to speak by doing something like not buying their food. My mom, in skilled nursing also had to have her tray in her room. She was mobile. There was no reason for her not to go, other than the fact she was terrified of men and afraid one of the male residents would approach her. She was antisocial and a recluse. We all just went along with it. After all, we reasoned, it wouldn’t last forever. When she lived on her own she looked forward to our visits when I took her shopping. Could be your mom enjoys those as well. My mom was a picky eater too. That also we just dealt with.

Perhaps more frequent visits to Mom to monitor what she’s eating and not eating, and also for company. And, in the long run, might me a good idea to consider moving her into skilled nursing if you feel she’s becoming more and more forgetful.

Would she eat if someone sat with her and also ate?

It would be a bit of a pain but that way you would know for sure.

Can you make arrangements for her food to be taken to her on a tray?

Myself, I would stock her up with food that does not need heating. As long as you get some food into her, it has to be better than nothing, YES?