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I recently posted that my mom was improving with her PT/OT after a bad fall but since has had no appetite. Now after 6 weeks, she remains on Boost shakes and a few soft foods, but is eating less than 25% of her meals. The dietician/nutritionist has tried all her favorite foods, and she has been on an appetite stimulant, but to no avail. Mom's reply is that she is not hungry and gets nauseous if she eats a regular diet. She said she will not agree to a feeding tube, and as POA, I am not sure what to do if anything as Mom is of sound mind and is very opinionated and stubborn. Her social worker and the nurse manager were also trying to feed her with little results. As a result, mom has lost 20 lbs. in that time. When I relayed all this info to my out of state brother, he called her to ask what was going on since she always had a great appetite and was even overweight after eating 3 big meals daily. Mom replied that I was making up stuff and not giving him the right info. She has also lied to him in the past about what I do or don't do for her, the quality of the SNF, and the inadequate care that she receives. I have been forwarding the pertinent e-mails from the staff to my brother as I follow up almost daily on her progress. Her intention has always been to move in with my husband and I and our fur babies, but for many reasons, this is not a viable option. Thanks for your constructive suggestions.

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Get her a psych evaluation and a swallow study done. Once it's determined she's able to eat but choosing not to, you'll know what you're dealing with..... a hunger strike in an effort to get her way. A feeding tube should not even be a discussion. If your mother has lost 20 lbs from eating less, I'd venture to guess she had 20 lbs TO lose and is not emaciated as a result. And can probably lose even more weight without issue.

Once she realizes a hunger strike will STILL not get her moved into your house, she may suddenly find her appetite once again, at least for her favorite foods or when nobody's looking. You'll know shes eating on the sly if she stops losing weight or starts regaining. This PROVIDING the psych evaluation and swallow tests show no issues.

The human will to get what we want is amazingly strong, so don't be shocked if thats what's going on here. Nobody can prove she's not really nauseous, and she does have control over what she eats, so this can easily be your mother's manipulation tactics which so far are working quite well! She's even successfully playing your brother against you, making you out to be The Bad Guy when you've done absolutely nothing wrong, making your brother question you. This proves she's got an ulterior motive here, let's face it. Cause as much chaos as possible and see what happens! 😑

Make sure you run those tests so you'll know for sure there's nothing medical going on preventing the woman from eating. Or depression that a simple anti depressant would cure. Process of elimination will give you your answer.

Best of luck to you.
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MissGypsy Sep 2022
Appreciate your assessment and kind words. Recently visited and she was out of bed and walking with PT assistance. We then took her outside in a wheelchair for fresh air and sunshine. Mom replied that she felt better getting dressed and out of bed, so it seems she is moving forward and eating a little better too
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I am so sorry you are going through this. I hope and pray for you.
By feeding tube, do you mean the kind where it goes in through the nose and down into the stomach? Or the other kind where they make an incision and place the tube directly into the stomach?
Your mother may not even be able to tolerate the naso-gastric type. My mother could not and kept pulling it out. It was an awful experience for her and me too. And my mother (years earlier) had chosen the incision into the stomach type for her mother and therefore my grandmother lingered on for another 2 years of just lying there. That was also awful.
So after my Mom pulled hers out for the 2nd time I said no more and she was put into hospice where her last weeks were peaceful.
I hope this helps.
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Has she had a swallow study?

Has she been to the dentist recently?

Is her depression being treated?

Long ago, my FIL was in the hospital for kidney related issues. He stopped earing. When asked, told everyone "I can't eat".

Every one brought his favorite stuff. Tongue sandwiches started to pile up in the hospital fridge.

Finally, a psychiatric consult was suggested. Psych noticed that his COGNITION was off. Ordered some imaging and a Speech/language consult.

The answers?

He'd had a stroke, was saying "eat in place of swallow. He couldn't swallow.
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MissGypsy Sep 2022
She is swallowing fine based on many different and favorite foods and liquids. Just the appetite is mostly gone. Depression and anxiety not being treated as she refuses any assessment as well as any further drugs.
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I hope Mom has a Health directive saying she wants no feeding tube. Now that you know she doesn't you should not override her decision.
As a POA your decisions need to be made on what Mom wants or you think she may have wanted. You are her representative.

I may have a doctor look at her with the idea its a case of the "Failure to thrive". You don't say how old Mom is. My daughter is a Nurse and says no feeding tubes unless a means to get over a hump. She sees too many residents where its used to keep someone alive with no quality of life. Once placed, a court order or hospice is the only way to get it removed. Before, its letting nature take uts course, after placing, it's considered starving a person to death.
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MissGypsy Sep 2022
Mom is 85 with many chronic health issues. I am honoring her wishes for "no feeding tube" and she is eating a little better. In general, she has a very good quality of life in SNF and is getting a lot of care and attention. Thanks!
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My dad has lost near 40 percent of his body weight in the past year. He has stage 3 ckf—no dialysis required. He’s at home, no dementia, no swallow study, but he’s just lost his appetite.

He just turned 90. My sisters say there’s nothing to do about the situation medically, and given that one of them is a surgeon, I’m going to believe her.

Sometimes it’s not senior brat behavior. Sometimes they just start eating less.
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My mother was in SNF dor two years one day she just stopped eating. She was 89 and had a stroke two prior years. She was offered food daily and always refused. It was hard for me to observe, but she passed. I am not in favor of tubes unless it is to get over a hump. I would not want one just to prolong living. No way to live.
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Since you know your mother does not want a feeding tube, in my opinion you should absolutely not consider it. I cannot speak to why she is not eating but you should respect her wishes nonetheless.
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MissGypsy Sep 2022
I am not in favor of the feeding tube as long as she can make coherent decisions...Thx.
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Usually LOs are familiar enough, ESPECIALLY if they are lucid in their illness, to KNOW what they have signed when they say “no feeding tubes”.

Don’t question her choice or your own. You’ve made a comprehensive and reasonable assessment, based on your love for her and her own choices.

There won’t necessarily be any “happy ending”, but you’ve both done the best you could come up with. Your brother’s loving input has probably been his best too.

Continue to offer nourishment as you’ve done, for your peace of mind and with the potential that she may respond, but be at peace with what plays out.
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MissGypsy Sep 2022
Your response is appreciated. She is eating smaller meals and snacks/Boost in between.
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My mother, my husband and I all filled out health directives to prevent tube feeding: we want to be in charge of our own bodies. Just like you want to be in charge of yourself, so does mom....................let go.
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Bring her a favorite fast food treat and see if she eats it.

If mom is of sound mind i dont see how or why you would force a feeding tube on her.

Based on other posts you made about moms personality disorders it could be she is on a modified intentional hunger strike to get her way with letting her live with you.

Or maybe she just likes all the attention she gets with all these people trying to get her to eat.

Or maybe food is making her nauseous and she cant eat as much. If thats the case maybe it's caused by a medication she is on or an underlying health issue that hasn't been caught yet.
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MissGypsy Sep 2022
Thanks for your input...all good ideas!
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