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.
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.
But if your mother IS, then doesn't that make the choice that much easier to simply follow her wishes?
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.
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.
I would ask and/or insist on a swallow study, performed not by a nurse or anyone on staff unless it's a speech pathologist. That will determine whether or not swallowing is an issue.
What about favorite foods before she was in care? That's usually an unofficial good indication whether she's not hungry or not able to eat.
Recently, when I fell and injured myself and could barely walk, I also couldn't eat for 4 days. I wasn't hungry and everything I normally liked seemed repulsive.
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.
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.
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.
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.
Loss of appetite/interest in food/reports of GI upset after eating are symptoms of many things.
Medications can be the culprit - can you discuss the idea of temporarily stopping some medications that are not life sustaining (vitamins, statins, blood sugar management, etc.) for a. month to see if that improves her appetite/interest in food? Is her BP and heart rate running really low? Maybe cut back on cardiac meds? Conversation for you with the NP or PA or MD who sees her in the SNF.
A bad fall, and the realization that she will be staying in the SNF, is often 'the beginning of the end' and she knows this is true. Letting go of the world and turning inward is a normal sign that a person's time is coming to an end. Not that she will die right away, or that you have to do something or it will be your fault that she dies.
I'm the POA for my mom, recently had to force a psychiatric placement for her own safety - something she NEVER wanted, actively avoided, and now blames on ME. I didn't do it, ,though, until all 3 of my siblings indicated that they believed that she did need this type of care, and that they had no objection to my taking the actions.
Maybe you can see what she thinks about her situation, what she wants for the future, etc.
"The doctors and nurses are concerned about her being weak.." so a dumb decision to have it.
The one she had was not portable, in fact it was similar to the one that hospitals would use to hook up an iv bag for intravenous fluid, (the one with the bag hanging on the tube(?) that can be moved if the patient gets out of bed and wants to walk around). It was big and bulky. There was hardly no way she would have been able to walk around with it on her own. Also, in a NH setting, it's up to the nurse to keep it and the area where it is inserted clean, and to fill it. (Tasks that may have to wait until other people are fed).
I found out later, after she passed, the hospital made some money and the GI doctor definitely made money (he even came around after it had been disconnected and his services were no longer needed. He could charge insurance for these visits, which he did, all the way up to her death).
If mom does get one there is a good chance she will have it for the rest of her life.