Help! My Parent Won't Eat
We humans appear to be hard wired to equate feeding with good caregiving. If someone we care about won't eat, we feel we have failed. Even very young children will first try to feed a tiny bird and are devastated when the poor injured fledgling won't open its beak. Food and nurturing go hand in hand. But, there is a reason why the bird won't eat, and there is a reason why a senior isn't interested in food, as well. The issue is to deduce what that reason may be.
1. Illness: If your elder has been ill, not having eaten much for a while can reduce feelings of hunger. As the stomach has shrunk, often more than two or three bites can cause a feeling of "fullness." Chemotherapy and certain medications can also affect the appetite. For someone recovering from an illness, residual weakness can result in loss of desire to get up and move around, which will further reduce appetite. An undiagnosed medical condition or one still under treatment can also lead to loss of appetite.
2. Constipation: Being constipated is extremely uncomfortable and can lead to loss of appetite. Certain medical conditions and an awesomely long list of medications can cause constipation. Relief often leads to an almost immediate improvement in appetite.
3. Depression: Depression is often the culprit in loss of the desire to eat.
4. Difficulty Swallowing: Individuals with Parkinson's Disease, those who have had a stroke, Alzheimer's Disease patients, and many others may have problems swallowing food and/or fluids. The fear of choking can reduce the desire to eat.
Issues 1, 2, 3 and 4 above should first be addressed medically. If you haven't communicated with your parent's physician about an unusual loss of appetite, this should be your first step. The doctor can address untreated medical conditions, adjust medications and make referrals for appropriate therapies if that would be appropriate. Sometimes an appetite-boosting medication might be an option, or an anti-depressant may be in order. It always pays to start with the doctor.
Encouraging fluids will do a lot to help constipation by helping to move food through the digestive system. If your elder has any dietary restrictions be sure to consult with the doctor before adding very high fiber foods or fiber "products." Avoid laxatives unless instructed how and when to use these and which product would be best.
5. Dental Issues: Dental problems can make eating uncomfortable, or even painful. Ill-fitting dentures can cause painful gums. Dry mouth, often caused by medications, can also make eating difficult. A dental check-up to eliminate the possibility of tooth and mouth problems is always a good idea.
In the meantime, if you suspect mouth or dental issues and while you're waiting for a dental appointment, try a softer diet. Small servings of nourishing soups, pasta, eggs, or whipped potatoes with butter and a little tasty gravy require little to no real chewing. Google "soft diet" for thousands of recipe ideas.
6. Loss of Taste: As we age, loss of taste receptors is normal. Food that once tasted good may not taste "the same" to an older person. Depending on your elder's preferences and any dietary restrictions, try increasing the amount of seasoning you use or encourage your elder to use appropriate seasonings at the table.
The taste receptors for sweet are commonly that last to deteriorate. Many caregivers say they have increased the amount their elders will eat by using honey, syrup or sugar substitutes liberally, even on foods where you might cringe.
Certain medications can reduce the sense of taste, or make some foods taste disagreeable. Check with the pharmacist, who may be the most knowledgeable about these possible side effects.
7. Boredom and Loneliness: Eating alone is often an appetite reducer. Those who fix their own meals and eat alone may not find any joy in cooking for one. Eating is a social activity for most people, who tend to eat better when they have someone to share their meal.
Try sitting down with your senior and eating together. If you aren't ready for a meal when your senior eats, have a small piece of fruit or a cup of tea. Encourage conversation about whatever may interest your elder.
8. Forgetting How to Eat: Those with advancing dementia may actually forget what to do with a piece of food or the tools on the table. Offer small finger foods, and sit with your elder to remind him or her to take a bite, chew, swallow, and have a sip of fluid between bites. Watching you eat may also serve as cues about what to do next.
Be sure to keep servings small so they aren't overwhelming. Use bright, solid-color plates so the food stands out and is easy to see.
9. Being Ready to Stop: For the very old old or someone who is terminally ill, there will come a time when food is no longer desired. As the body begins to shut down, the feeling of hunger and desire for food wanes. If this is the case with your senior, continue to offer small bits of whatever food seems appealing. At this stage you will not be worried about maintaining a balanced diet. If ice cream tastes good all day every day, then ice cream it should be.
However, try not to feel that you have failed if your elder refuses nourishment. You haven't failed, and force-feeding will not help. Taking in food that the body can no longer use will only increase discomfort as the food is no longer digested properly. Your doctor or hospice nurse will be able to help you define when your elder has reached this point.
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Many people turn to nutritional supplements such as Ensure or Boost to supplement poor dietary intake. These products are reported to be nutritionally complete, and many people will drink one of these products even when they have little interest in other kinds of food. With the buy-in of the doctor they can provide a large portion of someone's needed daily intake. Beware that some of these products can cause diarrhea. If your senior has diabetes you will want to find a nutritional drink that is designed for diabetics. Glucerna is one such product.
Some find that these drinks taste much better when they are chilled, and when a little ice cream or pureed fruit is added. A drop or two of flavoring such as coffee, peppermint or orange extract can also zip up the flavor.
Yogurt, puddings, custards and other smooth, cool foods often appeal when meats and vegetables don't. With the doctor's approval you can stir in protein supplements or a little baby cereal for an added boost in nutrition.
Home made fruit smoothies and other "shake" type drinks are also often easier to get down a reluctant eater than hot food, especially in warm weather. Offer these in small glasses so the amount is not overwhelming. Store the rest in a covered container in the refrigerator. This is another way to get fluid into a reluctant drinker, as well. Beware of unintended side effects: bananas can be constipating, while too many cherries, apricots, raisins and many other fruits can cause diarrhea.
Your blender or food processor can be a lifesaver for warm foods, too. A little broth added to shredded cooked vegetables and small bits of chicken, meat or fish can easily and quickly be blended into a tasty soup.
Once in a while a little sin might not hurt, either. Try bringing in a fast food hamburger and a small order of fries, or some chicken tenders, pizza, moo-goo-gai-pan, an over-the-top fancy coffee emporium drink, or whatever hits your and your elder's fancy. Always having food that is nutritious and good for you can eventually get downright boring. A bit of a food fling now and then into the realm of not-so-good-for-you-but-WOW-really-tasty! might be enough to at least temporarily wake up a slumbering appetite.