Father's decreasing appetite - advice?

[FurryDogMother]

Bear with me, this might be long, but want to explain it all...

2 months ago, my Dad (85) fell and broke his hip. Although I live in another country, I've been over here (UK) caring for him during his recovery. He's done brilliantly, but one thing I'm noticing is that he's not eating as he did before the accident. He used to start the day with cereal and fruit juice, then he'd have something at lunchtime - often crumpets - and then a dinner in the evening, possibly followed by a bar of chocolate, or cheese and biscuits. Now, he's not eating breakfast until later in the day (maybe 10, 10.30?), most days it's still cereal, although he's quite partial to an egg and bacon with toast if I cook it for him - but that's now it until dinner time, when he doesn't seem to be able to eat a normal quantity of food - he eats perhaps 2/3rds of what he used to.

He's lost half a stone since since falling (I'm weighing him once a week), and his weight seems to be remaining steady - but this is in the context of rather excessive alcohol indulgence (he's been drinking far too much for the past 10 years, but he was diagnosed with Stage 4 prostate cancer 10 years ago, so I reckon he's entitled to have a few drinks if it makes him happy), so I can't really judge his nutritional intake, as such.

We've got a Dr's appointment on Monday, so I'll be mentioning this, but wondered if anyone else with an elderly parent has experienced something similar - I don't want to start pushing food at him that he doesn't want, but at the same time I'm concerned about the change in eating habits, and wondering if it has any significance? He keeps saying he's full - which worries me.

Anyone got any input?

[CMOTDibbler]

I think that I might be concerned about his nutrition levels, rather than actual quantities of food, especially in the context of him drinking excessively as that will leave him short on B vitamins.
Realistically, how much is he drinking ?

[FurryDogMother]

He gets through 3 litres of vodka a week, plus 6 bottles of white wine (this is when he's left to his own devices, I've installed a shedload of non-alcoholic wine in his wine rack). I rather suspect he's getting a bit more than that from sources I don't know about. I'm certainly not an anti-drinker, I just know it's causing issues for him as far as memory and balance go. He takes multi vitamins every day (prescribed), plus some calcium pills, BP meds, and various other medications.

I just managed to get him to eat a plate of cheese 'n biscuits, despite him being 'stuffed' 2 hours ago. I'm winderng whether his stomach capacity has shrunk for some reason?

[Loshad]

Older people do seem to eat less, probably not least due to reduced exercise so reducing their need for food, my now deceased dgrandmother used to make a meals on wheels lunch (small anyway) last 2 days, and would go some days on only a sainsburys strawberry tart
However your dad is drinking waaay too much, the six bottles of wine would be too much without the added vodka!

[ClareMarriott]

First of all I would just say that whilst you will be going with your father to his GP appointment , HE is the GP's patient so trying to discuss his drinking with the GP may not be appropriate coming from you. Having said that though, I would be concerned at his constantly high level of consumption. It seems he may not have addressed it himself . Alcoholics Anonymous ? I'm assuming your DM is either divorced from him or dead, so apart from you and you live abroad, who else is there to look after him ? Are there things apart from his cancer/hip that he needs sorting out ? Appetite is something that does decrease with age but it would be good to make sure that however little he does eat is nutritious .

[whataboutbob]

If you are going to the GP you could suggest he does B12 and folate levels and a full blood count. Those who drink excessively are often short on B vitamins and that can be reflected in the red blood cells. Also, his diet may have been lacking in green vegetables so again possibly low folate levels which contributes to anaemia.
Finally, alcohol contributes to calories, not the vodka so much but wine and beer certainly does If he's drinking less because you are around, he'll be missing out on the calories so that could explain some weight loss. You don't say how long ago it was that he ate more copiously.

[whataboutbob]

If you are going to the GP you could suggest he does B12 and folate levels and a full blood count. Those who drink excessively are often short on B vitamins and that can be reflected in the red blood cells. Also, his diet may have been lacking in green vegetables so again possibly low folate levels which contributes to anaemia.
Finally, alcohol contributes to calories, not the vodka so much but wine and beer certainly does. If he's drinking less because you are around, he'll be missing out on the calories so that could explain some weight loss. You don't say how long ago it was that he ate more copiously.

[FurryDogMother]

Thanks for the advice and info - he was eating more right up until when he broke his hip (9 weeks ago tonight), whilst maintaining his alcohol consumption (and believe me, I know it's far too much!). I was here for the 3 weeks after he was discharged from the intermediate care home (and the 3 weeks when he was in hospital etc. before that), and made sure he had plenty of good food then, also stocked his fridge with ready meals he could cook for himself while I went home for a week - he ate all the pies, and left all the veggies, of course!

I think I'm beginning to get a handle on this - he seems to do best with smaller meals, but more of them - I'm just slightly concerned that he may have a smaller stomach capacity for some reason, which is why I'd like the Dr to check it out. He also seems to find most meat 'tough', even when it most definitely isn't. That's a new thing, too. I'm pretty sure the results of his blood tests (which we get tomorrow) will reflect his high alcohol intake, so that'll probably be a topic that I won't have to raise myself.

Yes, my Mum died some 20 odd years ago, and Dad is living alone now. He has a neighbour who comes to see him once or twice a week, and a good friend who does the same, also a niece lives locally, so he's not totally isolated. I speak to him on the phone every day, and we've got him a panic button that he wears 24/7 in case of another fall. I'm planning on being here 1 week per month for the foreseeable future - wish we could move closer, but it's not practical.

Anyway, I'll have a clearer idea of it all after tomorrow's Dr visit. I'm probably overthinking it all, but you only get one Dad, and I want to look after mine as well as I can!

[whataboutbob]

FDM you obviously care a lot for your Dad, I'm in a similar situation with mine who is a widower and has early dementia. Small frequent meals often work best for the elderly. From what you say there's no obvious reason why he's eating less now. maybe it just goes with age, or the physical stress of the operation.
It 's easy to say but don't push yourself too much, you're putting a lot of effort in which is great but you can end up feeling drained. I know I often do, and in fact have been getting counselling and one of the areas that emerged was my over involvement and obsession with tackling each and every problem. I've had to learn to turn a blind eye to some things and prioritise. But it's scary sometimes. Good luck.

[B1ueberryS0rbet]

Perhaps the accident is a coincidence and his swallow reflex is fairly typical for a person of 85.. Get him one of those high calorie nutritionally complete drinks like fortisips (?) but there are MUCH cheaper ones available on prescription.
The high calorie liquids can be added to things like custard and soup as well.

[FurryDogMother]

Thanks again - saw Dr yesterday, he says appetite reduction is normal after a trauma like the hip break/replacement, recommended eating little and often - and he also gave Dad the all-clear to fly to Florida on Dec 1st, which is good news all round, because it gives Dad a month of being treated like a king, in the sunshine, and I get to go home and spend Christmas with my family:) The drinking didn't really come up - will fight that battle in the New Year when we're all rested and refreshed! Also got to talk Dad into being assessed for mild cognitive impairment - it's unclear whether his recent brain fog has been down to alcohol, early signs of dementia, or a bladder infection which has now cleared up. I suspect the latter, but want to make sure so that he can get the correct medication if he needs it - always something, isn't there?