Following on from my other thread about mum I wanted to ask some specifics and thought it would get lost on there.
So mum is settled in her nursing home. She is able to walk with a frame now but is still not eating. This has been going on since July. She is drinking enough and has the high calorie Calgen (?) shots. Her actual food intake is a couple of pieces of banana or a slice or two of carrot, maybe a biscuit, per day. That's it. Even with encouragement. She just covers her mouth and refuses.
Her weight has dropped dramatically. She is about 47kg and skin and bone. At one point, when she was admitted to hospital, she had stopped drinking but they remedied this and she is basically surviving on the fluids. Soft foods are no good either, she just doesn't want to eat full stop.
So, she can't continue like this forever I know. Obviously she has little energy, sleeps a lot, would like to stay in bed all day but they are doing their best to get her up and dressed every day, not always successfully. I think her body can't accept the food anymore, you can hear when a mouthful hits her stomach and it is uncomfortable for her. I think this adds to her reluctance to eat.
How long can she go on like this? the calories from the drinks and shots are keeping her alive but she is so weak that I think an infection would probably finish her off. Particularly as she is also uncooperative with medication. I don't want any interventions, feeding tubes or PEG is out of the question. I am wondering if they should stop the Calgen shots as surely these are artificially prolonging the inevitable? Or would that be withdrawing treatment? I don't know what I'm asking really. It is like being in a state of limbo, just waiting, it is only going to go one way.
Elderly parents
When someone stops eating
DowntonTrout · 25/10/2013 12:51
I think in your situation, I'd be sitting down with the Matron or nursing manager, and having a discussion of what will be in your mums best interests in the months to come. For instance, if your mum gets an infection, do you want her to have antibiotics or would you like her to be made comfortable and nursed, but see what happened?
I think I would stop the supplements, obviously get them to encourage her to eat and drink, offer her ice cream or anything she might fancy.
My mum is eating less and less, some days nothing, and will rarely eat food that needs chewing or that has lumps. She's 5'8, and probably weighs less than 55kg now - you can see all her ribs clearly. Dad gives her a lot of clotted cream ice cream, which she likes, but the supplements get spat 
so we've stopped trying those.
Oh, Downtown, that sounds so hard and awful .
I came on this thread with some gems of wisdom re the eating issue, but things have obviously progressed.
What I am going to post I am saying as a GP and also as the granddaughter of a 100 year old woman who is severely demented (my gran is like an infant in all her needs), so I hope some of this is helpful in a small way.
It sounds as if your mother is nearing the very end of her life, I am sorry. If a simple UTI is causing her confusion it is certainly worth treating with an antibiotic. If she refuses/cannot take it, she can recover from it or it can get worse and lead to sepsis and death.
It is very worthwhile, whether cancer rears its ugly head again or not to have a long 'end of life' chat with her GP: how much active treatment do you feel is appropriate? Where do you want her to be looked after? Is there a way to inform OOH drs of your mum's condition and your wishes for her care (lots of people don't know that GPs/OOH/hospital IT systems are not automatically dealt) to avoid middle-of-the-night 999 ambulances to A+E which is often inappropriate and very distressing for all concerned? Is there a way to have "just in case" medication at the care home for OOH nurses/drs to give to your mum if she becomes agitated/in pain in the middle of the night or at weekends?
Re the food issue I agree to stop the supplements and keep offering her anything that she likes: ice cream, custard, yoghurt, chocolate, bits of cheese, anything that is calorific and that she likes.
Dementia is a progressive illness of mind AND body - they both declined, sometimes one more rapidly than the other and it sounds like you mother's body has reached the end of what it can cope with.
I am so sorry you have to go through this. It's shit and dementia is a right bastard.
Looking after my gran is very, very hard for my mum and I am of no practical help as they live in another country from me.
Please look after yourself and try and make your decisions based on what is best for your mum, not what makes you feel less uncomfortable (withdrawing feeds is such a counterintuitive thing to do, I know).
I hope none of what I wrote will sound unnecessarily cruel x.
Oh, when did she break her hip?
And what kind of cancer did she have?
No, I don't think that a fall which leads to a broken bone can 'reawaken' cancer, but it it is possible to break a bone without much force if there is in fact cancerous deposits in the bone IYKWIM.
My gran has severe osteoporosis and has broken more than one rib/vertebrae turning/being turned in bed .
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I know what you mean about documenting what's going on.
My mum took a photograph of my gran lying in bed on the morning of her 100th birthday this summer - she was lying on her side in a kind of fetal position. She looked like some kind of Egyptian mummy. With a nightie on. Once up and dressed she looked great (she has a full head of bright white hair which is a real feature), but the person she once was is long gone.
I think the cancer theory is maybe a bit of a red herring tbh. A recurrance would not just necessarily show up in a blood test and treatment would be inappropriate anyway.
She may simply be reaching the end of her rope .
I am so sorry x.
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