Elderly woman not eating

Dementia affects all bodily functions including digestion, not just cognition and speech, they're just the most visible and upsetting effects. Even when people with dementia eat relatively well it can be harder for them to take in calories and nourishment from their food.

Talk to her GP. See if you can get palliative care involved. In my case the GP refused to refer to them but did agree an end of life plan with me that meant antibiotics and a morphine driver stocked for in the nursing home and she would only go to hospital if she was in pain that could not be managed there such as a fracture.

OP I came to this board tonight looking for similar advice. It suddenly occurred to me that the refusal to eat isn’t entirely dementia related, but the body starting to shut down. My DGF (also 92) is still living at home and I am wondering who I need to discuss this next phase with. Such compassionate advice here so thanks to pps. DGF was always so aware of the need to keep his energy up with food, even if he didn’t really want it, it has been upsetting to see that go out the window. It’s hit me it is unlikely there’s any coming back from this.

You really do need to do some advanced care planning with the GP. pneumonia used to be called all the old man’s friend. It’s very likely that she will develop an infection or become physically unwell in the future and you need to plan in place so the home and medical staff know what level of treatment you wanr for her.

I think one of problems with encouraging her to eat is that she could potentially end up choking and this in turn can lead to pneumonia.

It’s very hard watching someone you love die of dementia but one of the kindest things you can do is to sort out escalation of care.

It really is like losing them twice but your DM doesn’t sound content and it does sound as though the disease is progressing.

Maybe call the Admiral Nurses and talk this through before you talk to the Care Home. They might give you some points to consider

You can ask for her not to be sent, even if she falls.
She'd hate being in A and E and if she had a fracture she wouldn't survive an anaesthetic.

I'm also sending you a hand hold OP. You really need to talk to your mum and the care home about her signing the "purple form". Gently, you dont want her suffering resus procedures (I'm not a nurse). For food, take whatever she will eat or drink - lucozade, chocolate milk, rice pudding, soft fruit pieces. Sending love, it's not an easy time.

It sounds like she's at the end stage of the disease now @AInightingale

Leave her be. Keep her comfortable and make sure you talk to the staff about end of life medication. The GP will need to prescribe this.

It's unkind to keep forcing very ill, very elderly people to eat, when there is no hope of recovery. Some care home staff do have trouble not offering food to their patients, but really, they should be guided by your mum.

Make sure the staff also know not to send her to hospital for any reason. Also, not to attempt CPR (though surely they would not).

So sorry, it’s really tough and you clearly want the absolute best for her. It’s worth starting to understand the end of life landscape for her. Again, it doesn’t mean she is there but it is so so much better to be prepared. Ask the GP covering the home or if you have a local hospice, check what they can provide and whether they cover the community (sometimes it’s hospital and sometimes it’s hospice). Your mum should have an anticipatory care plan (stopping emergency dashes into ED that you collectively deem not to be in her best interest) as a minimum. Again, in my experience you have to be the one to ask for this and push to make sure her care is as coordinated and in her interest as possible. You’re doing a brilliant but painful job OP, look after yourself.

My mum did this, too. She had vascular dementia - very fast compared to Alzheimer's - and was only in a nursing home for two months. Prior to that, she had little appetite but would eat well when given food. She picked up in all ways for her first few weeks in the home, but then started slowing down very noticeably. She received excellent care, with staff presenting frequent small tidbits and a variety of drinks, organising her medication, but they very gently warned us that she was signing off.

I feel she had a very good death, actually. She moved, day by day, further into a twilight world of waking sleep, dreams and imagination. She was physically comfortable ... she just gradually wore out and slipped away.

Trust the care team, @AInightingale, and do what you can to let her feel love. Sending you a quiet hand-hold.

Sorry posted too soon. I’m sorry that you are having to watch her deteriorate

Gently - I think that the kindest thing would be to stop trying to make her eat. This is likely to be part of her deterioration.
Is it fair to force her to keep on being alive if she does not have a good quality of life?

Talk to her GP and perhaps agree a treatment escalation plan.
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Sorry OP, that’s really hard. Difficult to say whether it’s disease progression - probably based on my experience, but lack of nutrition and hydration can make it much worse for sure. Approach we took (multiple times, different relatives) was to take and give them whatever they will eat, wherever they will eat it. Not at all ideal as it depends on you, and others, being able to go and sit with her and having the right rapport with your mum to encourage her to eat. All the ‘five a day’ goes out of the window and it becomes about fat and calories to keep her as comfortable as possible. Gently though, this could also be her starting to die and her body’s way of moving towards that. Not that this is imminent, but it could be part of the last year of life when reduced appetite and frailty are often seen. Hopefully someone with palliative care experience can give you a view.