Do I buy what she wants or just what she needs

[expat101]

Looking for suggestions, please. In May Mum weighed in at over 108 kilos and is 6 foot tall.

My Father died nearly 5 years ago, and since then, Mum has gone from using a walker to deciding she cannot walk so relies on a wheelchair. This was supplied by a rehab hospital after a fall to assist with her fear of falling.

Mum was diagnosed with dementia not long after Dad died (I'm aware he ended up being her carer) and he put into place with Mum's Doctor for the testing to occur if he didn't pull through an operation. However, it's not taking the ''normal'' path of forgetfulness, rather she goes through angry, lying, and abusive cycles coupled with periods of calm and pleasantness. If she doesn't get her own way, she becomes nasty, whether that is directed at me or nursing staff.

Because of her confinement to the wheelchair, she now lives in a private hospital. The staff are fantastic and the care is 2nd to none.

The staff have to use a large hoist which isn't the small lightweight frame type, but rather similar to a small bulky crane, to get Mum on and off the toilet (extra high chair already in place) and out of bed.

After the big weigh-in, I received a text from the hospital advising there was to be no more biscuits and chocolates, which I buy each week along with additional fruit and personal needs.

Mum claims she isn't eating dessert now (although was on the warpath when pavlova didn't make an appearance one meal time recently).

At the beginning of June, her monthly weigh-in was just under 108, so good news there however she has started to ask for biscuits again and now has decided she wants a bottle of sherry for happy hour glass.

Mum had a dietician visit her last year, however, she tells me she can eat whatever she wants, the hospital does not stop her.

I have refused to buy any more biscuits unless its a special occasion like Mothers Day and the sherry until the Doctor/hospital confirms that it is ok. Of course, their ok hasn't come through so Mum retaliates by saying she will go and get drunk on their horrible wine instead... (it's like negotiating with an under 5-year-old terrorist).

I have emailed the Senior medical officer which has been acknowledged asking for direction but she hasn't responded in full. I know they have other issues on hand than worry about this sort of carrying on, but it doesn't resolve the issue with Mum.

My family say I should buy all the chocolates, biscuits and sherry she wants and let her go to it. One of her Brothers is upset that she will do nothing to get back into some sort of shape, even if only to move on and off the toilet unassisted.

Mum is quick to email newspapers when she is one of her angry cycles and her emails do get published. I have a fear that one day she will go too far and be expelled from the private hospital where she lives.

The computer is the only form of communication she has with her family and I'm loathed to take it from her. She relies on it very much, reading overseas newspapers, links to articles my Uncles have sent her, seeing family photos roll around on screen saver etc. Once a month I have to fiddle with it to get it up and running again as she will crash or lose a programme.

I have had the mental health team visit her more than once, and her Doctor has her mental state re-assessed annually which shows further deterioration.

So that is my predicament. Do I buy the biscuits, chocolates and sherry or try to enforce a stricter reduced calorie diet even though she can eat what she likes at the hospital (I think they let her go for it in the name of less arguing and upset).

Thanks for taking the time to read... and sorry to off load.

Birthday, Easter, Christmas can be times for a box of chocolates? They don’t normally form part of adults diets do they?

Everything else say that the hospital have told you not to bring them in?

I used to work in care, and having to hoist larger patients is not easy. You try pushing someone of 108kgs around on a carpeted floor on a hoist and say it's not that heavy! If your Mum is sedentary, any extra calories go straight to fat and people put weight on very very easily when they are immobile. Every extra pound puts her at greater risk of blood clots and obesity related illness, including Diabetes. It's not "kind" to let her have something that really isn't good for her.

As for the relatives who think it is OK to laden up their elderly relatives with Sherry, you're not the ones who are left to try and manage their care. Dementia and alcohol do not mix well especially when you add in medication....... it can send people batshit for want of a better word.

If it's a good care facility, work with them and not against them.

I would say that 100kg for a six-foor tall woman is not huge!108 kg is not much over 16 stone.

She's big, but that is very much related to her height. The issue may indeed be for the hoist and their ability to generally care for someone who is heavy. But she isn't dangerously overweight.

I agree with a PP that a meeting with the dietician (with your mum present) is the best bet. That way you can come up with a plan that incorporates things she likes without gaining weight. I get that her weight is an issue for the carers, but she needs quality of life. Also, nursing staff deal with people who are that weight all the time!

Am I missing something? She's 6 foot tall and around 15 stones, yes she's heavier than she should be but she's not the world's fattest woman?
I personally would tell her that you will bring the things she asks for if she in return makes efforts to get herself to and from the toilet and starts walking around the facility at least once a day, even for five minutes.

I would really listen to: -

@PeoniesarePink
As she worked in a nursing home and knows what she is talking about.

If the user gets admitted into hospital then the home can refuse to have her back. This happened to a dementia patient at my grandmother's private home. The lady was very hard work for the staff, always shouting and being abusive. In your case I would work with the home and not against them. Save the treats for special times.

Are your mothers mobility issues a result of her dementia ? Its just that you mention that she decided she could no longer walk following a fall ? That she had had rehab and then been provided with a wheelchair . How does she feel about being hoisted ?
I presume that some sort of assessment has happened that meant that she was no longer deemed safe to transfer independently or with assistance ?
Even with significant weight loss this is unlikely to change, if you don't use it , you lose it and the older you are the quicker this occurs unfortunately.

I actually think it's rather mean to suddenly withhold all her treats at your mum's stage in life

She does get 'treats'. She says the hospital allow her to have as she wants.

What they are asking is that she isn't given a lot of additional stuff. It must have been alot because without those extras she is losing weight.

Isn’t this 17 stone? BMI of 32.2. Obese category.

Frankly, the dietitian is more than likely not to know as much as the nursing homes of how your mum reacts to food and how it affects them. And they do not have as much time to check each case in detail, I have had to query a recommendation about substituting cows milk for almond milk for a nut allergic toddler.

Go by what the nursing home suggests, it is not as if they are recommending going into fasting or removing food groups, it is just biscuits and treats that do not contribute absolutely anything to her diet apart of making it worse.

PS and there is a big difference between she can eat “everything” and “as much and as often as she wants”

Fgs the woman has dementia and is living in a private hospital. If she want's to eat a sodding biscuit and it stops a blow-up making other lives miserable, let her.

That makes you about 16 stone, I'm not sure how you're fitting size 16 clothes.

It's 15 stone 10 and I can absolutely assure you that I wear a size 16 in pretty much every shop I buy from. When I was 12 stone I wore a size 12.

I have a decent amount of muscle and carry weight well; people are generally surprised when they hear how much I weigh vs how I look.

There shouldn't be hoisting issues. I worked in home care and regularly hoisted people of 20+ stone. If the flooring and hoist are correct
Same with rolling people, I've rolled people of 25 stone to do personal care and hoists were used for everyone from 6 stone up who didn't have the mobility

While some people with dementia lose their appetites or just forget to eat - my mother was like this and lost a lot of weight within a few years - others do constantly claim to be hungry, and a marked preference for sweet things is very common, whether they're eating much or not.

Personally I'd do as a pp suggested and allow biscuits etc. in small and very controlled amounts.

There’s a very good chance I’ll get dementia and if l do, I intend to live on a diet of champagne truffles. People with dementia can often only taste sweet things, my mum would only eat sweet things at the end, despite that she weighed 5st dripping wet.

Life in a care home - no matter how expensive - must be a living hell if you have dementia. I’d give her exactly what she wants, poor woman.

Slightly different point of view.

My relative who had dementia in a care home was allowed treats there but they wouldn't allow any to be sent to her as they had strict diets for patients unless it was a special circumstance. She couldn't understand why she was allowed "disgusting muck" sweets/chocolates/wine but not allowed the decent stuff she'd always had at home and asked people to send/take her.

For her she couldn't see the difference between being allowed their "disgusting muck" and what she wanted and would get very violent about it, to the point she was being moved somewhere more secure. She died just before the move, Unknown if related to dementia at the moment, her dementia wasn't classed as severe but she wouldn't allow anyone to care for her at home but there were things she no longer could understand and after a lifetime of holding her emotions in (something she was extremely proud of doing!) part of the illness was that control being gone and the person who rarely even raised their voice would rant, rage (to the extent of bursting blood vessels) and lash out at the slightest thing.

She couldn't use a computer but would write to me and the letters were begging for "decent" food (and very hard to understand due to swearing and other issues). I did contact the home and they explained the difficulty was basically her diet at home couldn't be sustained by them (she only ever bought her food from m&s and wouldn't touch anything from anywhere else unless it was the luxury ranges) but her diet was fine and they had a strict policy about relatives bringing/sending food. They understood it was part of the illness for her but in the end they decided she needed to be moved to somewhere more secure.

Your relative may be similarly confused as to why she's allowed their "muck" but not nice treats from you.

Sorry missed the most important point of my post there!!

Jesus if I was experiencing dementia and in a care home I think worries about my weight would be the last thing I was thinking of. I'm overweight and losing weight to look after my health. But I really think with a potentially rapidly progressing degenerative illness she deserves some nice food.

Let her have her treats. I knew you'd get people moralising on here about this, but we're not talking about somebody with a potentially full life ahead of them, for whom preserving good health long-term would be a priority.

What difference will it make to her to eat some sweet stuff, if it makes her happy? It's not as though her dementia might improve, and then she might regret any long-term effects of the sweets and biscuits, is it? Her world has shrunk massively, it won't get better, and she has limited avenues for having pleasure. Don't cut her off from the food she enjoys. In terms of quality of life, this is now more important than any long-term effects of excess sugar/fat consumption years down the line.

Alsohuman, a good care home - which does not by any means necessarily mean the most expensive - can be a very good place for someone with dementia. I can't say my mother was ever really happy in hers, but then she hadn't been at all happy at home either - constantly anxious or frightened of things she couldn't even name.

In her specialist dementia care home there was always someone there to reassure her, even when she was wandering a lot at night (accepted there as normal for denentia) - night staff would chat, make her a cup of tea, etc.
And I have to say that many of the other residents - admittedly not all - always seemed perfectly contented. I am still haunted by the lady in her 80s who was often distressed because her mother wouldn't know where she was and would be worried about her, but I dare say that would have been the same wherever she was.

However another lady was invariably very happy, and told me nearly every time I went that her mum and dad and grandma and granddad were coming soon, and they were all going to the seaside together.
I wished so much that my poor mother could have been permanently back in some sunlit childhood idyll, too.

My mother’s care home was excellent, some of the other residents were awful. Satre was right when he said “Hell is other people”.

You also mentioned recent weight loss. This may not be due to the lack of treats, but more to muscle wastage due to sudden immobility. If this is the case, then there may be health implications to follow - and it is vital that your mother doesn’t gain it back in fat.