to think my elderly dad needs to eat less?

[LouuLou]

I know this sounds harsh. 72 year old DF has already had a heart bypass and is now very immobile. He’s steadily getting bigger and bigger, and it’s reached the point where it’s affecting his care.

We can’t even weigh him anymore because we can’t get him onto scales. The carers are struggling to move him, bathe him and change him. When he fell recently, even two paramedics had difficulty getting him up and into a w
wheelchair.

I do understand that food is one of the few comforts he has left. I’m not blind to that, and I’m not trying to take away the only thing he enjoys. But at the same time, this is starting to feel unsafe and unsustainable for everyone involved, including him.

My brother does the online food shop and just buys whatever DF asks for, including things like fried chicken. I’ve tried to say maybe we should rein that in a bit, but he thinks DF should just have what he wants. The carers also tend to give him whatever he asks for.

So I feel like I’m the only one thinking long-term about his health and practical care and I end up sounding like the bad one.

AIBU to think we need to put some limits in place, even if he won’t like it?

Would he consider WLI? It seems like the only reason for his mobility issues is his size which means it's really in his interests to try and reduce his weight. Wouldn't he like to be able to go out and do nice things?

He would probably qualify for NHS WLI.

Literally the second sentence of the OP

Not if he is relying on others to manually move him. The carers are within their workplace rights to insist on a hoist.

You can think it. You can’t impose it, as others have said.

You say you’ve spoken to him about it, and he insists he doesn’t eat much. That may be the truth, an outright lie, or self-deception on his part. Do you think he might be open to an approach along the lines of, “Dad, if you’re not eating much, then something else must be going on to result in you getting bigger. How about asking the GP to come and review things, and maybe refer you to a dietician?”

You may get nowhere, of course. He might be unwilling to go down that road, or there may be no dietetics service which would come and see him. But if he IS willing, and he was assessed, then that would reveal whether it was self-deception (he’s eating more than he realises, or doesn’t realise how little he needs), the truth (there is a medical reason why he’s gaining weight), or a lie. In the first two cases, the right advice could help him.

If it’s a lie and he’s hiding how much he’s eating, then he is probably in the grip of food addiction . That is also amenable to treatment, but only if he is willing to engage. If he’s not, there is nothing you can do, sadly.

In any event, there should be a reassessment of his care needs, for the sake of the carers as well as his own safety.

Sure but if he has capacity and he is making those decisions, OP can’t interfere.

Hoists will have a weight limit, I think.

At some point the care agency will be saying they can't manage him.

I would talk to the care agency and find out what the worst case scenario is and then discuss with the family how to avoid it.

I think the post may have been edited after I asked the question. And even so, how is this helpful? I tried to engage in a constructive manner. You could try to do the same.

No it doesn't. They took the vein from his leg for the bypass and it made his leg very weak. Over time, he has become immobile. It didn't help that he didn't do any exercise.

GP are aware. Th operation was may years ago so he is no longer under th cardiology team.

GP does regular visits and has no concerns.

The carers are changing all the time and a lot of them can't read or write. I discovered this when I left signs about recycling and other notes.

The GP does home visits regularly and has no concerns.

I have tried ordering good quality ready meals with vegetables. He would rather have biscuits, cake, friend food, chips, burgers etc.

It depends what sort of "overweight" you are talking about. 15 stone or 30 stone? I know you said he can’t be weighed but you must have some idea.

Your are not being unreasonable to think this. But you are being unreasonable to think you can change it.

He is immobile so he burns few calories and would find it difficult to lose weight unless he radically restricts his eating. And restricting his eating will again be difficult because he has little else to occupy himself with. So it is very unlikely he's going to do it.

And you can't stop him ordering food and eating it, so he's likely to keep gaining, or at least not lose anything. I know it's affecting other people, but there is little you can do about it.

How does he move around at the moment? Is he hoisted?

He only goes out for hospital appointments. It has been this way for years. He is happy in front of the TV for 12+ hours a day.

He doesn't see a problem with his weight so I don't think he would consider WLIs but I can suggest it.

He is hoisted out of bed, put in a wheelchair and moved to the sitting room. The carers give him a bed bath.

I can see where you’re coming from but it’s his choice and his life. Think you are right to tell him of your concerns but beyond that you shouldn’t really be stopping him. It’s not your responsibility.

He just saw the bypass as solving a problem which it did.

He has major sarcopenia as he has been in bed or in a chair for years.

If he has capacity he has the right to make an unwise decision even if we disagree. You can’t make him eat less or put restrictions on him as in the eyes of the law you are depriving him of his liberty.
Perhaps consider referral for a capacity assessment and go from there?

He has had a capacity assessment and he is fine. It is hard to see the paramedics and carers struggling to move him. Ok he can make whatever decisions he wants, but is it ok to make the life of others difficult?

The first line states he is 72, yet right away’how old is he’ does anyone even read the OP??

I edited the post to add his age after the first few posts.

sometimes the thought of being hoisted is enough to motivate some people to change lifestyles but if he’s accepting that then there’s not much else you can do op if he has capacity. Sounds like it might be worth seeking out an assessment by a physio and an OT to see what support could be given with his mobility, if he’d accept it.

It’s not ok, but there’s no law to stop people being difficult and selfish. You can’t reasonably use his disability against him by refusing to let him eat what he would buy for himself if he was mobile.

I'm still interested to know your estimate of his weight (and height). If he’s 15 stone YABU. If he’s 30 stone or even 20 stone surely the GP would be concerned.

His body might not get worn out (joints ) but his immobility and weight will be putting extreme stress on his pressure areas - heels , buttocks , elbows , shoulders . Even with pressure mattress
His skin will be hard to clean in the folds leading to maceration and risk of fungal or candida infection , even tearing .
The effects on his circulation.
Muscle tone
Oedema in his lowers limbs especially if he sits .

It is frustrating and heartbreaking to see him deteriorate in this way , but it doesn't sound like he'll listen to you . He'll switch off and food is his comfort .

I'd try and pursue Weight Loss Injections with him, they switch off the food noise .
Does he have Diabetes or been tested . He's at risk of developing Diabetes .

He’s an adult - so he gets to decide what he wants to eat even if it’s bad for him.

You don’t get to to make these choices.