How to get post-op mum to eat?

[MumWillNotEat]

My mum (80) had a hip replacement three weeks ago, following a fracture. She was in hospital for a week afterwards and lost weight during that time because of a mixture of not liking the food or not being interested in eating.

Since she came home we’ve been trying to get her to eat little and often, and to drink water, tea, juice, Complan … she never finishes anything. Food or drink. No matter how small the portion.

She has no appetite and forgets to eat unless we remind her. She complains her bowels are not right (constipation despite taking laxatives for a week); she has no energy (not heatwave temperatures here!); her stomach feels “off”.

I’m going to get her to phone her GP. Any other suggestions?

There is a psychological aspect to this: she views being fat as the worst thing for your health. She’s a tiny little woman. Hasn’t been remotely overweight her whole life. But she has never seemed able to admit to enjoying food - it’s like it’s greedy to enjoy food.

Help!

I had the same with my mum and what we did is we served her smaller amounts of a wider variety of food using her own good crockery and we bulked up with protein powder. It was a constant fight that lasted weeks, though. Sending good wishes 💐

Tiny portions of nicely prepared food. So half a pork pie, cut in half, halved cherry tomatoes, sticks of cucumber, olives crackers with butter, egg mayonnaise sandwiches with crusts off. Small glass of Guinness and top it up. Her favourite food- marzipan, chocolate?
Can you appeal to her vanity and tell her she’s becoming scrawny? And emphasise the danger of becoming dehydrated in this weather.
Is going to the loo uncomfortable? She might be avoiding food and drink for that reason.

And thinking about high calorie dense but palatable foods an 80 year old might like:
pâté, eggs- scrambled with butter, ‘cream of’ soups, really thin toast with butter, cream cheese, grilled cheese. Mashed potato with butter and cheese stirred through.
But you’re right, it’s psychological so you need to work with her head as much as her appetite.

What about the drinks like ensure? Dm will drink some flavours.

are you into syringe territory? Complan in a syringe? Elderflower water is very refreshing.

Thanks - some good ideas here.

@Veetavix Tell me more about syringes … 🤔

Well, it sounds like she can feed herself, so might not take kindly to you syringing Complan into her mouth!, however, it’s a tool for getting something in and knowing how much they have had.

If you are worried about dehydration, then syringing something like elderflower water might freshen her mouth up a bit.

i hope the GP solves the constipation. That will affect her appetite.

For the psychological aspect:

Finger food
High calorie and tempting food (a little bit of what she fancies)
Serve on a blue plate

The blue plate isn't as widely know as it ought to be, but its a brilliant trick. Food appears more appealing on blue because of the greater colour contrast, so its ideal for use with feeding the elderly who have low appetites or any condition like dementia.

I was trying to encourage my 93 yo dm to eat post op ( she has always watched her weight “I’ve never been above 7 stone in my life” “I don’t want to be greedy” etc ) and I realised that the language I was using “mum, you’ve got to eat to be big and strong” might have been feeding in to this. I changed to “this will help you get your strength back”
Also is she getting any exercise or fresh air which might give her an appetite ?
Good luck

Tiny portions. Less off putting.

Put 'Food First Approach' into Google - this is what you would get as a first try from a dietitian, the approach being to encourage normal food first rather than supplements.

It will bring up a lot of helpful leaflets with ideas for high calorie snacks, how to fortify the small amount she is eating (this quite often is 'add butter to it') and you should get some ideas that go with the sort of thing she does eat. For example making sure it's full fat milk and fortifying it with milk powder.

She may well need to continue the laxatives - if she isn't moving, she will be more constipated. Plus it will make her less hungry.

Is she actually, already underweight, or just short? Post hip replacement, my mum had no appetite either. She is a size 16, but a combination of pain, lack of movement and possibly coming off HRT made her have no appetite at all. Her appetite returned though once she was more mobile.

Lack of fluid and movement will be contributing to your mums constipation, and also codeine/tramadol based opioids if she is still taking them? Where she can, she needs to move more, increase fluids and fibre. Apples and pears can help. If she wont drink water, then water rich food like melons, cucumbers, celery etc might help.

Is she taking codeine or morphine as both can kill your appetite? She's likely to be constipated because there's nothing to come through if she's not been eating.

My Nan almost became anorexic in her last few years and went from a size 18 to a size 6. She tried to insist that she'd never been big and we were all fools the best trick we found was getting her full fat yogurts and decanting them into a diet yogurt pot. Or any dessert type pots like trifles. Cucumber sandwiches plastered in salt was another favourite - she'd eat one tiny corner and declare herself "stuffed to the brim". At that age, it's likely that her taste buds aren't working well so things need to be quite salty or quite sweet..........

Love the idea for decanting diet yoghurt!

I see a lot of people who are losing weight through illness and one of the first things is to point out they are usually still having skimmed milk, low fat spreads, diet yoghurt - because that is their lifelong shopping habit and they haven't thought to change it.

Look at Macmiillan website which has advice re increasing calorific value of foods.
Things she likes
Fry rather than grill
Pudding
Cream
Butter
Add skimmed milk powder to milk.