Anorexia in elderly woman

[Orangesandlemons77]

DH's elderly Aunt was sectioned last week under the MH act. She's suicidal and anorexic.

She's in her 80s. Obviously family are very concerned. However it is also putting a great degree of pressure on them as she is eating with visitors but refusing without.

Would they tube feed her? It is quite far away and not getting much input from the hospital.

Just wondered if anyone has any experience of this. The anorexia is not a new thing, but has worsened recently.

I have an older person in my life with an eating disorder. Very sadly she has now also got other conditions that may well be related including serious osteoporosis and teeth problems.

I don't have much advice for you as we have reluctantly sort of accepted that when somebody has this kind of condition for many decades it's very unlikely to improve in later life.

Just offering solidarity and my sympathy.

If she’s in her 80’s could it not be that she’s nearing the end of her life and so therefore choosing not to eat or has she been anorexic for a long time?
it’s pretty normal for an elderly person to stop eating for weeks even months before they pass.

Poor old girl. It seems she’s had enough, but instead she’ll be force fed and stuck in a horrible MH ward.

How is that going to make things better for her?

Sorry you’re going through this OP.

Is she drinking ok without visitors? They could give her the build up type drinks?

She can’t be using much energy up just sitting there so she shouldn’t need many calories to keep her weight steady?

I’ve no knowledge of this sorry. Presumably staff will be working to get her on the correct meds and they may take a few weeks to build up in her system but then she could improve once she feels happier?

Tube feeding via the nose isn’t apparently too horrific as many have to have that.

I find the situation sad. I'm not close family however so aren't able to get too involved.

If she is compos mentis then they shouldn't be able to tube feed her without her permission. It's an awful procedure and if she refuses then all they can do is offer her food and try to cajole her.
Have you tried high calorie protein drinks? you could lie and say they are low calorie.
We are going to try them with my dad as he is steadily losing weight (late stage dementia), although he's not refusing to eat, he has very little appetite and has to be helped with food.

She's not near by, I expect they will try those drinks but I don't think she will take them unfortunately.

I hope they do not need to do the tube feeding, sounds really traumatic. It's strange because they are keeping her there under section but e.g. she is refusing a blood test and they are therefore not doing that at the moment.

I guess it is all about capacity and decision making.

If she’s ‘with it’ and just had enough of life then that should be her choice. I know too had elderly relatives like that. Their bodies wouldn’t do things they wanted, everything hurt or was hard to do. They just wanted to call time. I don’t blame them.

If she’s got eating disorders then that’s a different reason for her to refuse food. They will have her records and should be able to see that from them and treat accordingly.

Sorry she’s struggling.
in terms of section three - this gives them powers to treat but they will still be as least restrictive as possible and so will start with high protein drinks etc (will get advice from dietician about what) and force feeding is really really far down the line in terms of options

My Mum is in this situation- I don't think she's depressed or wants to end her life. She just won't eat & it's now a reflex to refuse food. She's always had issues around food but it's got much worse in the last few years. She has dementia as well, but even before this set in it was impossible to reason with her.

I don't think there's much help for elderly anorexics. If she were 14 she would probably be getting treatment but there's apparently nothing available for older people. Her psychiatrist treats dementia & says that eating disorders are outside his remit. The dietician simply advises on what supplements she should take and doesn't address the underlying psychological disorder.

She's in a residential home where the staff do their absolute best - they spoon fed her, distract her, encourage her. But she is becoming so weak she can barely walk.

I don't think there is anything I can do.

Depends entirely on her capacity.

Depends on her capacity. You can have capacity and make an unwise choice (not eating) if you understand the risks and weigh them up.

Tube feeding is not horrific though. Its uncomfortable at times to place but not traumatic and horrific. Generally it is traumatic when someone has one but doesn't understand why so tries to pull it out etc

Is she using food as a control over her life? Has she given up? Is she lonely and therefore eating with visitors so they will keep visiting?

I know it's difficult if there are mental health issues involved, but my experience of elderly relatives is that they stop wanting to eat as they are coming to the end of their life. We have a strong urge to nurture them and get food down them, but actually, the correct thing to do may well be to trust their instincts and let them not eat. Our health system is marvellous, but it is designed to keep us alive at all costs, and actually, there comes a point where people are physically and mentally ready to go. Especially with dementia, we have to be realistic about what the quality of life will be if we do manage to extend life. It's so hard though.

This with bells on. 👏

Their bodies start to shut down & not wanting to eat is part of that.

Keeping people going when they aren't going to get better is inhuman imo.

I completely agree that it's not right to insist on extending life at all costs.
But we wouldn't say that for a teenage sufferer would we?

My Mum is elderly & has memory issues but I honestly don't think she wants to die. She has been severely depressed in the past but is now much better & could have a decent quality of life if it were not for this awful illness.

The fact she has been sectioned shows she is unable to make decisions about being able to feed herself. They can restrain and tube feed should they deem it necessary, however given her age, they may choose to palliate instead. Anorexia is a horrendous illness, it makes me sad people are suffering for their entire lives.

I had anorexia for 20 years, sectioned and tube fed against my will. But I was younger. I was in hospital with women in their 60s and 70s being tube fed but never 80. It's a horrible position for her to be in.