Mother no appetite, why?

[AInightingale]

I have posted about this before, but my 90yo mother in a care home who had a bug a few weeks ago has experienced sporadic nausea and lack of desire to eat since. Tbh I think it may have predated the bug - she didn't touch any sweets or biscuits for weeks, highly unusual for her, and seemed very take it or leave it about food. Has also had some brief episodes of right- hand sided chest pain accompanied by severe pain swallowing. She has lost a lot of weight and they now want to give her liquid protein drinks. She has dementia but is still (fairly) lucid, still converses etc, so it's hardly end-stage stuff. We will ask for bloods and a health check by the home's GP obviously but any ideas what might be causing this? She is on calcium as she has had many fractures so I was wondering if that can affect the gallbladder at all.

For many people it’s an indication that they will die within the next year. It’s a normal
part of the start of the end of life process. It doesn’t mean death is coming in the next few months or weeks.

Obviously for your Mum there could be another reason.

💐

It is natural progression of the dementia and with age as well. The pain could be swallowing difficulties or reflux. I would consider how much medical intervention is actually in Mums best interests at this point and look at symptom control vs invasive investigations.

My Mums appetite diminished in her last year. Now I'm pretty much the same age, my appetite is small, to.say the least. At the moment I eat one meal a day. And I'm full. Really, I've had enough food, any more would just make me uncomfortable.

Just let your Mum do what she needs to do, or not need to do.

We will ask for bloods and a health check by the home's GP obviously but any ideas what might be causing this?

It's very, very normal in people with dementia. I would consider whether invasive tests and the resulting conclusion would be in her best interests, sorry OP

Thanks for replies. Tbh I would prefer that they don't intervene too much, when it's just to prolong what will inevitably be just a cruel slide into severe dementia, I do not want that for my mother, neither would she. It's just worrying when you read some of the other threads on here and how caregivers relentlessly cram antibiotics and spoonfeeds and even feeding tubes into very old, frail people. I am very much of the opinion that the person's body knows best, ninety is very old and unless you are very lucky, either the body or the brain is seriously under strain by that stage.

I am very focused on not overtreating or overfeeding people who are reaching the end of their lives or putting anyone through pointless investigations or hospital visits - but she shouldn't be in pain when she's swallowing. Has her GP suggested trying anything - checking for oral thrush, anti reflux meds, making sure she has pain relief before trying to eat anything? If swallowing tablets is difficult, then maybe to try liquid meds? Those would seem worth trying. I wouldn't do more than that.

It's just a sporadic thing but alarming when it happens. I witnessed her cry out in pain as she tried to drink water. Is that reflux? An hour later she was fine!

Is she always in pain when swallowing liquids, or only sometimes? What about food?

Does she take alendronic acid weekly? It's something they prescribe to help with the bones. A side effect with alendronic acid can be pain when swallowing, if she is taking this she should have an urgent review as the medication may need to be stopped.

I have seen her list of prescriptions and pretty sure it's just calcium along with other drugs she has been on for years. now you come to mention it @Mads123 the alendronic acid (I think) was mentioned by the GP as a possible treatment but then she decided against it as it's not great for people with dementia, isn't it the stuff you need to stay upright after taking? My mother would never remember to do that.

Yes that's the one, you have to stay standing or sitting for 30 mins as it can cause oesophagus ulcers.

If she's not on that then it could be acid reflux maybe, that may explain the loss of appetite aswell.

I hope the Dr is able to see her, and make her more comfortable.