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My mom is 90 years old and lives with me. She is barely mobile due to a bad knee and she also has vascular dementia. She has gained a good deal of weight over the past several years. Her doctor has told me that she would benefit from losing weight but he hasn't told her that. She eats more sweets and carbs than ever before. I feel as though her dementia impacts her ability to monitor her intake. I prepare all of her meals and feel guilty when I limit her choices. Over the holidays she received gifts of sweets which she hoards and I feel as though I can't take them away from her. She doesn't have that much pleasure in her life and so I am conflicted about depriving her of the foods that she likes while then feeling guilty that I am contributing to her bad habits. Ugh. I could use some help. Any thoughts?

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I have the same issue with my mom, and someone made a suggestion to me that may be helpful to you.

My mom has Alzheimer's/ Dementia and is diabetic. She has gained nearly 30 lbs and her sugar level has elevated to the 300 mark. She likes crackers, bread, peanut butter, wine, and peanut M&Ms.

At first, I didn't want to limit her pleasure, but doing nothing wasn't helping either. So I did something extreme - but it worked- you can't eat what you can't find.

I utilized a food cooler we used for picnics, found space in my closet, and dumped every possible starchy product and sweets she loved into it. I cleaned out the fridge of those items - so when she went into cabinets and the fridge, it wasn't there.

I then put out smaller "sweets" she could eat daily- a bagel in the fridge in a sandwich bag, cheese snacks, a package of cheese crackers. Then I added healthier snacks - chunky apple sauce, yogurt for digestion.

I feel your pain; but think of limiting access to food in the house as an act of helping her eat in moderation and not limiting her pleasure. You're not taking food "away" - you're limiting her ability to eat it all in one stroke.

When we first started this approach in the house, she wasn't happy and ransacked the house for what she "wanted" to eat - and I assume she is going to do the same thing- you're taking away her sweets - but eventually, she settled into the routine we put into motion - because she didn't know where all the food was - and she wasn't starving.

If you do this approach; hold your ground- just like as kids we wanted sweets 24/7, our parents didn't give in to every desire we had; especially when we threw a tantrum. This is what's happening in reverse - minus the temper tantrum. When my mom demanded where her "stuff" was, I simply stated, "You ate it, right?" In most cases of diabetics that can't control their sugar, she ate it the minute you set it on the table (like my Mom did at first.)

The second thing I noticed is that she is not just eating out of boredom, she was eating because the starch she was eating was satisfying in the mouth (a "mouth feel)." She wasn't gaining any pleasure in eating it - so she ate more. So when I set out chunky apple sauce (in my case, homemade so I wasn't adding sugar to her diet), her cravings started to change.

You can start portioning it out her sweets in smaller amounts - and if it's gone and she wants more, tell her "i'll see if I can get more tomorrow" and put some out the following day is an approach I did with my Mom.

The end result is that I had to get past my guilt factor and not play a part in compromising her health. I didn't want to hurt her choices. I suggest you limit - not eliminate, and in my mother's case- her sugar level went from 330 to 150. That's the direct result from hiding her go-to starchy snacks and doling out smaller portions of sweets.
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Rosiesmom Dec 2018
Thanks for taking the time to tell me your story. It is helpful.
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Personally, at 90 years old, I don't see the point in restricting your mom's carb intake. There is so little left for them at this age, why take away even MORE of their limited joy? Yes, I know it's not what the doctor recommends, but hell, HE doesn't have to LIVE with her!!! Besides, what will a diet do........extend her life by a year? Quality of life is more important than quantity of life at these advanced ages, in my humble opinion. My own mother *92 years old* has gained about 50 lbs living in an ALF for the past 4+ years. She never allowed herself to eat sweets and was constantly dieting and weight obsessed for 80 years. Nowadays, she just eats whatever she wants and calls herself a 'fat horse'. It's a no-win situation, really, isn't it?

Best of luck!!!
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Rosiesmom Dec 2018
Thanks for taking the time to respond. It helps to know that others understand.
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Rosie; Most of us would benefit from losing some weight, I'll bet!

What did the doctor say would be the beneficial impact of weight loss for mom? Better mobility? Is she diabetic? Better heart/lung function?

I would weigh your mom's quality of life carefully against generic weight loss. As you say, she has few pleasures left in life.

Is she seeing a geriatrics doctor?
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Rosiesmom Dec 2018
Thank you for your quick response. I guess I am trying to weigh quality of life with weigh loss. The primary detriment to her weight gain is that it places more weight on her very bad knee. She can hardly walk now, has become mostly sedentary, struggles with most ADL's and is becoming incontinent. She does see a geriatrician who comes to the house and he doesn't push her at all but will suggest things to me. I guess it is the enormity of feeling so responsible for her that has me in a quandary. My dad died this past May and also lived with me. He also had vascular dementia and also began eating a lot of sweets but he didn't have the weight or knee issue so I wasn't as concerned.
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Since she lives with you and you have control of her diet you should be able to tweak things without having to deprive her of the foods and treats she enjoys, I'm a firm believer that there are no bad foods as long as they are enjoyed in moderation. So for example, dole out those christmas treats as dessert with her meals, or if she's rather snack then give her the choice - mom, do you want that (yummy treat) now or shall we save it for our afternoon coffee break? And balance the calories in the extra sweets by reducing portions and high carb foods at meals.

A little more activity could help her mobility - has she been offered PT? There are some good chair exercises for seniors videos available online.
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Rosiesmom Dec 2018
Thanks for the ideas.
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Stacey mentioned Bagels. I ate one almost everyday. Last Dr. visit showed my Triglycerides were high. She told me that a bagel has 150 carbs in it. A normal person should only have 200 a day. So the bagel was almost a days requirement. I cut the bagels out and lost 3 or 4 lbs. 150 carbs equal a half a loaf of bread.
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Rosiesmom Dec 2018
Yes you are right I just cut out my own Bagels!
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She has Dementia so making her understand she can't eat certain things will go thru one ear and out the other. These people who gave her sweets...do they not know she is a diabetic!

I noticed years ago that those with some type a mental challenges, Dementia, and ALZ tend to love the sweets. I was talking about this while eating out. The woman next to my table said "Its instant gradification". The elderly tend to lose the ability to taste. Sweets they can taste.

I see no problem in a treat . Mom did this with my Dad. She allowed him a serving of MM peanuts every night. They never raised his sugar levels.

In moderation. At 90 I wouldn't put her on a strict diet. Just cut back. Like said, she should be allowed something she loves.

Just a heads up if you don't know already. Sugar free candies have a sweetner in them that can cause diarrhea. Happened with my Dad.
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Rosiesmom Dec 2018
Thanks for the tips.
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The doctor HAS to tell you that.

At 90? Let your mother eat what she wants. I was most fortunate that DH's doctors all said to let him have whatever he wanted when he hit 90.
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We all have hormones that are released to tell us we are done eating. They are called satiety hormones. When you eat processed foods (foods that quickly turn into sugar- pasta, bread, sweets) you do not produce satiety hormones. This helps to explain why you might have trouble finishing off a third pork chop but not a third piece of pie.

Processed foods and sweets also trigger the reward systems in the brain. That's why we call them "comfort foods".

I don't know if you bake, but if you do, you can add fat, protein and fiber to baked goods. These foods will help to trigger satiety hormones and your mom might eat less of them. There are really good recipe for brownies made with black beans and chocolate muffins made with yams and eggs. You can't eat more than two. You just can't. They don't sound terribly appealing, but really, all you taste is chocolate.

I agree with the advice not to put a 90 year old on a very restrictive diet. But if you can tweak what she's eating and include more fat, protein and fiber, you might find she is gorging less on the sweets. It's worth a try, anyway.
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At 90 years old the idea of a weight loss program seems ridiculous to me. Which is possibly why the doctor didn't mention it to her? Although, from a medical perspective, he agrees losing weight would be good for her. He, likely, expected her to be unable to comprehend it and unwilling to comply. Add to that the dementia which means she may eat and then forget that she has eaten and it's a battle probably not worth the fight. As others have said, you can substitute some healthier options for meals you prepare. As to the stash of Christmas candy you can slowly remove a piece here and there when she's not looking and throw it away. Tell the people buying her gifts that they are not allowed to give her candy, cookies etc. Be kind, but firm. Tell them some other options they can purchase if they want to bring food. Things like cheese trays, fruit baskets, popcorn, variety flavored oats, mixed nuts, even flavored nuts or whatever she likes that is a better option than candy. We let pops eat whatever he wants but his options, of course, are limited to what I allow in the house. If he is going to be home all day with little to do but eat, I don't clear his area immediately after he eats, which helps him remember that he has already eaten. I generally wait to remove empty plates etc till about an hour before his next meal or snack. Good luck and don't do the guilt. She's old and happy with her life, you are giving her a good life by your loving care, even if you never restrict what she eats.
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Dad's doctor didn't care about his DM and what he ate. His attitude was, he's old so let him enjoy. The result was a stroke that stopped him from driving, reading, clear speech and general participation in life. His last years were a big drop down in the quality of my parent's lives. If your Mom is in generally good health, get the weight off and get her moving. It is the only thing you can do to try to slow her dementia. You have lots of great advice that will help. If she hasn't got much life expectancy then do what is easiest for you and kindest to Mom.
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