I need help implementing a weight loss program for my mom without feeling guilty about it.

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?

Would losing some weight allow your mom to live with you longer? Sounds like she is on the cusp of needing a lot of physical assistance to complete ADLs, which of course is much more difficult to provide safely to a larger person. I know I wouldn't be happy to be feeding a lot of carbs and empty calories to someone who would then be even more problematic for me to assist, lift, turn, etc.

On the other hand, as you say, food is one of her few pleasures left. And it is difficult to lose weight and perhaps maybe wouldn't really change the trajectory of your mom's life and care at this point. (For example, perhaps she will soon need to be in a facility anyway where trained staff and Hoyer lifts, etc. will be better able to take care of her than family at home.)

Difficult decisions! I think at the very least I would dump large amounts of the sweets when she is not around her hoard, leaving only token amounts left. I wouldn't feel any guilt about that.

Have you read Atul Gawande's "On Being Mortal"? Lots of material to mull over about quality of life vs. longevity.

I believe that I've read that as dementia patients progress, their taste buds become dulled to many flavors except for sweetness.

Sorry I’m of no help just hear you & understand. Mom with dementia & congestive heart failure. Her sodium & liquids are restricted & with her dementia she constantly wants something in her mouth. I’m trying only healthy snacks available at her reach but without much success. Her insistence on water, coffee, anything is a 18 hour a day record. At 90 I would seek her doctors recommendation for a specific dementia weight loss plan. Maybe a nutritionist consult for you regarding mom because she won’t retain it. I don’t know, I just understand the struggle.

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!!!

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.

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.

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.

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.

I would just simply get rid of all of the bread, pasta, cookies, sugar , etc..buy fruits, fruit spreads, apple sauce, berries, grapes, all real food, very high in fiber and very satisfying. Prunes are sweet and healthy , grapes are yummy, melon, berries, yogurt non fat with honey, figs, dates, raisins, frozfruit bars, etc etc etc.....popcorn (homemade) ,
Being obese is a nightmare for all involved and if you continue to enable her eating you are killing her by default. Sorry to be blunt but this nation is dying from being fat and guilt is not how we will heal this epidemic.
Wine has 350 per cup, and is full of sugar-it is in no way smart to drink at her stage of health.

You don't say how many pounds she should lose. If it's 10, that's not that much and I think is doable. But if it's a lot more than that, I'm not convinced it's worth it. But if you choose to do it, get a registered dietitian involved. Because your mother is sedentary, she does not need so many calories; however, she still needs nutrients.

Prunes, for example, now come individually wrapped. Perhaps you can restock the treat tins with prunes?

Also, making healthier but still satisfying substitutions such as yoghurt, which now comes in so many delicious flavors, rice pudding instead of tapioca, dark chocolate instead of milk chocolate, can help your mother lose a little weight.

I agree with you completely that her enjoyment matters and that at 90 and with dementia, life is hard enough to spend it eating rabbit food.

I did a ‘finger food’ Christmas lunch for bed and wheelchair bound rellies. Virtually everything was either rolled up and spiked with a toothpick, or presented on a mini-toast. Even the cheese was ultra-thin slices cut in 1” strips, rolled and spiked. The salad wasn’t dressed, so you could pick up bits without getting messy. A pasta shape dipped in spicy ricotta and spiked, yoghurt on a cucumber slice with cracked pepper on top. It probably all looked like junk food, even though it wasn’t (I don’t do junk food and the rellies weren’t junk addicts either). Certainly it looked like cocktail junk food, and it didn’t take much extra time to prepare – just a lot of toothpicks. Perhaps an idea? For something in the fridge?

Quality of life vs quantity. My mom is 5'2" and weighs 150 pounds and been that size for years and years. She is 89. It is doubtful I'll want her to change. Despite her insulin-dependent diabetes I keep her sugars well managed and I pretty much let her eat what she wants. but I DO keep her moving. I take her out for walks daily. If I did not let her eat small crackers, cookies and popcorn, she will put the food in her mouth and spit it out and not eat at all. In between the "junk" food, I get her to eat healthier foods so she gets plenty of protein through soy peanut butter (on crackers), and she loves beans which helps with protein and fiber. Adjustment to her insulin keeps her sugars very well managed. I give her plenty of cocoa and thick-it to help her swallow the chocolate drink mixed with soy milk which is high in protein.

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.

At what point is she in the dementia? I ask only because as she declines it will be difficult to get her to eat, or eat much. When my Husband was on Hospice one of the things they chart is weight loss. That for a while was done by me, when he was mobile I took him to the local recycle center and got him on the large scale. He could get on it with his walker and had plenty of room so I was not afraid he would fall. (I could not get him on the home scale because it was small...I tried several times) Later the CNA would measure his upper arm. This measurement would be recorded and as he lost weight the measurement went down. Later when he became immobile the Hoyer Lift had a scale on it so when we would hoist him up we could get a weight.
Weight loss is inevitable
Maybe at this point focus on good well balanced meals high in fiber and higher in protein and do not focus on weight loss.
If she has a lot of sweets "squirreled" away if you can sneak in and take some once in a while and put them someplace else so she "runs" out faster then you can dole out the treats better. Maybe one in the mid morning and one after dinner. Or if she has a problem with medication give her a treat after she takes her medications. One downside to dementia is "out of sight out of mind" but in a case like this it can be a positive, once removed from her control she may forget about them.
One thing to be cautious about is at some point with all Dementia swallowing becomes a problem and if some of her sweets contain caramel, peanuts or other nuts, nut butters or other sticky things these can be a problem they can get stuck in the back of the throat, nuts can get inhaled leading to aspiration pneumonia and other problems.

My dad, not dealing with dementia, has advancing heart failure and has been told losing weight would help with the symptoms. He will never do it. He’s definitely developed the love of sweets and snacks throughout the day. He well knows losing fifteen pounds would make a big difference in the shortness of breath and mobility issues but has no desire to change a thing. It’s another issue we’ve tried multiple tactics and lost on, plus there’s a big part of me that thinks he does have so little enjoyment left why bother him over it? Good luck on this, living together should make some changes easier to implement.
The author Nora Ephron said in one of her books that she didn’t want her last thought before she was hit by a bus to be “I should have eaten the doughnut!”

I agree with the prior posters who talked about focusing on high fiber and whole food.

Maybe think less about weight loss and deprivation - which "feels" negative - and think about increasing whole foods/fiber/fruits and veggies - this "feels" more positive.

What about smoothies? That's a great way to get in some good whole foods, and you can make them sweet with fruit. Win/win?

Check out Pinterest - there are tons of pages of smoothie recipes! But in my book, you can't go wrong with the basic banana, some sort of frozen fruit, almond milk and a dash of maple syrup (real syrup, not the Aunt Jemmima stuff). The grocery store brand of any frozen fruit is usually pretty reasonably priced, as are bananas, so this is a cost efficient method to get the good stuff in too. A 1/2 gallon of Almond milk runs about $3.

Once Mom gets used to a basic smoothie, maybe try adding some greens (spinach is good - just make sure you really blend it) and vary up the frozen fruit selection. I also like adding oatmeal to smoothies for extra fiber, but it can be a texture issue for some people, so probably don't start with that.

Other veggies that are good for a sweet tooth - try roasted sweet potatoes with a sprinkle of cinnamon and brown sugar. Or toss some baby carrots with a little olive oil and maple syrup and roast. Also good. Applesauce also resonates with the sweet tooth, but as long as you get one with no added sugar, it's a healthier choice.

Oatmeal, generally, is also a great choice for a carb lover. Add some apple sauce and spices, or a tablespoon of almond or cashew butter and a sprinkle of mini chocolate chips and it's a real treat.

Good luck - you're a really good daughter and you're doing a fantastic job!

First, it depends on her current medical condition, medication she is taking, age, weight and activity level. Considering all these factors, weight loss will be accomplish by difference between calories in and calories out. Find out how much calories she needs to loose weight, then simply adjust her current diet to match needed calories. Portion control is the key. One secret, decrease sugar intake will also greatly help. Good luck.

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.

My daddy's doctor says my daddy is overweight. Puleeze! My daddy is 6 foot 2 and 246 lbs. I get so ticked at that. My daddy barely eats as it is and I really don't care what he eats. All blood tests come back normal.
If your mother is really gaining weight and it really is bad for her then just have her eat more protein, oats, fiber and fruit.
Also, you can check the internet for suggestions regarding what your mom is craving... sometimes you get a substitute for what she wants. Like instead of ice cream have frozen yogurt. I would crave chocolate so I started eating dark chocolate... yes different taste took me a while to get use to it but its better for my and I don't eat as much.
Blessings
hgn

I always tried to keep my mom small, so I could move her around if I needed to. She was 5' 2" and weighed about 145. I gave her snacks like you would put in a kids lunch box, protein bars, bananas. She loved sugar, and if she would find a candy bowl she was all over it. Out if sight, out of mind. If she doesn't see it, she probably won't miss it.

I would suggest you focus on providing mostly healthy food choices for your mother - provide her with good stuff she likes - and not even try to "deprive" her of stuff she enjoys. My mother has a sweet tooth and certainly enjoys cakes and pies but it is easily satisfied with less intense sweets too. She loves sweet apples like gala, honey crisp or jonagold or Clementine tangerines or fresh nectarines. I keep a small fruit bowl filled with these favorites and she eats 4-6 pieces a day. I cook a pound cake every week and serve a couple of slices with either morning coffee or lunch. If I'm out of cake, poptarts are good too. Every month or so I make/bake a "splurge" cake/pie that we enjoy for a few days . Meals are well balanced and relatively low fat and carb but again not any extreme effort. My mother loves corn bread and I serve it almost every day with homemade soup or cottage cheese. Although cake and corn bread are carbs they are less glycemic than buttercream iced cake or purchased baked breads. I am fortunate my mother is not diabetic and doesn't have heart problems but we still eat a mostly diabetic compatible diet because it does run in the family. We eat low salt because I need that to help control my high blood pressure.

My advise is when caring for an elderly person is for the most part let them eat what they want unless there is an immediate negative health impact. After someone 80+ has developed a health condition, changing the diet will not change the prognosis. If my father had been willing to drink more water and eat less salt/fat before the high blood pressure and TIAs that caused his vascular dementia, his health may have taken a very different path. After the damage was done, it becomes all about getting him to drink enough water and reduce his salt and fat intake enough to control the blood pressure and avoid a major stroke or heart attack. Another example would be when my grandfather was dying of congested heart failure and some family members didn't want to follow the doctor's guidelines on salt intake since "he was dying anyway". After I pointed out to them that exceeding the salt guidelines could cause water retention bad enough to cause his legs to split open into painful running sores that may not ever heal, they had a slightly different view. It took a little more effort to cook everything he ate from scratch and source his food from fresh or frozen sources that had not already been salted, but it was worth the effort for his comfort. Controlling salt intake also meant we didn't have to limit his fluids.

Overeaters Anonymous. www.oa.org. She will meet nice people and there are also online meetings. During the day day and into the evening!

You say she doesnt have much pleasure in her life. As a person who struggles with weight, I understand. Perhaps you could find some things that give her pleasure that aren't involved with eating. As far as the sweets are concerned, I see nothing wrong with putting them away and then rationing them. On the other hand, your mom is 90. Ask the doctor to balance her enjoyment in life vs how much weight loss will help her at this point in her life.

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.

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.

I certainly would not advise taking a person with vascular dementia to an OA meeting. Those meetings are not structured for people with dementia impairment, nor it is appropriate or respectful to the people in attendance.

I attended OA for over a decade many years ago (40+ years ago). I left when I was 27 (joined at age 22). I then developed my own program - holistic weight maintenance - and led workshops and worked with individuals. I drew from many workshops and trainings I took myself for personal growth and I was on an MFCC track (psychotherapist).

Of course, it is very different working with people of sound mind who are able to make decisions that serve their best interest. And, having the desire and willingness to change / become healthier. Know that you mom cannot do that.

I sense you will have a fight on your hands (if you fall into that trap) or at the very least confrontations with your mother. You need to be prepared for her resistance and know how and what boundaries to set - for her health - and yours. The key to changing one's behavior starts with changing one's thinking. A person with dementia cannot do that; certainly not consistently. It is up to you to monitor food intake, slowly. And encourage her, offer stimuli to engage her to shift away from the food.

* You may need to start with setting boundaries with food intake (or sugar-desserts). Give her a choice of 1 xxx at lunch or a snack and 1 xxx in the evening (or) however you design the 'treats.' Cut down slowly. Don't cut out unless medical provider insists on it. Do not deprive her 'too much too fast.'
* Substitute wherever you can (apples, any natural sugars).
Do this perhaps once a day. As needed, watch portions of proteins and starches. She is eating for reasons to do OTHER THAN being hungry. She is trying to fill a void to not feel / numb out.
* Do not argue with your mother. No one wins. You will only get more frustrated yourself (and go run to the kitchen for a goodie . . . )
* Do not put her on a diet; slowly change the foods she eats.
* If need be, lock the kitchen or food cabinets. If she is allowed a 'free for all' in the kitchen (or her room, as you indicated), there is no use in you expending energy trying to support her. You need to change your thinking before you can support her. You have to come from a place of emotional strength.
I am maintaining a weight loss of 70-75 lbs for over 45 years now, without dieting. I was a size 20 in my early 20s and now in my 60s (35-60s), I am a size 10. Learning self-love and self-compassion is an ongoing process. I do not deprive myself. I had to become my own mother to heal the child within me. That is another aspect of this process.
* Your mom is likely addicted to sugar at this point. So, go very slow with limiting intake - and do replace options with apple sauce, fruit bowl, etc. Whatever you can do.
* Understand her emotional needs and offer substitutions or distractions from food / eating whenever you can: talk to her, read a book or something you've written, whatever might engage her and shift her feelings (loneliness, frustration, anger, pain, depression, sadness) from the automatic eating patterns to slowly offering other options. Do not fight with her. Agree with her by reflecting back to her how she expresses her feelings and needs.
* Do whatever movement you can with her - even if a hand massage. Give her a 'soft ball' for her to hold and move in her own hands. I would not expect too much from a woman 90 although I've had clients older who get up and walk for 5-10 minutes down the halls.
* If there is no desire or initiative from her, do not take this upon yourself to 'change her.' Do what you can (lock the cabinets / kitchen), limit sweets slowly and give them to her in regular times as a 'treat' (take that control away from her as she'll just eat until they are gone).
Hope this helps. Gena.

Since your mom

I have read all your answers and still can not find an answer to my own problem. I am 85 and live alone I have been told by all of my doctors to lose weight because I am obese. Can't argue with them I am now only 5ft. 2inches down from 5ft 6inches and weigh 214 lbs All my life until I was near 60 I never weighed more than 150 lbs and until I was 45 only weighed 123 lbs. I gained weight from stop smoking. I do not eat sweets or junk food but do eat processed food. I need to have a knee replacement and must keep my BMI under 40 or they won't operate. I live on mostly frozen meals and bread or sandwiches. My knees will not allow me to walk or even stand for very long, thats why I eat frozen meals. It hurts too much for me to stand out there and cook from scratch. So I guess I will just have to eat more salads and fresh fruit and hope for the best.

Similar issue - mom is 95, has been in MC for 2 years now. She was already a bit overweight, but gained another 20 pounds in the first year at MC!!! I had to buy new undies, pants and tops. While asking her to say whether she liked/would wear the items, her focus was on the size tag. Oh, this is large, I usually wear a medium.... ummmm, not any more mom (shrunk to about 4'10", weight at 146 recently)!!!

In our case, I cannot control her diet. The only sweets provided other than what they might have is few and far between. One thing I have seen her eat a lot of is the ice cream bars (the ones covered in chocolate!) Once in a while, ok, but after many meals, not so okay!!!

I would, if possible, find her sweets "hoard" and put it all away, doling it out infrequently (don't let her see where you get it from!) Restricting her diet is not likely to get you much weight loss if she is not getting exercise/moving more as well. That's another of mom's problem - she sits WAY too much. They try to get her to do some minimal exercise or walk, but no. Recently she developed intense pain in her legs and has been relying on their wheelchair. :-( Going to ortho Tuesday to see if anything can help (not surgery for her!)

It would be best, if possible, for your mom to eat healthy foods, raw fruits and raw/cooked veggies, more plain meats, aka not many sauces which add calories, etc. Eliminate any processed foods that you can (aka boxed items like crackers, chips, cookies, etc - anything with an extended shelf life.) Others have listed some "sweets" like fruits, applesauce with some limited spice/sugar. Maybe make some tasty sweet dips for veggies to encourage eating some raw?

Beware of any "non-fat" and "low-fat" items. The reduction of fat takes away flavor, so some kind of sugar, usually way too much, is added to restore it to a palatable product!!!! I was horrified when my kids were little to find them putting sugar into PB!!! I only get the natural stuff (tastes better too!) The sad part of this is it would be better to eat the fat, as the body has to work to process it and store it. Sugar, might as well just apply it to your butt and thighs directly!!!

READ the ingredient labels, not that foolish white calorie, etc label they had to add (although calorie and saturated fat levels should be taken into consideration - but remember, fruits and veggies don't have any such labels!!!) The first few ingredients (3-5) generally tell you all you need to know!! If it looks like a science experiment, put it back on the store shelf!!!

We certainly don't want the person(s) we care for to be miserable, but neither should they suffer other ways for not eating healthy whenever possible. When the person reaches a point where it is sweets or not eating, then it is likely too late to do anything more than give in. Better to nip this in the bud now if possible!

Why are you feeling guilty about helping her make better choices? That needs to stop. My 84 y.o. mom also has dementia. She lives with me but I have a caregiver come in 2x a week for 4 hrs to assist with getting her showered and laundry done/ bedding changed, etc. since I work outside the home 40 hrs weekly. At Christmas the c.g. gave mom a basket of different varieties of popcorn...all sweet. I blew a gasket....1) because the c.g. knows mom is borderline diabetic & 2) because mom has no self control and would eat only sweets if I allowed it. I took it away from mom and returned it to the caregiver. I thanked her of course but told her in the future to not give mom food items as a gift, in fact to refrain from giving her gifts at all. She is paid for a service and it is not appropriate. Mom was mad but oh well. I told her "Just as you used to make my decisions when I was a child about what was and was not good for me, so will I make for you NOW since you have dementia and cannot make them for yourself." As I said, she was mad as he$$ but she got over it.