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?
BTW if I make it until 90, I'm eating what I want and when I want. If it shortens my life at that point...I don't care.
I think that diet things is just one more thing to focus on and frankly I am feeling exhausted so I am encouraged that you are all walking a similar path.
Thanks again.
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!
My advice would be to drastically reduce the carbs, read labels for healthier frozen meals (for example most hungry man dinners contain well over half of the RDA of fat, sodium and calories), and watch portion sizes. Ask your doctors to refer you to a dietitian, they should be able to help you with an individual plan tailored to your needs.
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
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.
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
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.
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!
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!”
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.
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.
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.
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.
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.
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 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.
Best of luck!!!