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My 91 year old mother has basically stopped eating. She has had some upper digestive issues for the past several weeks - constipation, vomiting, burping up food. She had a stroke 3 years ago. She probably has mild dementia. She and my dad live alone and WILL not listen to a single thing my sisters and I say or suggest. In the past she has cried wolf so much we vacillate between there being something wrong and all the symptoms made up. Her mobility has declined a great deal in the last month and she’s slurring her words. She is sleeping a lot. We have no idea what meds she takes because she won’t tell us and hides them. She has a doctors appointment tomorrow with the gastroenterologist - hopefully we will get some answers. But the bottom line she eats maybe a 1/2 piece of toast or one scrambled egg for breakfast and that’s it for the day. She drinks 1/2 cup coffee and maybe a few sips of water during the day.

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She may be having an issue with swallowing. That caused my mom to eat less. That can certainly be related to dementia that is progressed. It is worth asking the doctor.
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Yes, hopefully you will "get some answers" but the more likely outcome is that you will not. In the latter stages of dementia it is common for elders to take in little to nothing in food. Do know that they can often live months, even years on little to nothing. This is a 91 year old person. Now is the time for the family to decide whether or not heroic measures are called for in order to do tube feedings. As an RN I hope you do not decide to do so, and given what I have seen in terms of NG and PEG feedings I have written it DIRECTLY into my advance directive that I will accept no forced feedings either by hand or tube,
We all die. Not wishing to eat, a wasting away is rather a merciful death over all. Consider now if it is time for palliative care and/or hospice care, end of life care.
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Sharon44 Dec 3, 2023
You are so right. I, too, hope to be allowed to go when it is my time.
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Good she's seeing the dr soon.

But don't expect any miracles.

My MIL has lived on less than 400 calories for almost a year. She eats a hard boiled egg for breakfast and possibly on small piece of cheese. She drinks coffee with 3 T of Boost in it. That's it.

Incredible to me she's still standing. She has not lost a lot of weight, and she is considered to be 'doing great' in Hospice. IDK what that means, and nobody tells me.

She doesn't have issues with swallowing, she just doesn't want to eat. That's what put her in Hospice to start with. We were told 2-3 weeks at that level of malnutrition and we're moving into month 10 or 11 with this level of caloric intake.

MIL also sleeps about 18 hrs per day. She doesn't take any meds except for benzos to keep her from 'raging'.

It's fully expected she will live another 6 months to year.
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She may have had another stroke if she's slurring her words, which is what happened to my mother during the last year or so of her life. She was having TIAs and began slurring her words and leaning heavily to the right side in her wheelchair. Nodding off to sleep A LOT too, which was out of character for her. She also cut down her normally large daily food take dramatically. I got her a hospice evaluation and she was accepted in December of 22 and passed in late Feb of 22. She'd also suffered a lot with GERD and other stomach issues over the years. Prilosec did help her.

You really can't do anything to make an elder with a GI issue eat more or, God forbid, drink water 🙄. See what the doc says and go from there I guess.

Best of luck to you
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My mom lost her appetite in her later years. She claimed that she wasn’t hungry.

My friend who cared for her younger sister with Downs Syndrome and dementia was upset when her sister stopped eating.

At one point in time a feeding tube was discussed. My friend opted not to go that route. Later on when she went on hospice, the hospice nurse told my friend not to force her sister to eat.
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waytomisery Nov 27, 2023
Agree , Very common to lose appetite when elderly for multiple reasons .
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I agree with others that Mom may have had another stroke . Dementia could also be further along than you think . She may have a partial bowel obstruction too . Is she having swallowing problems ?
Will Mom drink boost ?

Let us know what doc says .
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Does your mom have a living will? Does she want her life extended in every way possible or more comfortable with letting nature take it's course? If she hasn't already documented these things and is still competent to do so, maybe it can be talked about with the doc tomorrow.

If this were my mom, I would ask about a hospice evaluation. A lot of people basically stop eating when they are nearing the end. I'm not saying that is definitely what is happening but is a possibility.

Best of luck.
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drat55 Dec 11, 2023
That's the first thing I thought of - it could be her body shutting down to some extent, because she's getting close to death.

I'm sorry for your pain.
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I’ve experienced the ‘hunger strike’ behavior in two ways that ultimately had little to do with food. It was all about keeping control.

My grandma-in-law would do the “I’m not hungry!” thing often. She had dementia and macular degeneration. Her bad eyesight was the initial cause of refusing food. She couldn’t make out what was in front of her and she’d smile, wave at the plate and say “Oh, take it away!”. She was trying to mask how bad her vision had become, or that her mind no longer recognized certain foods. Eventually the NH had to rely on Ensure to keep her going. 

My own grandma didn’t have dementia but was so stubborn and angry that she’d use not eating as a means of control and expressing anger. If we put a plate of food in front of her, she’d turn her head and make a scowly face like a 3-year-old. You’d have thought we’d put bugs on her plate, she looked so repulsed!

She broke her hip and was in a very nice rehab (even she agreed it was nice) place for a few months. She lost about 25 pounds quickly and insisted that “it’s just fluid”. Refused Ensure and appetite meds didn’t help. She’d eat a piece of lettuce and would just do the tiniest nibbles like a squirrel, then insist she’d eaten. It was so aggravating. Finally her doctor sat next to her and asked if she would prefer a feeding tube. Of course she got mad and said “NO!”. He said he could not force her to get a tube, but he flat out told her that if she continued this hunger strike game, that she was going to die very soon. That scared her. Guess who ate over half her dinner that night?
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AlvaDeer Dec 3, 2023
I know that you know, Loopy, that it isn't a "hunger strike" and it isn't "a game" in most instances.
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Sounds like Gastroparesis, which is something I developed after getting very mild Covid. It is one of the common issues some people have after Covid. I also lost my sense of taste and smell, which is often connected to Gastroparesis and or Covid. I was 158 lbs, in March this year and in two months lost 30 lbs. I'm stable at the 128 lbs now, my weight doesn't climb or drop, I'm just not hungry. My discomfort is in the high area of my stomach, you feel so full after eating the smallest thing, which is what Gastroparesis does. I could go days without eating or drinking, just didn't feel hungry. Doc told me to try and drink two Boosts a day it's best chilled in the fridge. I began to eat bits of this and that throughout the day, it still may not seem like enough, but it does work for me at 70, and it should work for her at her age. Don't try and get her back to her orginal weight, just make sure she eats what she can. PS: my doctor told me to eat the things I really like (junk food). She was quite serious about that. Then you gradually add healthier food to the lot. Be sure you keep her on a Boost, or something similar. We get mine in bulk on Amazon and you have to keep check for great deals, as they jock the prices around daily. You may want to evaluate if she needs a stool softener. I've never ever needed one until I developed this condition, due to eating less and bowels holding contents longer. She may not need it if she drinks a lot of liquids.
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AlvaDeer Dec 3, 2023
Such an excellent description you gave.
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New stroke or not, maybe her body is really just "winding down."
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KaciNC Feb 2, 2024
I agree, it is a sign of winding down. Sure hope that is what is going on for me. Doubtful, for I feel so good and strong. Have gained four lbs. since I last wrote.
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Contact your mother's PCP; share your observations; ask for a referral to hospice care, if she will not go to the PCP. Or, you can contact a hospice of your choice, talk with the clinical supervisor, share your mother's current situation and, have hospice come out to home and assess her for appropriateness for admit to hospice care. This will provide in home needed support with your mother and support for the family. She may have other conditions that her PCP can diagnosis and treat; if she wants. If she chooses to no longer seek intervention for treatment, hospice is the choice to provide support, honor her wishes .
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Short of an IV no
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In my experience, people who stop eating are done with living. She is 91, take yourself out of the picture and make sure she is safe and comfortable. Extensive treatments are often unwanted. Tell her you love her and stop the psychological judgements. She has had strokes and her brain is no longer up to speed for all that stuff. I was an RN and Anesthesia Practitioner for 38 years. My parents stopped eating too. Hospice is an option if she agrees or is capable of making that decision
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AlvaDeer Dec 3, 2023
Hope you will stick around! Your experience would be invaluable here.
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Unless she's confirmed to have lost cognitive abilities and declared incompetent by 2 Dr's there's little you can do so long as she's considered to be in control, you have no control. sorry, I've been there, and done that. Getting the LO to Dr, can be difficult to get an assessment if the LO isn't willing to see a Dr.
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My mom does this every few weeks and of course doctors say just get a PEG. She can swallow just fine but just had no appetite. We tried every OTC laxative known but nothing worked. Will that’s because she’s dehydrated. A small cup of coffee, and two small cups of tea aren’t nearly enough. We gave her 1000ml of IV fluids with Linzess which gave her a bowl movement in12 hours. After that she ate literally everything in front of her.

When people lose mobility and ombine it with low fluid intake the digestive system can be bit backed up. Plenty of fluids and Linzess as needed as made a world of difference.
A PEG would have put my mom in a really bad place mentally so I’m waiting until it’s an absolute necessity.
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lealonnie1 Dec 3, 2023
Your mother has vascular dementia and you'd choose to EXTEND HER LIFE with a feeding tube? Why? I prayed daily for God to take my mother with dementia and end her life which was riddled with misery. Dementia is THE cruelest disease I've ever had the misfortune to witness.
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When the aide for my DH aunt with dementia told me aunts breath smelled like poop, I took her to the ER where she was X-rayed. She was full of poop. She had nausea, wanted to stay in bed and her BP was elevated. Wouldn’t eat but had not lost weight. She was still going to the bathroom by herself at that time and when asked would say she had pooped.
They told me she had too much thyroid in her system. To see her primary.
They suggested a fleet enema which the home health did the next morning. Later that day she started back with the same symptoms and I took her to a diff hospital. They repeated the X-ray, told me the same as the first place and said it would take awhile to clear. Also gave me a referral to a gastro. When aunt saw the gastro, he said she had too much thyroid onboard, recommended a geriatric primary. Told me to give her Polyethylene glycol 3350 daily and no stool softener.
I got the thyroid med reduced, put her on the glycol as instructed and she was fine for years. I know some on the forum don’t recommend this which is basically the same as miralax. It was exactly what aunt needed.
Hopefully the gastro will do blood work or you can get a copy of recent blood work from her primary faxed to the gastro. It might give you a chance to learn more about mom’s condition. I had a copy of aunts labs with me and it was clear a problem with the thyroid. Her primary didn’t believe the thyroid caused her to be constipated. The gastro did. We changed to the geriatric primary.
After being sick a year go, she stopped eating and lost weight. She is on an appetite stimulate now and is slowly regaining.
in your moms case I would be concerned about how she is taking the pills. Tell her the gastro will want to know all that she is on so she needs to be sure and bring her meds. Tell her to bring any supplements she takes as well. This will give you a chance to see what she is taking, who prescribed, how long ago they were filled and if it looks like the appropriate amount of them are gone from the bottle.
If sis is going with you to take mom, maybe one of you can check the meds out while the other one distracts her. Or let the doctors nurse know to pay attention to those details to help understand what mom is actually taking. Sometimes when you arrive with the elder, they assume you as caregivers have all the answers..
Let us know what you find out. I hope she allows you to help her. It may be the neurologist she needs to see.
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waytomisery Dec 3, 2023
My FIL is on Miralax . it is the only thing that keeps him from being impacted. 3 trips to the hospital over 6 months to clean him out before they would give him Miralax routinely at his facility . He has a large hernia and the bowel sits in it and would collect stool until he got backed up .
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My mother will be 91 tomorrow and has virtually stopped eating. She has been in a NH and declining very, very, very slowly to the point she can't do anything, including get out of bed. She is now virtually deaf, sleeps almost all of the time, has dementia and now isn't eating. She does drink water, chocolate milk and coffee.
I discussed with her nurses, and they said once someone decides to stop eating, there is little anyone can do. As my mother is drinking, they said it will be a very slow (as if it hasn't been long enough) decline. I will not prolong her existence with any intervention as she had said herself that she is ready to die.
You may not get any answers as to why your mother isn't eating. She may have just decided to stop eating. There will be little that you can do, especially if they aren't prepared to allow anyone to help, even with advice.
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Skimbro000: Without nutrition, this could be deemed a medical emergent issue.
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My daddy stopped eating too, he would take the food but would not chew and then spit it out. As we age our tasters change and sometimes the food just is not appetizing. You can try protein shakes - just make sure she is sitting up when she is drinking. My daddy would not take the shakes and neither would my mama. This is only a suggestion but try it, it could work. Also, try making the food so she doesn't have to chew it. Blessings
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anonymous1732518 Dec 4, 2023
Especially a lot of NH food
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My Mom stopped eating too , a Bite here and there and got down to 93 pounds . Eventually she died of a Massive Heart attack after they Inserted a feeding tube Into her - I told everyone " she is Not to go under anesthesia " No One Listened so she was left brain dead after this Operation .
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I have a small Oster blender I use to make protein shakes.
frozen berries, ensure, a spoon of protein powder, add ice if you want.
blue berries, strawberrues, frozen cherries, whatever you like. It’s good, and doesn’t taste like a protein shake, and the berries make it a pretty color too. This time I added some Keifer too..
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It sounds like time for facility placement for both of your parents.

Ceasing to eat is natural response to upper gastric discomfort or other things and could also be a sign that she's losing interest in living, a natural process.

You and your sibs need to take action to get them into care before things deteriorate further, which they will.

It's very hard, the cold reality of our parents' slow or rapid decline. I wish you all well with the coming changes.
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A further thought: it may be a UTI and that can be evaluated while at the gastro.
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Skimbro

Mother not eating after several days the body starts to shut down two weeks if nutritional is not available . Body starts to inform other parts of body to shut down . Similar to a vehicle. Proper things need provided. Is father eating. With dementia there's time they say I ate already. Fusing is because of parents thinking you trying to take away their Independence. Don't know how to tell you. Stay calm even when she's screaming .

Do any family members has POA against parents. Possible call Area For Aging best resource for information. Need call Elder Law respectfully
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GI doctor will probably want to do an upper GI scope and maybe studies of lower GI tract. He/She should order a swallowing evaluation by a speech therapist to see if mom can swallow food/water safely. A speech therapist can also let you know which consistency of food and liquids is safe for her to eat if she does have swallowing problems. Doctor may insist on admission to a hospital if concerned about medication issues. If this is a problem, then mom - and dad - will most likely be told that she can not give herself medications and needs assisted living to home health to oversee this.
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Im so sorry your going through this , it’s so frustrating and worrisome! My 95 year old mom is hardy eating … im at my wits end, im having to practically force feed her! I hope you get some answers!! Hang in there ! 💚🙏💚
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