Weight gain; anyone else ever deal with this?

My folks have been in two different ALFs over the past 6 years and neither one of them 'monitored' the residents food intake, nor do they accommodate special diets of any kind. A Memory Care or SNF would, but not most ALFs.

So, to answer your question, yup. My mother has been in an ALF since 2014 and went from 140 to 188 lbs. Complaining all the while about the 'horrible food' and the 'tiny portions', etc. Now she's in Memory Care and wheelchair bound, so she doesn't move at all, for the most part. GERD has become a huge issue lately, and still she refuses to change her eating habits. Her one concession is to eat oatmeal for breakfast 2 mornings so far, rather than her usual bacon & eggs. She's not diabetic, so the doctor has not ordered a special diet for her. Plus, if she were to do that, my mother would be beside herself and furious. Food is her only enjoyment in life and all she feels she has left. She spent her whole life dieting and has now decided to eat everything that isn't nailed down. She's paying the price for doing so, and so am I for all the added problems it's causing, but it's not going to change. At 93, she can do whatever she want, I guess, at whatever price.

I think these women have to make some concerted effort THEMSELVES to push the plate away. Or to refuse dessert, or ice cream, or the birthday cake being served after lunch. Self-discipline, in other words, but I don't believe it's likely.

Wishing you (and me) the best of luck trying to get our mother's to exercise some common sense.

If I was 90+ and someone tried to step on my eating choices, I think I'd have a tough time with that. Absent diabetes (and I think the OP posted that her mom was NOT diabetic), she should be allowed to enjoy herself (within reason, assuming that she isn't trying to eat the whole cake). What's the point of living a long time if you can't enjoy yourself?

I have spoken with the Wellness Director and Food Administrator, as well as my mother. They have agreed to let me choose the foods Mother will have. Again, thank you for your answers.

Since people use AL indiscriminately sometimes, it is hard to tell what to say. Regular AL, people should have enough sense to make proper choices and monitor themselves somewhat. MC is a different story.

Our mother gained 20# in the first year of MC. I don't think the food itself is the culprit, but rather the deserts offered. Usually the choices are not too bad and the portions small, but when Ice Cream Bars are offered (chocolate covered of course!) we snag that right away! She wasn't eating great before the move (frozen dinners and boxed crap - forgot how to cook really,) I consider the meals she is getting now an improvement (she had those ice cream bars at home too, but might run out between times I could take her shopping.)

Trying to restrict foods or provide other foods (if specific orders from doc, they should provide that), it might run into battles - they generally eat together and might resent getting lettuce for lunch when others have mac 'n cheese! Certainly we can try to have them provide other foods, but to achieve what? If they don't exercise in some way, the weight isn't going to go away.

Our mom was one to join exercise classes and then stop after a while prior to dementia, and walk around the condo complex, so of the TONS of clothes she had in the condo, they ranged in size from 8-12. Not too bad. But, with the weight gain at MC, I had to get more clothes. Not much local choice except WM, so I got some there, mostly from the clearance rack. I asked her to decide if she liked/would wear them and all she was interested in was the size tag. Oh, this is large, I usually wear a medium... Couldn't say it but thought 'Not anymore!' The last time I brought new items, I cut the size tags off (some are now printed on the item, so can't remove those!)

I'm fairly certain she has gained more since then (we've just started on year 4). The staff try to run simple exercise programs, but she refuses to participate - "Oh I did that years ago, I don't need it now," The first year or 2, most of the ladies walked the hall (circular), walkers or not. Not mom. She would sit and read paper, magazine, sale catalogs. She didn't even need a walker the first 2 years, but wouldn't walk with the others. :-( After some knee pain, she did have PT, but probably didn't do much between appts. The last time PT was ordered (she developed a fear of standing and walking because of a few non-injury tumbles, which are likely due to lack of moving and losing muscle mass/strength from sitting too much!) she refused to work with them. So, now we're in a wheelchair most of the time.

It's not likely "water weight" mom has gained, because in addition to her BP meds, they added a water pill. Salt generally isn't put on the tables, so that doesn't contribute. In her case, Ice Cream Bars. Plus any cookies, cake, candies, sweet stuff... Anything a 2 yo would want instead of dinner (although in her case it would be in addition to dinner!)

For our mother, at 96 with dementia, I'm not about to fight any battles over food and weight. It is what it is. Doc did order tests for diabetes and wanted the second one fasting (1st wasn't) - sure enough didn't she scarf down toast, jam and coffee with cream before the nurse could stop her!! The report posted indicates the blood work is "fine", so I guess that's okay. But, at 96 (going on 2) with dementia, let her eat what she wants, gain weight, whatever. Staff mostly likes her, she isn't too demanding, doesn't ask much and is generally pleasant enough there, so I let her be. It wouldn't be worth the battle.

The problem is that in AL people are expected to be their own advocates in their daily lives. There are many people living in this facility and unless all of them are gaining unwanted weight some of the blame may have to do with your mother's choices, facilities here usually have two options at meals and one is usually more substantial than others. At lunch people can always opt for the soup of the day rather than the full meal, they can ask for their portions without sauces and gravy, they can forego dessert... so even though they aren't planning the monthly menu they do have some control, KWIM?

Try speaking to someone in charge to see if they can help her with her choices. Since she can’t walk someone is making her food and bringing it to her correct? Perhaps you can have lunch with her a few times to see what she is being served and if you can find a likely advocate to help slim down her portions. Many elders will eat whatever is placed in front of them. If she has someone to visit with, she might slow down eating during the time she is at the table.
Has she been placed on any new medications? Check to see if a side effect is weight gain?
Can you ask her dr to order PT so she can become more mobile?
If I were you I would weigh her weekly to see if she is continuing to gain. The initial gain is probably to be expected. My aunt is not quiet 5’ and weighs 144. Which is heavy for her frame. She fluctuates over the year up to 156 down to high 130s.
Her taste seems to change and seasonal foods will pack the lbs on. She loves cake and chocolate. Her BS is a little high but she’s not diabetic. Her geriatric primary isn’t concerned. At 93 she eats as she pleases for the most part. Her weight moves slowly up and down.
Sitting too much and eating too much salt can cause the body to retain fluid. Some of your mom’s excess weight might be fluid. Discuss that with the doctor also. We can’t leave a salt shaker out for aunt or she will add too much. Let us know if you figure out a way to help her. We learn from one another.

I've reminded the kitchen people at my mom's assisted living many times that she is not to eat so many sweets. Doctor's orders. That was going well. They took her nuts, carrots, and celery instead of cookies. Then another person was hired who bakes and my mom can smell the cakes and cookies and wants some. Some is fine, but the staff does, as you say, use food as entertainment. Often I see they've given her a cookie AND a large slice of cake with a sugary drink and I have to remind them again. I think if you could just keep up with the reminders to the care givers it might help. Ask if it could be written down in some sort of daily calendar that your mom is not to have so many sweets. As for the other carbs, meat, and fats, maybe they could be instructed to give her less of that at mealtimes and more of the greens. My mom is at a very small assisted living home, so it's easier. If your mom is in a large facility it might be more difficult to keep their attention on this issue, but persist.

The weight gain would be a big worry if this is water weight caused by high sodium diet. Things like canned soup and many prepackaged high carb meals are just too high in sodium. Often, high sugar content will cause inflammation and push A1C too high. It puts to great a strain on the heart.

I would look really hard at her diet. I would ask to talk with the dietitian at the facility.

You know where my bro is in assisted living he sometimes laughingly says that it is always time to eat. And portions are generous. His table mate always orders double portions. As far as exercise I think he gets MORE here, as he feels safer with his poor balance to move around where there is always help available. He is quite active. Yes, he has gained weight, but in all truth he NEEDED to do so. There are always snacks in the fridge, desserts with each meal. He says that he has noticed more weight round the middle and he is now having cereal and fruit for breakfast instead of bacon or sausage with eggs. So he is well enough to take some charge of this himself. I think this three meals for seniors who often only ate ONE at home is a big change. Good luck!

Thank you for all your answers. Mother is not yet diabetic, she is very mobile, but uses a walker after a hip replacement last year. She is, like one of you mentioned, a person who has dieted off and on her whole life but is now too cognitively challenged to make good food choices. She won't be able to make the better choice on her own. As the "off site" daughter, I am going to try to make those choices for her, but I need to meet with the wellness director and try to get everyone on board. Just yesterday, after a full lunch and ice cream, I purchased a small bag of popcorn at a movie we took her to see. She reached over and took two handfuls before I could stop her. I had to rudely tell my own mom that the popcorn was for me, and she couldn't have any! She just laughed. She has no ability to make the good choice, and she is as mobile as she has been in the last two years. I am comforted to know that others face this dilemma, however. Thank you for all your suggestions.