Mom, who is 93 and has dementia, is now picking bits and pieces out of her meals. For example, she picks every piece or chicken and every noodle out of chicken noodle soup and leaves it on the side of her plate.....after asking for chicken noodle soup! Foods that she previously devoured and cleaned her plate are now being picked apart. Now, anything of a different texture, ingredients that are recognizable, are picked out and placed on the side. Or she will chew up certain foods and spit them out and leave on her plate. Sometimes entire meals are chewed up and spit back out onto her plate. For my perfect-etiquette Mom, this has become quite concerning, not to mention disturbing. When I ask why she didn't eat (for example) the chicken, she'll say 'I did', or 'I'm full'; neither of which is true, as she will ask for dessert five minutes afterward. We are struggling with this, as we put a lot of effort into asking what she wants to eat, preparing her meals and then having to deal with discarded food on her plates at nearly every meal. It has become almost like an eating disorder that is worsening. Even some of her favorite meals she refuses to eat anymore. She would live on sugar and junk food if we let her- I have tried making milk shakes with Ensure to try and get nutrition into her and she says 'I don't like that.' But she will eat ice cream with hot fudge and sprinkles all day long. Her home health care nurse has not been able to offer suggestions or offer any good advice, other than give her what she wants to eat, even if it is sugar and junk food. HELP!?

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My 96 yr old Dad started the exact behavior 1 yr ago.
He used a bowl to spit stuff into as he ate as months went by, it got worse and he was basically just chewing and spitting instead of swallowing his food. He would say he doesn't want to swallow it.

I think with his dementia brain, he thinks the texture is foreign in his mouth and he should spit it out like we do if we feel a piece of bone when eating fish or chicken.
You will have to just go thru and find the most nutritious food that is smooth or dissolves easy enough. The most textured food my Dad will eat is scrambled or boiled eggs cut up, waffles or pancakes, Oatmeal, Soft Fruit Breakfast Bars.
A few months ago he would eat beans if they were soft, now we have to mash them but if he feels the skin from the bean he will spit it out. Potato Salad if the potato is soft and it is plain with no onion, celery or relish for him to fill in his mouth.
He could eat any meat except to chew and spit so I bought Vienna Sausage then had to switch to Baby Food Chicken Sausages with a little bar b q sauce.
He loves cornbread with it.
Yiu will have trial and error and in the beginning they will try to eat what they use to but they will chew and spit it out so, feed them what they will eat. I have found the following...
Eggs, Oatmeal, Waffles, Pancakes, Yogurt (smoothed or whipped without bits of fruit because the bits will be felt and spit out.

In the beginning he would still eat meatloaf but only if the hamburger was really grounded to make a smooth taste.
Try Cottage Cheese or anything soft that they use to like.
My Dad also eats, Applesauce, Mash Potatoes and Gravy, Mashed Carrots, Mashed Squash.
Besides the smooth yogurts.
My Dad will drink the drinkable yogurts which is good protein.
He also likes Milk and Juice which is good since he doesn't want to drink much water, but as long as they intake fluids, they won't dehydrate.

Chocolate or Strawberry Shakes are a Favorite and of course ice cream.

Look for sweets with the most protein and least amount of sugar.

Note that when you get old, you lose your taste and that's why the Elderly like the sweets so much.

I found some of the Little Debbie bite size brownies that come in a box of 5 with 5 in a package has the most amount of protein.
They also sale Little bites with different flavors like Banana, Pumpkin,

Soft Breakfast Nutriinal Bars are also a good source of protein.
My dad really likes the Apple ones but all the fruit ones are good and the fruit inside is more of a jam, not bits of fruit that would be spit out.

Little Debbie has a soft Oatmeal Cookie with white cream inside plus they have a Soft Round Cookie called Fudge Rounds.

He also loves sliced lemon cream cake from Walmart and Bakery Muffins like cinnamon swirl, pumpkin just anything with no nuts or bits of fruit.

My Dad also likes to have a snack every 2-3 hrs, like a newborn.

I'll give him a cookie or muffin and a small glass of milk which the milk helps keep him hydrated.
His favorite Ensure or other Breakfast drink would be Chocolate Flavor.

In the beginning he would eat peanut butter or cheese crackers as long as the peanut butter or cheese was the smooth kind.

I know you're thinking all the sweets and I did too in the beginning but when it comes down to it anything my Dad eats to kerp his weight up is better than trying to force him to eat and swallow things he doesn't want and really, at that age.

They should be able to do and eat whatever they want.

Your loved one might as well be happy and not miserable trying to make them healthy in their 90's.
Helpful Answer (6)

I have read that studies have shown that as the dementia progresses, the person loses their sense of taste for all but sweets. My 90-year-old mother is a perfect example of this as now she wants ONLY sweets like cinnamon rolls for breakfast and M&Ms and chocolate ice cream all the time. I will make her half a ham sandwich and she will only eat half of the half. Things she used to love to eat now don't appeal to her. Sometimes when I offer a food she has eaten and enjoyed for years, she will say that she has no idea what that is and has never had it before.

Your mother must not be as far along in the disease as mine. I no longer ask her what she wants to eat because she never makes a decision. Now I give her two choices: I keep it simple for her. Usually, she does not even make a decision regarding the two items I offer, so I just pick because I know she most likely won't eat the meal anyway. She has lost over 60 pounds since March and is becoming frailer by the minute. She will occasionally drink an Ensure with ice cream added. Most of the time if I ask her is she is hungry, the answer is "No". But, I know that as the disease progresses, the person no longer has the ability to feel hunger. It is quite a dilemma.

Mom does not spit her food out (yet) nor pick it apart and move it around the plate. She just does not eat it or I find chunks of it on the floor under the table after the meal.

Since I never learned how to cook, I tend to sometimes just give in and give Mom the sweets she wants. Yep, I know that is being a bad daughter/caregiver, but sometimes it is the best solution I can come up with.
Helpful Answer (5)

There are some good suggestions from others... My husband also - says he is full after a few bites and/or he thinks he has finished everything, when his plate is 3/4 full. Husband has progressive supra nuclear palsy, dementia and is blind - so meals can be challenging for both of us. His PCP referred us to a dietitian / nutritionist. He has already been seeing a speech / swallowing therapist. The nutritionist was most helpful and gave me several suggestions to help his situation. I, too, thought I was making all of his favorite things to eat. However, with dementia, the patient can't remember what their favorite things are. They have 'new' favorite things. It also seems like he likes a lot more sweet food. Since he does not have any other medical issues and has been loosing weight - the dietitian along with the PCP and neurologist said - let him eat anything he wants. For an example, I was told a person used to like steak. Now, the only way he will eat his smaller, cut up pieces of steak is with maple syrup on it. Sounds awful, but what does it really hurt. The person is getting protein and something sweet and he is eating and it helps to keep his weight up. It was also suggested I could supplement with Ensure or something similar. I was told it was to supplement - not be a meal replacement. So, I have to time things accordingly - to make sure he is not too full from the Ensure - so he will still eat his next meal. Regarding a supplement. I purchased the vanilla and add things (fruit, vegies or whatever), blend it and make it a smoothie. He is much more willing to drink it - when he thinks its a normal smoothie and not an Ensure. Generally, I will take one - cold (not frozen) 8 oz. Ensure, add for example a banana, blend it. If it is too thick one can add an ice cube and blend again. Some days, I will split the smoothie in half and save half for the next day. It will refrigerate just fine for 24 hours.

Best to you...
Helpful Answer (4)
AnnReid Nov 2020
BLESS YOU! My sweet mom ate every single thing during the last year of her life SOAKED IN STRAWBERRY YOGHURT.

She never lost an ounce until about a month before she died.
Texture can be a problem.
Bits that are of a different texture that have to be chewed can confuse her.
You can blend soups so that they are all smooth.
Now for the more difficult part.
You or someone may have to sit with her as she eats and encourage her to chew then swallow what is in her mouth. You may then have to rub the outside of her cheek to feel for any "pocketed" food. There may be a time when food will get packed between her jaw and her cheek. You need to get her to swallow that food or she can choke on it later. (or it begins to breakdown in the mouth if her mouth is not cleaned after eating)
You are also going to have to pay attention to foods that have a thinner consistency. Soup, water, coffee, ice cream, jello, these are some of the foods that can be aspirated. You may have to start thickening thinner foods. Either with a product intended for that or by using vegetables or reducing liquid so thinner foods become thicker.
I switched my Husbands largest meal to the morning when he was more alert and had more energy. By evening he was not able to eat as well. So try different foods at different times of day. Get the meal with more protein into her when she is at her best. That could mean "Dinner" at 7 am.
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LexiPexi Nov 2020
Some great suggestions. Husband is having biggest meal in the morning - when he is most alert and has the most energy. Eggs, protein, toast (or carbs), fruit or juice, coffee, etc.
Lunch is pretty good and then dinner (even though I keep moving up the time), is a slow process.
I've been told that it takes a LOT of energy to eat and chew and they just get tired and don't have the energy - even when we feed them.
My mom had late stage Dementia. I can relate to your experience. The nurse aid said its very common for this to occur. Her biggest meal became breakfast. She too was a huge sugar addict, I started replacing cookies with more nutritional choices like low sugar energy bars like Zone.. Belvita is good choice if you can find that product.. She would also eat some fruit during the day. She used to love dinner but she just started pushing food around her plate. I ended up giving her dinner around 4. By 6 she was exhausted and sundowner syndrome was starting to kick in. Eventually your loved one will not be hungry anymore. I learned to be ok with that. Its part of the process of late stage dementia. When you look at the cycle of life as a natural progression regression it becomes more exceptable though painful to see.
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Unless they are diabetic, my dad’s doctor said that all calories are good calories when they get to be that age. If sweets are all they want to eat, let them eat sweets. We did try to sneak in Ensure. We also bought danishes, so it was not pure sugar.
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I can understand your mother's lack of appetite. I am widowed and 81, and now I don't feel like eating at all. I fix myself a breakfast and dinner, don't feel like eating, and just eat because I have to, not because I want to. I have absolutely no desire to have a dinner, and force food down for breakfast. I, too, can eat an ice cream bar, but don't like the looks of cooked chicken, beef, potatoes, mac and cheese, nor vegetables. I only make a small salad because I need to eat some bulk, and I do eat fruit. But appetite is not there at all. So, I have purchased protein bottles that give me 30 grams of protein in each bottle. I don't like that either, but the flavor is good and I need the protein. I do eat 2 meals a day, but don't like the looks of the food, just eat it, again, because I have to. I buy package of cookies from supermarket, and it lasts me a month or more, just take one or a half cookie, just to eat. So loss of appetite is one of aging, at least for me.
Helpful Answer (2)

This happened with my mother, who has dementia. It is common for people with advanced dementia to have eating issues. My mother had to go onto a diet of soft foods (everything the consistency of mush). First she was doing odd things and playing with her food, like a 2-year old. Now she doesn't eat on her own and has to be fed. You have to touch her lip with the spoon and she'll open her mouth. I've noticed that elderly people also seem to prefer sweet foods (like children). Talk to her doctor about it. Her doctor may have some suggestions. Also try to get connected with a social worker or alzheimers group who can put you in touch with professional people who have experience and can advise you on what to expect and how to handle the changes that will happen with advancing dementia. If all else fails, let her eat ice cream!
Helpful Answer (2)

Your taste buds die out as you age. Same reason little kids don't like to eat things like vegetables, the taste is much stronger for them than for an adult. Sweet is one of the last flavours to go. That's why so many seniors only eat desserts and such.

At 93 let her eat what she wants imo. What's the worst that can happen, she gets diabetes in 10 years?
Helpful Answer (2)

Mom just went for therapy for dysphagia, and the therapist stressed to her over and over, "you do not have to do anything you do not want to do, you are 94!"

HaHa! she immediately canceled the therapy because she hates therapy and exercising!

I am letting her do anything that is safe. We fight a lot less!

When she wants to do something unsafe I remind her the goal is dying at home, not in the hospital with broken bones or pneumonia or Covid on a ventilator!

(like yesterday when she wanted to help me move recliners. She can barely walk and is really unsteady! I did have to add 'the talk' about her not understanding or remembering that she just can't do some things, and that I was calling out the caregiver card and putting my foot down. She doesn't like it but knows I am right. I try not to do that too often so it doesn't wear thin.)

Luckily I live with her and her dementia is early stages. Which she also denies!.
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NeedHelpWithMom Nov 2020
God bless you! Sounds like you are handling it all in stride though.
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