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Before we moved my MIL to an independent living facility, she was so eager to go and be waited on restaurant-style for every meal. She said she never wanted to fix so much as a piece of toast again. Now that she is there, things are dramatically different. She is having a ton of back pain from arthritis/stenosis/spondylothesis and says she is in no condition to go anywhere. She’ll eat a meal if it’s brought to her room, but she doesn’t want them to deliver it because there’s a charge each time and she says the food isn’t worth it. She IS capable of walking to the dining room but she adamantly refuses to go, saying it’s too much trouble to get there and then talk to people. Even if she is down there during mealtime if we have just come from an appointment she will not eat there, but wants the meal taken to her room. She is isolating in her room and becoming depressed, and has lost 18 pounds. We got her some aides to come in, but she doesn’t want them. Yet without them she just sits around, doesn’t get dressed, and her condition worsens when she doesn’t move around. She has food in her kitchen but she won’t fix any of it, she just eats crackers and peanut butter and Coke. (Last time I went to the store for her I did not buy her the Coke.) I suggested to my husband that we not buy her crackers and PB either but he says we can’t use food as a weapon. Ideas? We are very frustrated. Is it time for assisted living?
(NB, I am doing EVERYTHING I can with the medical community to help her pain, but cannot get her in to the pain doctor for a few more weeks. I have begged them and still can’t get an appointment any sooner.)

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She may feel it is inconvenient to have to dress to go to the dining room. These places can have cliques reminiscent of high school, she may have encountered snarky comments about her clothes, her manners or countless other things, or seating is assigned she may have been paired with disagreeable table mates. Even if the food is generally good she may find the menu repetitive.

I wouldn't cut off the foods she likes but try to supplement her diet with some other healthier options that she doesn't need to prepare - single servings of yogurt, fruit cups, applesauce....

And finally - she sounds depressed, not just sad but clinically depressed. You/she need to talk to the doctor about that.
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I’ve been in a facility. The dining room is horrible. Too much noise, too many bad manners. I paid to have my meals delivered. No one will ever force me to eat in one those dining rooms. And don’t use food as a weapon. And get her Coke if she wants it. She’s not a prisoner. It’s her decision not yours.
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Cover999 Oct 2022
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Yes, it's time for Assisted Living in my opinion. If MIL is in THIS much pain, she needs more help available on site 24/7, docs that come into the facility to see residents, and an activity director who'll knock on her door daily to get her involved with the community and the other residents. My parents lived in AL and loved the dining room. After dad died, the ladies gathered around mom and kept her from isolating by insisting she join them in the dining room for 3 meals a day. In most ALs, the dining room is the social gathering place for the residents. And the Activity Director will see to it she gets dressed daily (with the help of the caregivers) and comes out of her room to join the others in daily activities. You can make that part of her care plan and goals when admitting her.

Additionally, MILs doctor needs to be contacted about her depression to see about writing a prescription for it and another for pain management. Chronic pain can easily lead to depression. Wellbutrin helped my mother a lot. A huge sign of depression to me is your MIL not getting dressed and losing weight while staying isolated in her room.

The food in my mom's AL was great and it was seasoned and spiced well, too. AL is not a nursing home where the "patients" are restricted to bland and salt free diets or fed pureed foods, etc. Mom's AL had a full menu with everything on it from Reuben sandwiches to beef stew with dumplings. The buffets they set up for holidays were mind boggling. They did allow 6 meals a month to be delivered to the room, but any more were charged at $7 per meal. That is a big deterrent for most residents to order room service.

Best of luck.
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AlmostLisa Oct 2022
She is already taking Wellbutrin, but dose may need increases.
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AlmostLisa, I see in your profile that your Mom-in-law has a hearing loss. That in itself can make someone not want to socialize.

Once my own Mom started losing her hearing, she didn't like to eat out as it was too difficult to adjust her hearing aids to reduce the clatter of a restaurant.

When my Dad, shy by nature, moved to an Independent Living facility he was assigned to sit at a table with a couple who was from his old home State and from a town he was familiar with. Dad was so happy, otherwise he would probably eat in his apartment.

I know for myself, I don't like to eat out. I just find the noise gets overwhelming and it is hard to talk to the others at the table. We do carry-out and eat at home. Plus I can wear fuzzy socks.
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AlmostLisa Oct 2022
Thank you. MIL has hearing aids but usually does not wear them.
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Your going to have the same problem in an AL. She would be expected to go down to the dining area at least to pick up her meal. She will be charged to have it delivered. And the food may not be up to her liking. They should not be using salt for one thing. Might not be as spicy as she likes. Tgey have a lot of people tgey need to cater to. Aides in an AL can come to her room and take her to the dining room but they can't force her. Maybe she thought the not cooking was a great idea but sitting and eating with strangers is a different thing.

Sounds like depression. She is not adjusting to the change. Its hard for the elderly to adjust.
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I would recommend going and having some meals with her. Bring a special dessert that you can share with lots of people. This will get introductions started and make MIL a superstar if it's homemade and yummy.

I had to do this with my dad and it was very effective. He found out that some of the people were really nice to visit with and he could tell them any story he wanted.

We all need some help adjusting to BIG life changes, help her find the good and settle in.

I would definitely get her some type of pain control, whether massage, accupressure/puncture, PT or meds, because a good pain doctor will always treat the emotional, psychological and physical aspects of chronic pain, it can cause depression, as well as other issues. So get her seen by her doctor to treat the pain and depression and help her adjust to a very BIG life change.
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My mom is an introvert. She didn’t like the table she was at and I asked the staff to find her a table of people who were friendly. They got her a table with delightful people who are social but moderately.
She prefers to eat in her apartment, but doesn’t because I asked her to please go to 2 meals a day. I asked her to do this for exercise (body movement) and that I felt this was a good compromise of 2 meals out and 1 meal in. The one meal in her apartment is Ensure that is in her frig and a sweet protein bar. That has worked well. She initially resisted private caregivers but when she became so stiff that showering, putting on lotion wasn’t something she could do, she agreed to let a “friend” of mine help her. That friend bonded well and is only working 1-5 or 5:30 p.m. every day so mom gets the 2 meals. If she gets up for breakfast, she can either go or have that ensure. I told mom that if she didn’t take care of herself with movement and nutrition, she would be moved to memory care because she would not be able to walk and I really didn’t want her to be bedridden (bedpans, bedsore, bed baths come with that). I also said, that if you want that, it is okay, there are people to help her but this was her choice. She chose to move around! I did ask her if she wanted to die and if I should call hospice. She said no. My mom likes to make decisions so giving her the options is empowering to her. Her caregiver is good at helping her make decision. 2 choices of clothes, 2 choices of meals, “lets get some fresh air today, I will help you go in 10 minutes.” Mom wears her clothes to bed and stays in her clothes after her shower until her next shower. So far so good but some evenings are hard for mom so patience and redirecting is required.
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Some great suggestions here! My mom went into a nice independent living place a few years ago, she has since passed away, but we had very similar problems with her.

We did find that there was a lady who was very nasty to her, and the admin addressed that quickly.

We found that accompanying her to meals on occasion was very helpful to facilitate some good relationships.

We also did get her antidepressant tweaked a bit, and her primary ordered PT and OT through a home care agency. The PT worked wonders and building her strength which ultimately led to decreased pain and better mobility.

Initially I did lots of visits (daily)in order to support her in her adjustment to the place. I made friends with staff, who then were more inclined to make a greater effort to keep an eye on her.

She also slept in her clothes and washed and changed after breakfast, however she was never a morning person so we left stuff for her to munch on in the morning and she had a kuerig machine to make her own coffee. She liked that and enjoyed making me coffee when I came by to visit.

Also, since my brother lived 4 hours away, his job was to call her daily to encourage her to get to lunch, which was the big meal there. So he or my sister in law did that, and if she put up a fuss about going, they told her that they were going to call me, their joke was that I was the big gun.

After awhile, she got in the groove and even began to go to some activities! But we gave her lots of time to adjust and gave her lots of attention. It was absolutely a huge transition for her, and she could only make baby steps. Slow and steady wins the race.
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My dad has a lovely dining room available but says that it's too far to go for his meals. I have to agree that he's 101 years old, and uses a rollator and it's kind of a trip but I still encourage him to go just for socializtion. I also pay to have his meals delivered just to assure he'll get food every day. In actuality, he lives on cookies, pretzels, and Hershey bars. He loves ice cream and they deliver it with both lunch and dinner and he gets Boost twice a day as prescribed by the doctor. He'll go the the dining room occasionally and enjoys when he goes but he really is just no longer that interested.

Has your MIL been screened for depression? She seems to be avoiding the socialization as much as the food. And when in pain you really aren't interested in eating or talking or much of anything. My suggestion is let her eat whatever she wants. Calories are the important things right now, not healthy meals. Get her food she likes, inclulding Coke, which requires no preparation. Also, get some Boost or Ensure and have her drink it a couple of times a day. Moving to Assisted Living may not help with this since my dad's assisted living works like her current situation - meals can be delivered at an extra cost and no one 'makes' you go to the dining room if you don't want to. I even have an aide in the afternoons especially to encourage him to go to the dining room and be with him during dinner and all that ends up happening is that she brings his food up to him. I don't fault her at all because she is required to take her cues from him.
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Maybe some resident or a group of residents said something mean to her? Unfortunately, people can be cruel to one another at any age and the answer is the same, keep going down to the dining room and dealing with the people or go down at another time to avoid them. My father experienced unkind behavior or simply other elders asking him why he had a bandage on his head and my dad didn’t want to admit to falling. It made him angry and he started wearing a hat to the dining room.

Sometimes my dad just refuses to go down at all because he doesn’t like being told when he can eat. They will bring him a tray and he gets mad about that too. After years of going through this with him, we just let him make his own choices. He has figured out if he doesn’t eat, he gets confused and falls more often. He doesn’t like either scenario so he will go down to eat when he wants. Sometimes he misses the dining hours and gets mad. My father is 96 with very early dementia and currently lives in AL, but exhibited these same behaviors in IL. Because he refused to eat in IL, his confusion progressed so much that his physician determined he needed AL and we are going through his lack of eating again. We keep protein drinks in his refrigerator. We open them for him and give him a straw because his grip strength is non-existent and he has a tendency to pour it down the front of his shirt without a straw. So maybe grip strength is an issue for your LO?

Also, sometimes my dad didn’t like eating in the dining room because he didn’t like all the attention a “new” person gets.

There are a lot of reasons why they won’t eat in the dining room, but at the end of the day, it’s just something they need to figure out on their own. We never stop having lessons in life.
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