My wife will not eat. She is 69 with early onset dementia and has type 2 diabetes. About a year and a half ago, she started complaining that some foods tasted too spicy for her to eat. At that time we ate out a lot and during the pandemic mostly carry out. Gradually her complaints increased. She complained that her mashed potatoes or roast beef were loaded with pepper and made her mouth burn. The situation continued to deteriorate until around mid-March 2021. At that time she decided that the only thing she could eat that would not make her mouth burn or upset her stomach was two medium size cups of soft serve vanilla ice cream each day. She would not eat anything else.

Our family doctor prescribed magic mouthwash and one try of that she thought would make her puke (she didn’t vomit, of course). We went to a periodontist, and he had her use a perio mouthwash. She reluctantly brushed her teeth and used the mouthwash. This did not help her eating. The only thing she could eat without irritation was the ice cream. We asked her dentist and periodontist about Burning Mouth Syndrome, and it was something they were aware of but didn’t know of a treatment.

We are now approaching four months of this scary eating habit. She is losing weight, but I cannot tell how much because she refuses to step on a scale. She does not look good, lacks energy and stamina. She is taking Centrum multi vitamin and one Glucerna protein shake each day. She rejects any food item I provide: mashed potatoes, banana, yogurt, chicken. With each food item she claims it will either burn her mouth or make her puke.

I am at a loss for finding a way to get her to eat. What happens to someone like this? Do they eventually become so malnourished that they end up in a hospital and fed with an IV? I am also concerned about her diabetes. Her morning glucometer readings tend to be in the 160-180 range. When she was eating normally they were 102-108.

When I try to discuss this situation with her, she claims that she does eat normal food (not just ice cream), that she doesn’t care about her glucose readings (she used to be a model diabetic who did everything right), and that she isn’t losing weight (everyone comments that she has lost a lot and doesn’t look healthy).

Does anyone encountered this situation or one like it? Does anyone have any suggestion for overcoming this problem? Everyone (doctors, friends, family) think I should have the answer to this but I don’t.

Thank you for your input.


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Could it be that sugary foods, especially ice cream, are a mood enhancer for her?    And that the ice cream is covering up a serious condition such as depression?  

We chocolaholics know how much chocolate can improve a mood, especially in desperate situations.

I wouldn't disagree with her though that some foods are too spicy.  I threw out all that stuff plus a lot of cooking additives years ago.   Have you tried organic foods?

I'm wondering also if she's eating ice cream b/c it melts and doesn't require as much swallowing effort as more solid foods.    Has she ever had a videoscopic swallow test?   (Ice cream would be one of the foods to avoid since it melts so quickly though.)   Did she choke when she was attempting to eat solid foods?
Helpful Answer (2)

Just read the Mayo Clinic article on BMS. Here's what I would try:

A B complex vitamin in addition to Centrum.

An antidepressant, prescribed by a geriatric psychiatrist (these often have a side effect of increased appetite).

Buy an ice cream maker. Experiment with adding blenderized white vegetables and fruits (white sweet potatoes, peaches, applesauce) to the vanilla base.
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I would try freezing any of the liquid protein drinks and then blend them to make them line a "soft serve" ice cream. This would give her added protein and she may accept it more than she might other foods.
Frozen banana also might be a good option. they freeze well and get nice and smooth when pureed.
There is a product that is used in Skilled Nursing facilities and Memory Care and others called Magic Cup it is a calorie dense product and can be eaten frozen, done as a smoothie or drunk like a shake or milk. I am sure the doctor could order it and that might be an option as well.
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There is a long article on Wikipedia about Burning Mouth Syndrome, which you could read if you haven’t already found it. It says BMS can be related to Diabetes Type 2, and your wife is spot on for the problem in age and gender. However it seems that it is usually a persistent pain, not intermittent or related to food. It’s a ‘mystery ailment’, and is often written off as psychosomatic. Perhaps that’s related to her doctor not apparently being too bothered by it.

If your wife visits the doctor, he/she may be more successful in getting her on the scales. Poor nutrition and weight loss is probably more concerning than the BMS. If it really is getting dangerous, you may have no option except putting it to her that she will starve herself to death if she doesn’t eat more and better. She needs to eat an adequate amount and type of food, even if she finds it difficult. You could compare it to the other things that older people simply have to do, even if they don’t want to eg exercise therapy.

You both have my sympathy in a difficult and confusing situation. Yours, Margaret
Helpful Answer (1)

I don’t know too much about dementia. My mom only had mild dementia towards the end of her life. She wasn’t a diabetic and was always thin. My mom loved her ice cream too. She liked those small cups of vanilla ice cream too. My mom was never a big eater.

Others here have parents with ALZ/dementia like your wife. They will offer help to you.

Have you spoken with her doctor about this? Neurologist? Dietitian at a hospital? Her primary care doctor?

Wishing you and your wife all the best.
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