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Mom is 87 and has Alzheimer's Disease. Her daily routine is centered around caring and feeding her 4 rescue cats. As the disease progresses her attachment to the cats has reached a borderline obsession. She constantly overfeeds the cats and they are obese. Talking to her about this does not help as she forgets and when reminded gets angry and defensive. Mom follows the cats around the house and often does not like to let them outside despite the fact that they are outdoor cats. The cost of overfeeding both in financial terms (several hundred dollars a month) and health wise in terms of veterinarian costs is excessive. If we remove the cats I fear she will have a breakdown or develop depression as she often talks about death. I really don't know if we should just leave things as they are and accept the situation if it make her happy or remove the cats and hope that she will forget about them. Looking for suggestions.

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NancyJane: This is not just a problem for people with Alzheimer's disease. Owners of pets with No mental problems fall into this trap of over feeding their pets.
I agree with Madeaa, please don't, take her beloved pets away from her, as it gives her a sense of 'well-being' and shows you she is capable of giving .care & love.
If these cats have been spayed and neutered (this adds to them putting on weight) (She may not want to put them out as she may be afraid they won't come back) This is a very real fear!
I suggest you shop around for other cat foods from reputable (pet) stores, that have (healthy) diet foods for pets. Actually the cats won't like the diet food and will even eat less of it, but will still have a healthy diet. The diet food may cost more but you will still save,$$$ because they plainly won't eat as much, because the taste is not there.
However letting them out, they will hunt prey and this can add to more k-cals for them. plus as Madeaa says put them around disease, and they could be hurt.
I am considered elderly, (70) I am competent, but I get defensive when it is friends and family start telling me what to do and how to do it.
I do wish you the best, with this and hope you keep us updated.
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Oh, yeah, she has dementia. She doesn't think so, of course. To her, she is normal and has no problems with her mental capabilities. In some cases, this is true. She has never been a very sensible person and does not think things out. She has always been an emotional reactor, a screaming hot head. She can't do this very often, because it raises her blood pressure. My Aunt use to refer to her as Tinkerbell, because she never acts like an adult...she is very child like in her behavior. It has gotten more acute, because of her dementia. I try not to let it upset me as it use to. This experience can make you sick and has. I have had to take things in stride, take a step back and take care of what I can and accept that which I cannot. I now go to the gym three days a week to help with the stress and keep me fit to deal with all the physical and mental demands this job has.
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I agree those cats are her lifeline and give her joy, but OCD is OCD.
there are pet dishes made for vacationing,that feed the pets for you, while you are away, maybe those could work as a switch out,
Is someone there on a daily basis, that could doled out the cat food in pre packaged daily doses and only had one daily dose of cat food available for her to feed her pets?
I mean she can only do what people let her get away with doing, some things need to be modified with dementia, not only for their protection, but also for their pets.
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Nancy, hi. I have EXACTLY this problem. EXACTLY.

CarolLynn’s suggestions are very well thought out and expressed. I definitely recommend trying the routine that she describes ... but of course, success will depend on your Mom’s condition and memory. My Dad has gotten to the point of not being able to track the day or date anymore, so dates on bags would be meaningless to him. Even assuming you follow the practice of putting only today's bags within reach, you may still run into problems. For example, Dad sometimes calls me in a panic because he thinks he has “run out of” cat food (even though I know the cats are in no danger of starving and that a caregiver is coming within hours to ensure that he has what he needs). If your Mom is in a similar state, I suspect she would start feeding the cats regular food from her own fridge if she couldn’t “find” their cat food. But I still think it is worth a try! If you’re lucky and she’s still at a state where she can accommodate a gently introduced change in routine, you may be able to “set” this new practice in stone and manage it far into the future.

I know you’ve gotten a fair amount of response from other posters, but I hope you’re still following this thread, because I want to caution you about something to particularly watch out for if you can. I don’t mean to add to your worries, but I think it’s important for people to know about this.

(WARNING to readers: What follows is disturbing and graphic. If you are easily nauseated or squeamish about “gross” things, please stop reading now. But if you love house pets and want to be informed about a serious potential health problem that can kill obese cats, either keep reading or look up “myiasis” online.)

My Dad has FTD (fronto temporal dementia). His entire life and routine rotates around taking care of “his” cats -- which currently include two indoor cats, two garage cats, and a rotating cast of 10-15 feral neighborhood cats (thanks to an annoying neighbor of his who never bothers to get their outdoor, wandering pets "fixed").

My Dad lives a state away from me, but I drive up there at least once every month. Every time I go, I find the following in the garage where the two "garage cats" live:

* 20 - 30 nearly full bowls of water
* 20 - 30 nearly full bowls of kibble

He is better about not endlessly over-feeding the indoor cats. I'm sure he is also over-feeding the outdoor cats, but that a fair amount of what he puts out for those is being eaten by possums, raccoons, and blue jays as well as outdoor cats.

The garage cats do not overeat even though the excess food is down, fortunately. Whether a cat will become obese from "over-feeding" is definitely a case-by-case question, though. I have had cats who will not limit themselves on free food, and others that stop the nanosecond they’re sated.

Obesity can become a very serious problem, though. I’m about to get graphic, so those of you with sensitive stomachs and empathy for animals will want to stop reading now. :-( The following happened almost a year before Dad’s dementia diagnosis, back when I was starting to become concerned about his short-term memory problems, but before I had fully cottoned on to the extent of his judgment/executive function issues.

One of the neighborhood cats that was abandoned by the idiot neighbors and adopted by my father ate everything he gave her and more. I think she may have been regularly starved/neglected by her original owners and had a “wolf it while you got it” mentality about food. This proved to be a very dangerous combination with my father’s notion that if the cat was still eating whatever he put down for her, she must still be “hungry.” Over the course of a few months, she became alarmingly fat. She had a lot of fur (he called her “Fluffy”), so I don’t think he realized how very heavy she’d become.

On one of my visits (at the time, I was only going up every 2 or 3 months), I was surprised to see how much fatter she had become than the last time I’d seen her. I am a cat person myself and have very carefully managed various cats’ weights over the years (including buying a pediatric scale to get precise readings on our older cats for whom weight fluctuations usually have to be managed as part of managing their various conditions). Shocked, I picked Fluffy up and estimated she weighed somewhere between 20 and 25 pounds. I told Dad she was far, FAR too fat, and that he needed to start curtailing her food. At the time, I emphasized the likelihood that at this rate, in spite of being a young cat (two or three years old), she would become diabetic and require daily insulin shots and glucose monitoring. I tried to scare him with this because I knew he would not be able to take on this kind of regimen, and I thought that he would respond to this warning my stopping the over-feeding. (Again, we had not gotten the progressive dementia diagnosis at that point, and I didn’t fully understand the kind of “fugue state” he gets into when it comes to acting out his daily routines.)

About two weeks later, Fluffy died horribly, and in a manner I had never before heard of, but which I have since read a fair amount about on the Web. Basically, she had become too fat to groom herself thoroughly because she could no longer bend/curl enough to reach certain areas – including, unfortunately, her rear end. Because she regularly went outside, she was vulnerable to flies settling on her. Yes, that’s right – common house flies.

Okay, final warning ... this is where it gets very gross and very sad.

One or more of these flies laid eggs in the uncleaned mess around her rear end. When the maggots hatched, they crawled inside her anus and literally ate her from the inside out. This is called “myiasis” (better known as “fly strike”). It is a well-known problem in rabbits, but can also affect house pets who are unable to groom properly, or who are immobilized or have impaired movement or soiled/damaged skin (such as diarrhea and discharge). In fly strike, maggots typically either infest the anus or crawl beneath the skin (such as when the eggs are laid around open sores or wounds). It is a painful way for an animal to die, and it very quickly reaches a point of no return where the kindest treatment is to euthanasia.

Unfortunately, Fluffy was not euthanized. Had I been there, I’d have had her into the vet in about three seconds of noticing signs of distress, but I was home in California, and my father didn’t mention any of her odd behavior to me until it was too late. Dad, whose routine in caring for cats seems mostly to involve feeding/watering and cleaning up after them, had no clue how serious the signs were that Fluffy had begun to display (i.e., just suddenly peeing on the kitchen floor, crying out in pain and just freezing for a few minutes, and so on). He responded to these by shutting her in a bathroom and thinking maybe he’d take her to the vet in a few days if she didn’t “get better.” The next morning, he called me to say he’d found her dead in the bathroom, and “little worm things” crawling around on the floor. Horrified, I told him to collect some of the worm things in a baggie and take them to the vet to find out what they were (I had no idea what could have happened and was concerned about the possibility of contagion/infestment of his other indoor pets). The vet took one look and identified the cause of Fluffy’s death. My own vet, when I asked her about it, got a very pained look and told me this was a particularly bad way to go.

So ... if your Mom’s cats are becoming obese, it may be safest for them NOT to go outdoors. If they do, please try to be vigilant about looking for signs that they are too obese to move well or to clean themselves thoroughly.
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As for whether or not to take the cats away – this is a tough call, but I’d also recommend against it until it is obvious that there is no other choice. I know this is difficult ... you sound like someone who both loves her Mom (and wants her to be happy and calm) and who doesn’t want to see animals mistreated. A parent’s dementia makes it painfully difficult to juggle these two opposing forces as well as you’d like, and you end up having to compromise.

A dedicated “animal person” myself, I have had to make similar compromises where my Dad is concerned ... because the reality is that caring for his cats is literally the one thing that he enjoys and that gives his life structure and purpose. He does not read. He does not watch TV. The fact that his cats “need him” literally gets him up in the morning. I fully believe that having this purpose is keeping him independent and engaged much longer than he might otherwise manage.

Understanding this, I have “allowed” conditions to exist that are not ideal, and that I would never normally tolerate. Fourteen months ago, while he was still feeding feral cats in his garage (leaving the doors open in the winter months), a cat came into the garage and gave birth to four kittens under one of the shelving units. When he told me about it, I suggested that he shut the garage doors for a few weeks to give the kittens a safe space to grow a bit older (I didn’t want them to be killed, for instance, by raccoons coming into the garage to eat some of the endless bounty of free cat food). My intent was for the kittens to get their eyes open and a bit mobile, and then for them to go out into the feral neighborhood community with the rest of the colony.

This never happened.

Three months later, Dad had still not opened the garage doors. Somewhere in there, the gardener had opened the main door accidentally, and the mother had escaped ... but the kittens had stayed. I started pressing upon Dad the importance of letting them out so that they could learn to fend for themselves and deal with common neighborhood dangers (such as cars, dogs, etc.) ... and he kept saying he would, but didn’t.

At four months, I was tearing my hair out. The garage kittens were completely feral – as far as I could determine, Dad wasn’t spending any actual time “socializing” them, but just going through his routine of feeding/watering and cleaning litter boxes. Whenever I’d visit and go into the garage, they would dive behind various shelving structures, and I could not reach them. I didn’t know what gender mix the kittens were, and I was starting to have nightmares about them getting old enough to mate (which can happen as early as four months) and having more litters of kittens in the garage that my Dad wouldn’t release. I started panic-dialing local vets, trying to find someone who would fix the kittens. Everyone I called said the cats were “too young” (which is ridiculous, as most humane/adoption organization will neuter/spay at 2 months).

Finally, I managed to entice the smallest kitten (a girl) to come and play with me on one visit. Shortly thereafter, watching her, one of her brothers also risked coming out of hiding to sniff the extended hand of the strange blond monkey in the garage. Now I knew there was at least one of each sex, and I became more determined than ever to get them fixed. Dad was very resistant – he was sure the kitties would blame him and “not like him anymore.” He was also worried that after I’d gotten them fixed, I would let them out.

It took my husband and me four hours to catch those cats, and we had to completely dismantle the garage to do it. My husband got bitten by one of the more feral kittens. I tried to talk him into getting rabies shots, but he refused ... and to be fair, the kittens had never been out of the garage, so it was unlikely they’d been exposed. He had to take antibiotics for a few weeks. I took the kittens in to a vet that the local humane society found for me, who was willing to spay/neuter before six months. While the cats were at the vet’s overnight, my husband and I removed most of the old shelving and clutters from the garage. We took loads of old barrels and boxes to the dump. We reorganized the garage so that there are no longer any extremely difficult-to-access hiding places for the cats, but we made sure to construct lots of “easy-to-access” hiding places for them (i.e., chairs with blankets dangling down to create caves, and so on).

When the cats came home and were back in the garage, Dad visibly relaxed. I took a deep breath and asked if he would mind very much if I took two of them back to California with me. To my surprise, he seemed genuinely pleased by this request ... I’d expected him to be resistant, but it turned out that he was finding it difficult to navigate the garage when he went out to feed them because apparently they would all mob him and be underfoot, and he was afraid that they’d make him fall. So I took the girl and the boy that had interacted with me a bit ... I was definitely not “in the market” for new cats, as we were down to an older boy at home who is territorial, but my reasoning was that these two semi-feral kittens had a chance of decent lives as house pets if they could get some socializing, and that the window to provide this was shrinking. The other two kittens were (and remain) more feral than semi-feral. They trust my Dad to feed them, and will even occasionally spend time on his lap, but they will not come out for anyone else.

I would have taken all four, but ... and this was the biggest compromise I had to make ... I didn’t any longer want to remove all the cats from the garage. I knew that if I did this, the garage would be “reopened” as a feeding spot for the neighborhood ferals ... and that the likelihood of new litters of kittens being born there would skyrocket. So there are still two feral cats in the garage who have only ever been out of it for their neutering surgery. I think this is terrible. But I also think it is better than the alternative. The cats are cared for ... fed, watered, box-cleaned, and monitored by me and my Dad’s caregivers for any signs of distress, illness, or disease. If my father dies or must move to an NH, I will go up and live in the house for at least a month to see if spending an extended period of time around those cats allows me to establish a trust bond with them ... if so, I will bring them back to CA and reunite them with their siblings. If not, I honestly don’t know what I’ll do.

So ... like your Mom, my Dad with dementia over-feeds and over-waters his cats. I have accepted that he is not able to stop doing this, and that I cannot stop him from doing it. I don’t lecture anymore. When I visit, I simply carry bowls in from the garage and outside and clean them out and stack them on the counter. I leave a couple of bowls of kibble and a couple bowls of water for the two cats in the garage. I know when I come up again in a month, there will again be 30 bowls of kibble and 30 bowls of water there, and I will have to start over. The waste in terms of money on cat kibble is unfortunate ... but it is one of the “lesser evils” I can accept to keep my Dad content and happy in his routine.

When I come up, I play with and thoroughly inspect the indoor cats, and I corner and inspect the garage cats, looking for any signs of disease or distress. If I see any, I make an appointment with the local vet and I take the cat in for whatever needs to be done.

I also have Dad’s near-daily visiting caregivers check regularly on the cats to ensure that they ARE being fed/watered, and that their boxes are cleaned.

If I notice any of the cats becoming obese, I will talk to Dad’s caregivers about switching the cats to a less appealing diet food, and ensuring that this is what gets bought when they take Dad shopping. They will remind him that the new food is “what the doctor ordered” for his beloved kitties. I’ve got my fingers crossed that maybe this will work ...

Finally, I hired a geriatric case manager who comes once every few weeks and takes my Dad to the local Humane Society for supervised volunteering. He gets to go into the cat and kitten room and sit and pet/socialize the kitties. He was so resistant to my efforts to get him to do any volunteering, and now he LOVES this. He has gotten his other caregivers involved as well. I have reiterated to all of his caregivers and to him directly that he cannot adopt any of the cats at the shelter ... because there’s a limit to how many cats I can “take on” if anything happens to him ... and he accepted this with less resistance than I expected.
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Ah, Madge1, I'm so sorry ... but what can we do? We beat ourselves up and feel terrible ... but honestly, I had no idea this was even a risk, and you obviously didn't know either. I'm a long-time cat owner and lover, and I'd never heard of this condition. I was familiar with all the "normal" long-term problems that stem from obesity -- diabetes, heart strain, kidney damage, fatty liver, and so on -- but nobody ever mentioned or described fly strike to me. I assume most pet owners are in that position until they've had direct experience with it, or read about someone else's direct experience ... which is why I share this story whenever and wherever it might help to prevent a similar occurrence for someone else.
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Paula - as ugly as it is, thx 4 your information. Many of us in long-term animal rescue have seen unimaginable horrors, and some perpetuated by the innocence and mindless unawareness of dementia and, to some extent even worse, contributed to buy us, the overseers, who would never tolerate such treatment under normal circumstances. For those of us who do the work we do because of our love and concern for critters, it is truly heartbreaking torture to have to make these kinds of choices between our sick parents and and healthy pets.

Nancy - your only choice may be to switch to a less palatable dry food only, maybe similar to a kidney diet (ask the vet). I know it's hard but you're going to have to be learning to lie to your mom about certain things. Get some extra large ziplock bags, tell her you're able to buy in bulk, and put the food in the ziplock bags so she can see what kind it is. Commercial cat foods contains flavor enhancers that make the cats want to eat more. They won't like the foods I'm talking about, so they will naturally eat less. if you see a real problem developing with one of the cats, you WILL have to remove it either under the guise of taking it to the vet (and not bringing it back) or ooops it got out and got lost. You then do what you need to do about the cat depending on the situation: treatment, euthanasia, rehoming, etc. lf a cat disappears, your mom will frat and have a little distress but she will forget about it after a while. This approach is gentler then trying to tell her how to change her routine to which she has become very accustomed.

Dementia and all the ramifications its just a tragedy.
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I would not remove the cats at all. This is her impetus and motivation and gives her a sense of feeling needed, loved and gives her a reason to keep on trucking. I assume she is living with you and not alone right? Anyhow, I think it is quite unusual for a cat to overeat, I have had many for many years. I take care of one cat now and there is a lot of cleaning up, he is an indoor cat, not obese, well a few extra pounds he is 12. He always has dry and water available and I give him a few ounces of wet food a day. Vet bills would be high for cats that go outside and get into fights, worms, diseases, hurt, diseases. Indoor cats fair better. These are her friends and her source of joy, you would hurt her by getting rid of them in my opinion. Find a way to help her care for them if you want to love her and her cats.
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If you changed cats to dogs, you would be living in my home. I have the same identical problem with my mother. She will feed the dogs 25 times a day. Her own dog will run away from her anymore because she is tired of Mom constantly being "on her" to feed or brush or just make over her. My Mom too gets violent/angry if you try to remind her that they JUST ATE.

It is part of the disease and it does become an obsession but I know if Mom didn't have the dogs she would most likely die as they NEED her and everyone needs to feel needed.

I would not take her cats away entirely but if it gets really bad maybe you want to cut down to two cats verses four. She does need something to love and feel loved by and it is like a hobby. Personally I have made up big signs and I post them when the dogs have been fed breakfast and another one when they have been fed dinner. It helps some, but is not a 100% cure.
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Hasbro has a robotic cat that might be good, it purrs and mews and rubs into your hand...i'm thinking of trying it for my mom....
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