what can I do to stimulate appetite

mishnico12November 24, 2008

My grandmother is 93 and has alzheimer's. She has slowly lost her appetite. It started with meat, so I switched to eggs and cheese. No pasta of any kind. She just takes a few bites of cottage cheese and maybe some fruit. I tried some ensure and she poured that in a plant, so I guess that didn't taste good either!Is this part of this disease? Or something else?

Thank you,


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Hi Sherry,

It sounds like the AD. For my MIL who had AD, she lost her appetite and it was hard to get her to eat too. What stage is your grandmother at? This usually occurs more near the mid or late stages of Alz.,so if she is in the early stages there could be other factors, such as low zinc. At 93, probably nearer the late stages, I would guess. Taste buds are also not as active if a person is low in zinc. I would check with her doctor to be sure and maybe ask about liquid supplements or foods high in zinc. Most of the foods listed would be harder to get her to eat, unless she loves them and you haven't tried them recently.

HTH, Terri

Here is a list of zinc rich foods
Milligrams / Portion
Oysters 25 + 100g
Shellfish 20 100g
Brewers Yeast 17 100g
Wheat Germ 17 100g
Wheat Bran 16 100g
All Bran cereal 6.8 100g
Pine Nuts 6.5 100g
Pecan Nuts 6.4 100g

Ok Sources of Zinc Milligrams / Portion
Liver 6 100g
Cashew Nuts 5.7 100g
Parmesan Cheese 5.2 100g
Fish 3 100g
Eggs 2 100g

    Bookmark   November 24, 2008 at 11:05AM
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Sherry, she is winding down her time on this earth. It's a gradual thing with her alzeimers, but I think it is to be expected. Something has to come to an end, and this is one way that Mother Nature plans for her beloved children. Don't fret about it or get her upset trying to get her to eat. One thing that you often hear about alzeimers patients is that they just sort of waste away.

About all you can do is to let her eat whatever she wants, whenever she wants to. If she still likes candy, chocolate bars are loaded with calories. Offer her one as often as she will take it. At this point in her life, the fuel from the easily digested calories will do her more good than a balanced diet, as they will give her quick energy.

Eggs and cheese are good, but since they are high in protein, they are not as quickly digested, nor will they provide as much energy as something that more easily digested. Cheese can also be very constipating for the elderly. So watch out for that.

Remember that she probably has some difficulty in chewing. Teeth get dull and the jaws don't have the strength to bite either. Can you get her to drink soup? Sometimes, drinking soup from a cup is easier for the elderly than trying to spoon it from a bowl.

Please come and let us hear how you are doing. Sometimes it just helps a lot to talk about the situation.

    Bookmark   November 24, 2008 at 1:00PM
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I used mix ensure with milk, it helped to dilute that pasty ensure texture. Lots of puddings, maybe some yogurt??

    Bookmark   November 24, 2008 at 1:39PM
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Nursing homes etc. often use Megace (Megestrol acetate) for those needing an appetite stimulant. May or may not be covered by insurance and seems to work if even for a short period of time.

But in the very elderly just shutting down and gradually losing the ability to swallow or those suffering dementias with problems in addition to losing interest in eating - there comes a time when not too much can be done.

A sure sign to watch for though are choking episodes. Some can choke and aspirate on virtually anything - be it liquids, mush consistencies or solids.

    Bookmark   November 24, 2008 at 2:14PM
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Find something -- anything -- that she likes. Will probably be a PiA but there will likely be something she responds to. A decade a ago my mom (then 86) went through a period like this. My personal discovery was chocolate malted milks. She liked them and they stayed down. Bought a commercial mixer and got through that period. She's 96, now, and eats everything so we're pretty much back to normal. (Still don't know what that was!) From case to case there's no way to tell what your path may be. But I'll bet you may discover some calorie-rich something that she responds to if you work at it.

Don't beat yourself up if nothing works. People change as they age and we do, in fact, have to die sometime. Keep perspective, regardless.

    Bookmark   November 28, 2008 at 6:44PM
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Connie Kru

Lots of good advice already given.
One of the things I would like to suggest is for you to do some research on tube feeding in the elderly.
As always there are two side, some who believe in doing it and other do not, and only you can decide, but do some research now,(while you have a little time to think about it) so you know the pro and cons and before some medical people want to make it for you.
Good Luck
I promise you, your will be glad you have gone the course when the end comes, even thought this road is long and hard.

    Bookmark   November 28, 2008 at 7:59PM
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Agree with connie-k. Feeding tubes and PEGs are common as nails. Unfortunately there is a raging controversy about them, the problem being that once they're in, nobody wants to be responsible for taking them out. The literature is extensive. I encourage you to bone up. Hopefully you won't have to get to that point but you should be aware of the competing positions. HUGE legal battles have already been fought over it and there are, doubtless, more to come. I would encourage your avoiding all of them.

    Bookmark   November 30, 2008 at 7:26PM
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Does she like a particular flavor of ice cream? My father was in a nursing home and when I went back to visit he had lost so much weight. I didn't ask, I just went to Dairy Queen and got him his favorite shake. He sucked that down like no tomorrow. I did that everyday while I was home. He then started drinking Ensure.
My husband told me the regular Ensure is chalky but the Plus has a better flavor and he likes the milk chocolate the best. If she likes an ice cream flavor where Ensure has the same flavor, you might want to buy the ice cream and mix it in a blender with the Ensure to make just enough for 1 glass.
She may not want to eat but ask her what sounds good. I found that taking the time to fix a well rounded meal is too long of a wait for them and then they decide they aren't hungry again. Also sometimes the new types of foods aren't pleasing to them. Chicken soup is a good standby. If too soupy, put in enough crackers to thicken it up. Take time, and I know that is hard, but if you could make a mental note or write down what seems to upset her tummy or what she doesn't like and then the list of possibilities. If she's ok with tomato sauce, what about some of the canned meals like ravioli or spaghettio's or even a frozen meal.
My husband is 64 and disabled and we went through and still do sometimes, the problem of him eating. There are different medicines to stimulate appetite too. Now he can have no salt whatsoever. I find things he thinks will be good and keep it on hand. His favorite is chocolate ice cream and his milk chocolate Ensure.
Talk to her doctor of your concerns and the two of you will come up with a plan. She may be old and her mind in another place but I bet she knows she loves you and that you love her. Stick that thought in your pocket, take a deep breath and take one step at a time, even if baby steps.

    Bookmark   December 2, 2008 at 5:27AM
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Update: She is eating a little better. She is eating an egg for breakfast, then a yogurt mid morning. Lunch and supper are real iffy. Usually cottage cheese and peaches. I gave her an ensure and she poured that in a plant! So she doesn't like those LOL.
It just seems so odd because there are things that she always liked, especially chocolate. and now she refuses it.
She is also sleeping a lot. Makes me worry about pressure sores. I wake her at 8am and she will doze in the chair, then off to bed by noon. I give her 2 hrs then get her back up. When I go out to do the barn chores at 5 she usually sneaks back to bed. She is getting real wobbly when walking. She uses a cane most of the time when she remembers.
She is in the latter stages of this disease that has stolen my grandma and left me with an almost empty shell to care for........

    Bookmark   December 4, 2008 at 4:57PM
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I started another thread titled "Free guide booklets for Alzheimer's care" and one of them has several ideas to help patients with eating problems:

Serve meals at the same time every day.

Serve foods with different colors and textures.

Make the table a calm place to eat. Use plain-colored dishes with no pattern to set off the color of the food on the plate so she can see the food.

Use a shallow bowl with a lip on it if she keeps pushing her food off the plate.

Put only the knife, fork or spoon she needs to eat with next to her plate.

Allow plenty of time to eat. Don't rush her.If she refuses to eat it may be because:
-- She has too many choices on her plate. Try offering one food item at a time.
-- She may not know how to get started. Show her the act of eating.

I'll put a link below to the booklet page:

Here is a link that might be useful: eating suggestions

    Bookmark   December 7, 2008 at 1:56PM
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When Iw as a young teen my father's grandmother came to live with ut. She was about 86 at the time, very frail, ate almost nothing. A good friend and her doctor lived next door. He recommended a bit of booze before dinner. Great Grandma was a life long and militant teatotaler, but it was presented as the Dr said you need to. So my father boughrt a bottle of Southern Comfort and puta bout a teaspoonful in a glass and added a little hot water and she sipped and liked it. And that became a nightly routine and she ate and gained weight and got stronger. She was very very afraid her daughter would find out!
Anyhow as time went on they upped the "dose" to 1 tablespoon and after her appetite increased and she felt better her "cocktail" was no longer necessary.
She lived almost 10 more years. Her brain was fine until the end...but her eyes and ears failed.
Sometimes it's the obvious...but she didn't take any other medications, was not diabetic, nor did she have high bloodpressure....just was wasting away partly from calling a soda cracker dinner.
Linda c

    Bookmark   December 15, 2008 at 6:11PM
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Good Idea, Linda! Port Wine used to be used as an appetite tonic. I don't know if it was diluted or not.

However, the alcohol may not work well some of her other medications, so be careful.

    Bookmark   December 15, 2008 at 9:57PM
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