Adding Calories to Food

trianglejohnDecember 12, 2006

Help! I need to pump up the food I am feeding my elderly father. I sneak butter and cream into things and I have even been known to melt ice cream and use in place of water or milk in recipes but because of his failing health he only eats tiny amounts of anything. Any ideas to boost the calories of food?

The story: I've discussed this in detail here before so here it is in a nutshell. Dad fell through the roof and broke his neck and back (lots of minor fractures). While recovering in the hosp he contracted multiple infections including staph which damaged the valve in his heart. After the bones healed he had to endure open heart surgery to replace the valve. While recovering from the surgery he contracted psuedomonas which damaged more organs (he is the poster boy for infections). He spent almost a year in the hospital. He is so sick of Ensure and Boost that he refuses to eat it - even if I blend it with ice cream and fruit jelly. He is also sick of pudding which I had to crush and mix his medication into while he was laying flat on his back waiting for the bones to heal.

The fall also damaged his throat so swallowing is difficult and he is a cranky patient. He never liked pills or medicine and has never been injured or hospitalized before (except once a long long time ago).

So, though this is all pretty futile, I am supposed to get a minimun of 2,400 calories into him each day. He is only awake about 5 hours each afternoon. He can only eat about a cup or so every hour and he has some medication that cannot be taken with food and some that cannot be taken with milk products. He has between 18 and 20 pills to take each day. He likes pie and does best after eating a piece. I'm wondering if there is a way to hide extra calories in pumpkin pie????

The worst part of all this is that I am supposed to be loosing weight!

Any advice?

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Oh dear!!! You do have your hands full. Let's look at your father's condition realistically. I know you want to do what's best for him, but what are you accomplishing by worrying him about his food? You can't "cure" him.

With being awake only a few hours a day, he doesn't need many calories to sustain life. 2400 would be enough to make anyone gain weight. I am sure he could use a few extra pounds, but it wouldn't help his overall condition much. Let him eat as he wishes to. Don't fret about it. It may be that he has gotten in the habit of not wanting to be bothered so much about it.

You can make the pumpkin pie with cream and an extra egg. Taste and see if it needs extra spices. If pie is all he wants, then give him as much as he will eat. His taste may be impared. Perhaps extra seasoning or sugar might make it more tasty for him.

Talk to his doctor about all those pills. It could be that some of them could now be discontinued. It may be that his doctors have overlooked the fact that some of his medications may be a little pointless now.

I mention getting the doctor to re-evaluate the medication because of what happened to my husband's brother. He was dying, everyone, including his doctors agreed on that, but some of the dozens of pills that the family struggled to get down him each day were to keep his body from rejecting some grafts from his heart surgery. They even were fighting to get vitamines and medication for arthritis down. None of his doctors had ever bothered to tell them that he didn't need those things, so they just kept working to get them down him.

    Bookmark   December 12, 2006 at 11:23AM
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If you can get him to drink supplement drinks, there are high calorie drinks that will help. Imo, Boost Plus tastes best out of the variety available. There's also a brand that Walgreens sells under their own label that's good. Each can has 350 calories. You can also get high protein drinks, but they don't have the calorie value. I have had a couple of instances when I needed to encourage a picky elderly person to eat more for health reasons, and I found that if I made them a "shake" with a scoop of ice cream blended in a supplement drink, it was usually well-received. Good luck with your dad.
Mrs H

    Bookmark   December 12, 2006 at 11:31AM
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The most calorie-dense foods are fats. I don't cook things like pie, but perhaps extra oil slipped into his pumpkin pie? I have no idea what that would do to the taste or consistency of the pie though. Does he like soup? Maybe if you made a beef stew but run it through the blender/food processor until it was a thick liquid he'd eat/slurp that. Use a cheap-grade meat with lots of fat and don't drain it off. You could probably add extra fat to stews just by dumping in some olive oil (good for the heart).

    Bookmark   December 12, 2006 at 2:42PM
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Thank you, Thank you, Thank you!

His next appt. is in a few days and I will talk to the Dr about stopping some of the pills. Seems to me that a lot of them are anti-nausea or appetite stimulators which I think should be on an 'as needed' basis. And I wonder about the prostrate health pill for a man not expected to live much longer.

The Dr said that because of all the healing taking place (or barely taking place) to his damaged organs he needs a minimum of 2,400 calories just to stay stable, 3,000 to improve!!! He said I don't care what you feed him just make sure it has as many calories as possible - he can eat pie and ice cream all day long if he wants. Part of the problem is that dad gets picky, whatever flavor of pie we don't have on hand is the one he wants the most. And he doesn't seem to be able to choke down any nutritional supplement drinks even though he knows they would help him. They are only like a cup full and the way he spits and spews over them you'd think they were poison.

Everyone commented on how dehydrated he was so today they finally brought out some i.v. fluids. So now we have him hooked up to constant fluids and it is like night and day - he is perky and hungery and most of the pie(s) are gone.

I will check on the other brands of canned drinks. Of course I have no idea where they will fit since we bought what appears to be a truckload of Boost.

We know that he will never get strong enough to have another surgery to replace the defective valve (original valve damaged by staph infection, metal valve also damaged by subsequent infection hasn't been replaced). They told us that if he could be stabilized he could live for years, but that he would be mostly bedridden and homebound. Since his spirits are usually up and he isn't in pain, us kids have agreed to go along with his wishes and do whatever we can to accomodate him. He is afraid of going to any sort of 'home' or institution and refuses to go back to the hospital (none of us were impressed with his care either!) so for now we are doing what we can. But we know what the future holds and so does he.

    Bookmark   December 12, 2006 at 10:48PM
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It may be that the texture of the Boost is what bothers him. I don't care for it either. Pour it into a little dish and freeze it. If it gets too hard, zap it in a microwave for a few seconds until you can eat it up like ice cream. Being able to eat it with a spoon, might make all the difference in the world.

I like the chocolate flavor the best. But I confess that I like a couple of extra squirts of chocolate syrup in it too.
Vanilla tastes better with about a 1/4 tsp of almond flavoring.

It's good to hear that he's feeling better since he is not as dehydrated.

    Bookmark   December 13, 2006 at 9:38AM
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Homemade (using a blender) milkshakes made with rich ice cream might appeal to him if frozen or fresh fruit were added. Peaches, strawberries and bananas are very tasty.
A few spoonfuls of Ovaltine or malt powder would boost calories too.

Custards and Flan, if he likes either would be good too.

It is sure a challenge, and he is much blessed to have such loving, dedicated children.


    Bookmark   December 14, 2006 at 9:47PM
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Like a lot of severly ill people he good days and bad days and unfortunately today is a very bad day.

While he was in the hospital with the broken neck and back we had to crush pills and mix them with pudding. As a result he gags when you just mention the word pudding now. It used to be one of his favorite foods.

If and when we can get him up we tend to feed him anything he asks for which is often watery soups or pie. It is amazing the reaction his body gives when he takes medicine. Everything can be going smooth and just one pill being swallowed can set us back weeks in his recovery. He'll vomit til he has nothing but dry heaves and be exhausted and in pain. A call to the doctor gets us the "just get another pill down him, anyway you can..." I wish they would leave some of these all important pills in syringes and let us inject them into his iv line.

I have a bunch of the Boost frozen in the freezer to try as ice cream when he gets better.

    Bookmark   December 15, 2006 at 12:54PM
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I'm sorry to hear about the difficulties you and your father are having.

Have you tried crushing or dissolving his pills in his food so he doesn't know he's taking them?


    Bookmark   December 17, 2006 at 6:56PM
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When my daughter was 10 she was put on a medication than made her lose her appetite. For about 2 months we had to put her on a high calorie diet until the effects of the medication wore off. My sister was a nurse in a nursing home for years and she recommended something called Deliver. It is made by Mead-Johnson, the same people who make Boost. You should Google it and read about the benefits. You give small amounts several times a day. You can give it a spoonfult at a time several times a day if that's all you can manage, and even that helps a great deal with adding the calories. The goal is to get as many calories with as little intake as possible.

Another thing her doctor told us is NO PLAIN WATER. Fluids must have calories in them. Milk, juice, shakes, or anything other than plain water.

Anything that calls for milk (like a milkshake) we would substitute heavy cream. If he likes cream soups, use half and half or heavy cream.

I hope all goes well for your Dad.

    Bookmark   December 27, 2006 at 10:53PM
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I will hunt down Deliver and recommend it to dad's nurse. Hopefully she knows all about it since she is an experienced hospice caregiver.

The most current info from the team of doctors working on him was that dad could recover to the point of being strong enough to care for himself but will be bed ridden and homebound for most of the day - that he will never be strong enough to walk great distances or take care of my mother (who has her own monumental health issues). But in order to achieve this level he must eat more and drink more and exercise every day - all of which he isn't doing!

He is not in any pain, nor is he mentally impaired or even depressed. For some reason he just can't grasp how serious the situation is and that he doesn't have a choice about the eating and exercising demands - it's a 'do it or die' situation. I could understand his actions if he had recently injured himself but he got hurt in October of '05 and the year he spent in the hospital he wasn't in a coma. How can a person experience all that, the surgeries, the invasive tests, and not think they needed to follow the doctors orders?

The entire time he has been in the various hospitals and now that he is home - one of us kids has been there with him. For the first 5 months we even stayed with him 24 hours a day because he often panicked when he slept (he kept thinking he was falling). Only my older brother lives in that state and he had to go to work during the day so my little sister and I (on leave from my job) took the day shifts and let my brother sit with him at night. In the past 14 months I have traveled back home 5 times, often for three weeks each visit. Needless to say this has really hurt my paycheck (since it is all leave without pay). We thought he was improving after he came home but he caught some sort of bug (digestive) and went downhill. So we changed our plan of attack and hired a live-in nurse who will stay with him until he either dies or gets sent to a nursing home (against his wishes) or improves to the point that he only needs a daytime caregiver.

My other sister is there now and we have this rule that no ones gets to make demands unless they are there doing the work. So whatever she decides to do is what will happen, because I'm not going back for a while.

After the dad crisis settles a bit we will all have to focus on mom who is also in need of major medical work.

If this sounds like a classic old person situation, I am only in my 40's and my folks are in their 70's. If you had met my father before he broke his neck & back you would've thought he was in his early 60's. Now you'd think he was close to 100. We used to call him 'dynamo grandpa' because he was so healthy and athletic for his age. I've come to terms with all of this. Anything can happen now, it is beyond my control. In the end I will get to say that my dad died after falling through the roof and breaking his neck. The sad truth is that he really died after catching a bug while recuperating in the hospital.

    Bookmark   December 28, 2006 at 2:15PM
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