paradise

My Mom just entered a nursing facility and appears to be depressed. She
will not eat and wants to sleep all the time. She is tuning everyone out.
Has anyone gone through this with a parent? Did you have any success in
getting someone with dementia to be more alert and interested? The doctor
has just put her on a very small does of wellbutrin for depression, but I
know it can take weeks to have an effect. I try so hard to get her to drink
some nutritional drinks to sustain her at this time, as she is refusing to
swallow any food. Can anyone offer any advice?

tumbleweed

People with dementia are unlikely to be alert and interested, they can't be
as the nature of the disease. If you couldn't recall what happened 10
seconds ago, what could you be interested in?

Sorry, but this is the way it goes. There maybe drugs that help, but if they
are too 'alert' they wont necessarily be happy or content, you may have to
choose between one or the other My father appears quite content, but isn't
alert, or interested, he doesn't have the capacity to be. When he was more
alert he was much less happy and made unreasonable demands which made him
and everyone else unhappy as well. I'm glad he's less alert now.

Others here can comment on lack of eating, FWIW I'd rather my dad didnt
spend the next 20 years as a vegetable so bad as it might sound lack of
eating would IMHO be a blessing. I wouldnt want to exist as he now does. And
exist is the right word.

--
Tumbleweed

Remove my socks for email address

evelyn ruut

Part of what you are describing seems to be the natural progression of the
illness, but it depends on her level of cognition and many other factors
too.

In the facility where my mother in law is staying, they have a periodic
evaluation of all her abilities, interest in life, physical condition,
medications, weight, appetite, participation in group activities, physical
therapy, and they work out a complete treatment plan agreed upon by an
entire group of professionals, as well as her son (and POA).

I am confident that their assessments are accurate and that she is enjoying
the best quality of life she can have at this stage of her illness. They
note exactly how much she eats or doesn't, at each meal, and this is
discussed at that evaluation meeting.

Antidepressants can also suppress appetite a little, but if you are deeply
depressed you don't feel much like eating either. So that is a call for
the professionals too.

About the refusing food part....... Have you considered that maybe she has
advanced enough in her illness, not to be able to feel hunger anymore? Or
that such a loss of appetite may be a mercy to some degree?

When people reach that stage of alzheimers where they don't WANT to, nor are
they able to eat any more, there ARE some facilities that will press you to
force feed them with a tube (a practice I don't believe in at all).

This has the effect of artificially prolonging their life way past any
possible enjoyment of that life. Many people expressly make it clear in
their living wills that they don't want tube feeding when their physical
condition has left them feeling that they no longer want to take in any
food. I know that my husband and I have living wills that expressly forbid
it along with other questionable methods of artificially prolonging life.

You should ask that a meeting with her doctor be scheduled, and discuss all
these issues with him/her in great detail. You need to know if this is
just the natural progression of her advancing illness, or if she is perhaps
ill, possibly with a urinary tract infection or some other treatable
problem.

If all other possibilities are ruled out, you may have some ethical issues
to address, and you need to know where you stand on them, (or more
importantly, where your mother stood on them when she was well enough to
express her feelings).

I hope you get some real professional answers and find what is best for her.

--
Regards,
Evelyn

(to reply to me personally, remove 'sox")

jennie

Paradise,

Evelyn and Tumbleweed made some good points. One thing not in your message
was information on how your mother was just (weight, appetite, alertness)
before she entered the nursing facility and why the change in where she
lived.

Sometimes when people get close to the end (as Evelyn has alluded to below),
a drastic event can precipitate a rapid decline. Two weeks before she died,
my mother fell. Although she did not change living locations (continued to
be cared for in her own home), that fall seemed to speed up her decline.
She became bed-ridden after that. Her appetite had been declining prior to
that, and she had lost weight, but it REALLY dropped off after her fall.
It's part of the body's way of shutting down toward the end.

Also, in end stage AD, patients can lose the ability to swallow, presumably
because the part of the brain that controls the swallow reflex has been
"commandeered" by the disease.

It is very difficult to watch someone wither away because they won't eat or
drink. Does your mother have a living will, or did she ever express any
desire one way or another about using artificial, life-prolonging measures
such as a feeding tube? My mother did have a living will, and she did NOT
want a feeding tube, so that decision was already made for us.

The answer to this issue for you and your mother may be different than it
was for my mother and I. However, you do need to come to terms with this
issue. I highly recommend that you contact Hospice; they have a lot of
experience helping people deal with the difficult issues that come at the
end of life. If you are religious, you could also talk with your pastor,
priest, rabbi, etc.

I know this situation isn't an easy one to deal with, and my sympathies are
with you.

-Jennie

her.

no_spam_to_dpharris

first, did she ever tell anyone what her wishes were regarding
such things, back when she was still of sound mind? did she have
a living will or some other directive? if she had clearly
expressed preferences prior to her dementia, then you should
adhere to them.

you need to ask yourself if you are trying to keep her alive for
her sake or your sake. sometimes not eating is a signal that the
body is shutting down.

i suggest that now is the time for you to call your local hospice
organization. they can counsel you and help your family through
the inevitable.

barbfrombethel

My mom is having a swallowing test next week.What can I expect with
this?To see if she is exasperating food when she eats.Barb

evelyn ruut

Barb, don't you mean "aspirating?" breathing it in?
Though I am sure it would be exasperating too!
--
Regards,
Evelyn

(to reply to me personally, remove 'sox")

barbfrombethel

I knew there was something wrong with that word.LOL Yes i meant what u
said.LOL

mare

Hi Barb,
I'm probably to late but..... My Mom had a swallowing test and
the speech therapist had different texture foods that she watched
my Mom eat. Just by watching her swallowing Mom was put on a
pureed diet. She does fine with liquids tho which lots of people
with AD don't seem to be able to handle without thickening.
--
Mare
mfcoleman@THEOLEmindspring.com
http://www.muggsmulcher.com/kstuff/a.s.a/intro.htm
alt.support.alzheimers' FAQs and Stuff Pages

barbfrombethel

Mare,
My mom has not been scheduled yet .They are supposed to call me.

If I call you a fool,
Doesn't mean your a fool
It Only means
I'm a person with a need to Judge!