Any suggestions for when elderly folk refuse to eat and drink?

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Any suggestions for when elderly folk refuse to eat and drink?

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For the last few days my father has hardly eaten anything. He is also refusing to drink. He literally takes one sip of water and then refuses.
Should I accept his refusal or keep asking him to drink/ eat a little? He gets very anxious when I tell him that he will start to feel worse because of dehydration.
Any other suggestions?

Dad Diet & Nutrition Refusing Care

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Never force food or drink -- only offer it.

Is he in otherwise OK health? Take him into the doctor if he's not otherwise heading toward death, because this is a sign that he's shutting down.

Is he on hospice?

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What you do now really depends on WHY he isn't eating and drinking.
*Have you ruled out difficulties with his teeth and gums?
*Might he be having difficulty swallowing (dysphagia)? Water was actually the first thing my mom had trouble with.
*Could there be problems farther down - stomach pain, constipation?
*Do you have him on a three squares per day healthy diet or do you allow him to eat and drink whatever he wants whenever he wants it? Try keeping little tempting snacks and favourite drinks by his elbow constantly (now is not the time to worry about healthy foods and drinks, give him beer and chips if he'll take it!)
*Consider supplements like ensure or make smoothies if he's more apt to accept those

If you have tried all this and consulted with his health care providers then as MJ1929 says refusal to eat may be a signal that the end of life is nearing.

Coming back to add that my mom lost all initiative to feed herself many years before she died but never failed to open her mouth and eat when she was spoon fed

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I let him eat whatever he wants. He loves chocolate and biscuits but he doesn’t even want to eat those.
Meal-wise, I give him his favourites - lots of mashed potato, but this week he has just told me to give me what I think. At the moment he is eating a tiny portion of porridge for breakfast, hardly anything for lunch and about a quarter of a very small meal portion.

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For the last few weeks, he has been eating and drinking only a minimal amount. With drinking he says he just can’t.
He is obviously getting weaker ( having already been weak and very wobbly) and is probably dehydrated. He has been a bit delirious a couple of times on days when he hardly drank anything.
I also suspect that another reason for him not eating and drinking is he doesn’t want to go to the toilet which he finds exhausting.
No, he is not on hospice.

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Why isn't he on hospice? People make a mistake by waiting until a week or two before someone dies to call in hospice. Their true benefit is in the months leading up to that point, when they can come into the patient's home to ease the transition and help the family as well as the patient by answering questions and guiding care. Their services are free, in case you don't know, and that means that any medicines or equipment required are also free to the patient. The first thing they will do is to send someone out to evaluate your father. Then, it's up to the patient and family to decide whether to engage their services—please call them today.

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Based on your recent additional info he may have developed a swallowing issue. Are you able to get him to his doctor or an ENT?

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I don’t think it is a swallowing issue, more a reluctance to eat/ drink in general. He says he just doesn’t want anything.

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Have you tried thickened fluids Julie?

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Yes, I have tried his usual protein drinks and smoothies made with banana, apple juice and strawberries with manuka honey.

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It sounds like your father may have started his dying process. As the body prepares for death it no longer needs food or drink, and in fact is quite harmful for food or drink to be pushed, and can cause unnecessary pain. Your father will let you know if he's hungry or thirsty.
If you have hospice available to you, I would certainly be contacting them today.

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Imho, perhaps a call to his physician is in order.

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This is very common when someone’s start transitioning and it may be time to call hospice. I’m sorry.

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Julie I'm sorry I didn't see your question earlier - how are things now?

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How are the bowel movements?
A blockage will cause loss of appetite and dehydration, as well as be life threatening if left untreated.
Seek medical advice without delay.

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My Mom has difficulty swallowing and becomes dehydrated. She also forgets the drink is right in front of her. I raise my glass or cup and say "Cheers to Dad" or "another sunny day", or the "dog's birthday". Her automatic response is to raise her glass and have a drink. Sometimes just a sip but sometimes she realizes she is thirsty and drinks more.

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Brilliant! I'm going to use this one!

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i would remind my mother to make sure she drank water every day, her remark was well I drink coffee and juice. But its not clear liquid........she ended up getting UTI and being dehydrated.........went to ER. of course other things were happening as well (kidney function,etc) but after 6 days in hospital she decided it was time for the nursing home...she is 94. I knew she wasn't eating as much as she claimed because I could see weight loss, even though she had food in house which I took up every day. I think she would limit herself. The saying "you can take a horse to water but you can't make them drink" sounds like the situation at hand. You don't say how old your father is, does he have dementia, etc., but all you can do is just wait and then when the time presents itself.....take the measures that need to be taken. IF he ends up in ER....before they release him, let them know that he has no one to care for him at home and that he needs placement. HOWEVER.......IF you have POA....start checking now into an Elder Attorney who can help you with everything for finances, etc. Then find a good NH where he can be placed (make sure they take medicaid for the future). wishing you luck.

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There can be lots of reasons a person stops eating and or drinking.
It is common at End Of Life that a person will stop eating and drinking. The body requires less nutrition, it is using energy to keep the heart and brain functioning.
It is also common if there are other medical problems. Blockage, pain in the mouth, throat, stomach. If there are no medical problems this is a natural course and you should resist the urge to have a feeding tube placed. And in some cases IV's as well can do harm. As the organs shut down the kidneys can no longer function well so urine output is low you do not want excess fluids. Due to the decreased fluids the urine will get darker. The last week of my Husbands life the urine was a dark brownish color.
You might want to contact a Hospice and see if he is eligible if so they will help a lot. Their goal is to keep your dad pain free and provide you with the equipment and supplies and support that you need to keep him safe.

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Eligibility for hospice care can be decided by his physician and can take place in the home. That's what my mom had. It doesn't cost a thing that way.

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Please get him an appointment with his doctor pronto. Something is happening that makes dad refuse to eat or drink: a bowel blockage, pain in the digestive tract, a neurological injury, or a psychological issue. Please get this addressed. If he is ready to die, he will not last long without adequate nutrition or fluids.

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It's time for a difficult talk. If he's choosing to stop eating and drinking perhaps he's had enough of life and is choosing to leave. He has every right to stop eating and drinking.

Stop telling him he'll feel worse. Allow him to focus on what he needs to do for himself.

Support him, but make sure you support yourself. Contact his doc so he can be placed on hospice. They'll support him and you.

I'm sorry.

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take him to the emergency room to rule out infectious diseases. They can check his urine, do chest x-ray, look at labs. If no infections--decide feeding tube or DNR/hospice.

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I agree because you cannot judge this situation on the surface alone. However, depending on his age the medical professionals can also job the gun and start talking about end of life before it is here.

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Jello

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For most men and women they refuse to eat or drink for one of two reasons.

The first one is depression. Perhaps you need to talk with him

They other is they just want to die. All of their family and friends are gone, their health is gone, they are isolated. They just want to give up and die. I would respect that decision.

I have seen both a lot. It is hard to accept but we must respect their choice.

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I agree - age the the body is breaking down. It may be a hidden wish that he wants to leave and find eternal peace. Don't force him - let him lead the way and accept it as his wishes.

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Anything that turns to liquid can help toward keeping hydrated.

You can keep him hydrated if you hand him something every 20 minutes and tell him to take a drink.

If he's not a fan of Water, Offer Milk. Juice, Shakes, Tea, Lemonade, Hot Chocolate, Ect.

I stead of 3 meals a day. Offer him a small snack every couple hours.
Half a sandwich, Yogurt, Applesauce, Mini Muffin and Milk, Ice Cream,
Ask him whst things he would like to eat.

At 95 my Dad found it harder to chew and swallow so he only wanted to eat soft things like jello, ice cream. Yougurt, soup, bananas, avocado, muffins, eggs, pancakes, peanut Crackers, mash potatoes, sweet potatoes, Instant oatmeal, soft breakfast bars, ect.

Give him one can of Breakfast Drink like Ensure a day even tho he may take all day to drink it.

Also, start giving straws with all his drinks as it makes it easier for them to drink.

As people age, they start losing their sense of taste and like a kid, they like sweets more cause they can taste it.

They also have to be more careful swallowing.

Remind them to chew and swallow.

Don't give big plates of food..

They do better with small things..

Give a mini muffin with a small glass of milk.

Also, when your Dad stops eating and drinking much. Make sure he's checked out tight away for a UTI, urinary track infection.

Prayers

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There’s always a reason and it’s not always that he is ready to die. He might fear choking if he’s clearing his throat too often after swallowing liquids. Try to pay attention if he has a lot of throat clearing or coughing episodes . Also if he doesn’t like to pee too often or something like that. Or he’s blocked with dry or large poop at the lower colon that won’t come out and needs a small baby water enema of 3 oz to soften up what’s dry so that it softens a few hours later and is easier to poop and not bleed if it’s too dry and large to be pushed out. Or he’s bloated and gassy with pain. The gas usually can exit but if he’s not moving much, or having too much solid dry food rather than high water content foods like squash, he’s going to get impacted. Get help from a very experienced geriatric nurse caregiver.
He might have a lump feeling in his throat. If he has trouble talking or swallowing food, or hoarseness, it might also be silent acid throat irritation. A lot of respiratory and soar throats and sinus back drip is actually the acidity of foods damaging our throat lining . Sometimes there’s a slow deterioration of the lining of the esophagus and a throat or esophagus burn. Sometimes the sinus drip causes respiratory infection that an elder is too weak to cough and infection begins to grow and a person ends up testing positive for co-vid because the same particles increase in the body and are detected creating more cases of the wrong thing. We can have silent esophagus damage like a lower heart burn and just can’t feel it. There’s a book I just bought called the Acid Watchers Diet. I think my moms loss of her voice was actually caused by this. I’m kicking myself . The symptoms are very close and vary. Not many doctors can differentiate between GERD and allergies or sinus issues or low acid or high acid etc etc . Or if it’s the stomach sphincter that is weak and loose and the stomach acid or fermenting undigested food is rising up into the esophagus after laying down. Or if the esophagus and throat is irritated from the foods being consumed from the mouth going downward . It’s a big mess and is the biggest global epidemic right now .

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We went through this with my mom.

it started with an illness that caused Mom to lose her appetite and then she became completely repulsed by al food and drink, including water. She refused everything. She almost became combative. She was growing delirious. The doctors told me she was dying and I should give up and just get her morphine from hospice.

I would not have gotten her to eat again without the help of a wonderful CNA that loved Mom nearly as much as I. Together (with the CNA’s experience and guidance) we tag teamed to get mom to take a bite here and a sip there until her appetite returned.

We would try lots of different tastes and textures, hoping she would get even just a little. We would cheer after every bite, praise her and encourage her. The process seemed excrutiatingly slow and I was scared that I was prolonging her suffering. It took three weeks of one bite at a time and then she regained interest and appetite and eventually she was eating and drinking like before. Her appetite and love for food returned.

For the rest of her life she thanked me for not giving up. I had thought she was too delirious to remember, but she did.

i hope you have the same results. I will be thinking of you.

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Both of my parents were on Hospice before they passed. I can't tell you what a wonderful resource they were for our family. Keep it in mind.
If your father has not commented about wanting to die, perhaps he just has a lack of appetite. This could be discussed with his doctor, they do have medication that helps to enhance a persons appetite. Just another thought for you.

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Has he told you why he feels like this?

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My mom is 87, in memory care with mid stage dementia, and is refusing to eat. She’ll drink Ensure and water, but that’s it. She’s lost so much weight and is very weak. We contacted hospice last week. They have been wonderful so far. I really believe my mother is giving up. It’s hard to watch but I’ve decided I’d rather not try to force her to eat. I think she’s exhausted and just done. Hope you’re able to find out what’s going on with your dad. This is a difficult season.

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Any suggestions for when elderly folk refuse to eat and drink?

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