Before we moved my MIL to an independent living facility, she was so eager to go and be waited on restaurant-style for every meal. She said she never wanted to fix so much as a piece of toast again. Now that she is there, things are dramatically different. She is having a ton of back pain from arthritis/stenosis/spondylothesis and says she is in no condition to go anywhere. She’ll eat a meal if it’s brought to her room, but she doesn’t want them to deliver it because there’s a charge each time and she says the food isn’t worth it. She IS capable of walking to the dining room but she adamantly refuses to go, saying it’s too much trouble to get there and then talk to people. Even if she is down there during mealtime if we have just come from an appointment she will not eat there, but wants the meal taken to her room. She is isolating in her room and becoming depressed, and has lost 18 pounds. We got her some aides to come in, but she doesn’t want them. Yet without them she just sits around, doesn’t get dressed, and her condition worsens when she doesn’t move around. She has food in her kitchen but she won’t fix any of it, she just eats crackers and peanut butter and Coke. (Last time I went to the store for her I did not buy her the Coke.) I suggested to my husband that we not buy her crackers and PB either but he says we can’t use food as a weapon. Ideas? We are very frustrated. Is it time for assisted living?
(NB, I am doing EVERYTHING I can with the medical community to help her pain, but cannot get her in to the pain doctor for a few more weeks. I have begged them and still can’t get an appointment any sooner.)
I wish I had the crystal ball that told me, no amount of encouragement, lecturing , nagging etc was going to help my mom. She just wanted to sit in her room, in her gown , and be waited on. I told her when she stopped going down for meals it would land her in a wheelchair, it did..
go ahead and buy her the soda etc… treats are needed, along with some fruit..
maybe try going with her for a bit, but , that creates a dependency on you, would she continue to go if your not there..
I wish you luck with all of this. Just know you may not gain her cooperation and, let it go…I wish I had . All my attempts just caused me to look and feel like a nag….
let us know how she does- pain is no fun , and I think it is really not treated as it should be by medical folks as well as insurance - quality of life SHOULD matter. My pain was much better controlled for years than presently but the medication I was on has been completely demonized now (a narcotic) and though it helped me tremendously I never felt any desire to overindulge nor any “high” associated with it, now only thing I take is ibuprofen or Tylenol but can’t walk to the corner without pain. Progress huh.
good luck
Soft drinks are almost the worst thing a person can put into their body if they contain HFCS. I’m not sure if they all do. I would let her have it if that was on her order but HFCS or sugar in any form can make joint pain worse is my experience. The type of sugar that is in milk is not as bad if she can tolerate milk. In fact dairy is supposed to be good for some types of arthritis. Also salt can make matters worse. Dehydration is awful for pain. DH aunt likes the small bottles of water. She can’t open them but she can pick them up easily and will drink and not just sip. You might try that. There is a “new to me” protein drink called Fairlife. It is pretty tasty and with whipped cream it is a treat. For your MIL I would add ice cream. Most of us need more protein and she is getting basically none from what you describe.
I have arthritis so I feel for her. Just getting dressed sometimes is a chore when I have inflammation.
Wearing the hearing aids in a noisy room bothers my DH.
Home health is a great idea and also pt/ot. She can get to know the nurse and aides and have a nurse to talk to about her pain and help monitor her vitals.
I think I would try massage, acupuncture, aromatherapy, any and everything to make her more comfortable and let go of expectations that she join in the dining room. 18 lbs sounds serious to me. I hope her appointment is soon.
My dad had an occasion to go to a pain doctor and it was one of his prescription drugs causing the problem. Took about 30sec for the pain doctor to know what to try first.
Sometimes elders are careful not to say what is bothering them for fear someone will try and “fix it”. Aunt would say on the way to a doctor’s appointment “Was I complaining”. And no, she wasn’t. Please be sure to let us know what you find out and I would call her doctor and ask if she can increase the antidepressant.
Meeting with a Geriatric Psychiatrist in person or via Zoom? Depression is a sad companion to chronic pain........speaking from experience.
Visiting Angel or Care.com companion who likes to cook and will do it in her room.
Are there activities that draw her out of her room?
Ask if other residents or staff can call / approach her to join / encourage her to join one other in the dining room. Say, xxx would appreciate your company (so it isn't about her; its helping another person).
Depression is huge. Have you discussed this with MD provider(s)?
Ask social worker to intervene although in ind housing, they may not.
Coordinate as many visitors / friends / church members as you can to visit. Have them bring their own meal (and hers) to eat with her.
BE AWARE to listen, reflect what you hear.
DO NOT go into 'convince' mode as this will only bring up resistence. Key is compassion and letting her know you understand how she feels.
Is alarming that she's losing weight. I bring my friend (can't walk/bedridden) in nursing home strawberries and / or watermelon. Find foods she likes - fruit - fish - anything that she might eat.
Key is dealing with isolation and the overwhelm. With pain meds, she might be in a mental / psychological place to shift a bit (even one-on-one socializing). Ease into it and avoid setups that she will resist. She is letting her anger and depression to make her decisions.
If you/family (POA) can make some decisions, do it. There comes a time when a loved one cannot make decisions in their best interest. Even if this means having her 'carted' - wheeled into the dining room. If you can, have her seated w one person, who is also an introvert.
Touch Matters - - - - try touch / massage. Hand massage. Doesn't have to be a professional. Touch will reach her as words cannot. I am a massage practitioner.
We did find that there was a lady who was very nasty to her, and the admin addressed that quickly.
We found that accompanying her to meals on occasion was very helpful to facilitate some good relationships.
We also did get her antidepressant tweaked a bit, and her primary ordered PT and OT through a home care agency. The PT worked wonders and building her strength which ultimately led to decreased pain and better mobility.
Initially I did lots of visits (daily)in order to support her in her adjustment to the place. I made friends with staff, who then were more inclined to make a greater effort to keep an eye on her.
She also slept in her clothes and washed and changed after breakfast, however she was never a morning person so we left stuff for her to munch on in the morning and she had a kuerig machine to make her own coffee. She liked that and enjoyed making me coffee when I came by to visit.
Also, since my brother lived 4 hours away, his job was to call her daily to encourage her to get to lunch, which was the big meal there. So he or my sister in law did that, and if she put up a fuss about going, they told her that they were going to call me, their joke was that I was the big gun.
After awhile, she got in the groove and even began to go to some activities! But we gave her lots of time to adjust and gave her lots of attention. It was absolutely a huge transition for her, and she could only make baby steps. Slow and steady wins the race.
Sometimes my dad just refuses to go down at all because he doesn’t like being told when he can eat. They will bring him a tray and he gets mad about that too. After years of going through this with him, we just let him make his own choices. He has figured out if he doesn’t eat, he gets confused and falls more often. He doesn’t like either scenario so he will go down to eat when he wants. Sometimes he misses the dining hours and gets mad. My father is 96 with very early dementia and currently lives in AL, but exhibited these same behaviors in IL. Because he refused to eat in IL, his confusion progressed so much that his physician determined he needed AL and we are going through his lack of eating again. We keep protein drinks in his refrigerator. We open them for him and give him a straw because his grip strength is non-existent and he has a tendency to pour it down the front of his shirt without a straw. So maybe grip strength is an issue for your LO?
Also, sometimes my dad didn’t like eating in the dining room because he didn’t like all the attention a “new” person gets.
There are a lot of reasons why they won’t eat in the dining room, but at the end of the day, it’s just something they need to figure out on their own. We never stop having lessons in life.
" pain " . She should be formally assessed for S/ S of depression.
Take care of yourselves. Get adequate support from your support team, ( clergy , your own doctors etc). So that your own anxiety and distress do not affect your own health.
As long as your MIL is safe, let her decide where she eats and any other decisions that allow her to feel in control of her life and situation. When aging and moving, one loses some elements of control and Self esteem; empowering and respecting her decisions ( where to eat etc) may help greatly......
Peace...
What is S/S for depression? I agree although need to be aware of side effects.
She prefers to eat in her apartment, but doesn’t because I asked her to please go to 2 meals a day. I asked her to do this for exercise (body movement) and that I felt this was a good compromise of 2 meals out and 1 meal in. The one meal in her apartment is Ensure that is in her frig and a sweet protein bar. That has worked well. She initially resisted private caregivers but when she became so stiff that showering, putting on lotion wasn’t something she could do, she agreed to let a “friend” of mine help her. That friend bonded well and is only working 1-5 or 5:30 p.m. every day so mom gets the 2 meals. If she gets up for breakfast, she can either go or have that ensure. I told mom that if she didn’t take care of herself with movement and nutrition, she would be moved to memory care because she would not be able to walk and I really didn’t want her to be bedridden (bedpans, bedsore, bed baths come with that). I also said, that if you want that, it is okay, there are people to help her but this was her choice. She chose to move around! I did ask her if she wanted to die and if I should call hospice. She said no. My mom likes to make decisions so giving her the options is empowering to her. Her caregiver is good at helping her make decision. 2 choices of clothes, 2 choices of meals, “lets get some fresh air today, I will help you go in 10 minutes.” Mom wears her clothes to bed and stays in her clothes after her shower until her next shower. So far so good but some evenings are hard for mom so patience and redirecting is required.
Additionally, MILs doctor needs to be contacted about her depression to see about writing a prescription for it and another for pain management. Chronic pain can easily lead to depression. Wellbutrin helped my mother a lot. A huge sign of depression to me is your MIL not getting dressed and losing weight while staying isolated in her room.
The food in my mom's AL was great and it was seasoned and spiced well, too. AL is not a nursing home where the "patients" are restricted to bland and salt free diets or fed pureed foods, etc. Mom's AL had a full menu with everything on it from Reuben sandwiches to beef stew with dumplings. The buffets they set up for holidays were mind boggling. They did allow 6 meals a month to be delivered to the room, but any more were charged at $7 per meal. That is a big deterrent for most residents to order room service.
Best of luck.
Once my own Mom started losing her hearing, she didn't like to eat out as it was too difficult to adjust her hearing aids to reduce the clatter of a restaurant.
When my Dad, shy by nature, moved to an Independent Living facility he was assigned to sit at a table with a couple who was from his old home State and from a town he was familiar with. Dad was so happy, otherwise he would probably eat in his apartment.
I know for myself, I don't like to eat out. I just find the noise gets overwhelming and it is hard to talk to the others at the table. We do carry-out and eat at home. Plus I can wear fuzzy socks.
Has your MIL been screened for depression? She seems to be avoiding the socialization as much as the food. And when in pain you really aren't interested in eating or talking or much of anything. My suggestion is let her eat whatever she wants. Calories are the important things right now, not healthy meals. Get her food she likes, inclulding Coke, which requires no preparation. Also, get some Boost or Ensure and have her drink it a couple of times a day. Moving to Assisted Living may not help with this since my dad's assisted living works like her current situation - meals can be delivered at an extra cost and no one 'makes' you go to the dining room if you don't want to. I even have an aide in the afternoons especially to encourage him to go to the dining room and be with him during dinner and all that ends up happening is that she brings his food up to him. I don't fault her at all because she is required to take her cues from him.
I had to do this with my dad and it was very effective. He found out that some of the people were really nice to visit with and he could tell them any story he wanted.
We all need some help adjusting to BIG life changes, help her find the good and settle in.
I would definitely get her some type of pain control, whether massage, accupressure/puncture, PT or meds, because a good pain doctor will always treat the emotional, psychological and physical aspects of chronic pain, it can cause depression, as well as other issues. So get her seen by her doctor to treat the pain and depression and help her adjust to a very BIG life change.
I wouldn't cut off the foods she likes but try to supplement her diet with some other healthier options that she doesn't need to prepare - single servings of yogurt, fruit cups, applesauce....
And finally - she sounds depressed, not just sad but clinically depressed. You/she need to talk to the doctor about that.
Sounds like depression. She is not adjusting to the change. Its hard for the elderly to adjust.