Late last year, I told my Mom’s (82) Doctor that she still isn’t eating enough and losing more weight. She doesn’t do much but sit in her chair all day and watch TV and sleep. He suggested that she drinks Boost drinks. Much to my relief, she loves Boost and I was excited to find cases of 24 bottles at Sam’s club for $20 (sale price), but they’re back up to $25. I thought this was a great idea to supplement breakfast and lunch, but she’s going through a case in 4 days. Initially, a case would last a little over a week. As of today, a case of 24 only lasts 4 days, which means she drinks on average 6 bottles a day. While I’m excited this is working for her, she still isn’t gaining weight, but she doesn’t seem as weak or frail. The bigger issue for me is that this is an expensive solution and she is not eating prepared meals, except for when I bring them. She eats very little and leaves the leftovers to go to waste. She is essentially on a liquid diet. I have no idea how to get her to eat more food. I tried to cut back on the frequency of the Boost cases, but she’s going through them even faster now. Need suggestions as to how to figure out the best and most economic solution. Because of my persistence, she is now offering money. I told her I can’t afford to buy $25 cases every 4 days and don’t think she should spend money drinking that much Boost. Need suggestions and advice. Thank you!
I am sorry to hear that you have to spend $25 dollars every 4 days on Boost. That is about $50 per week.
That is a lot of money to some people, and people with money can often be insensitive to someone having to spend that much each week.
As someone else suggested A vitamin mineral supplement plus a whey protein supplement may be less expensive to use.
If dental problems or swallowing issues are the cause can you blend food in a blender to make it soft. For example mashed potatoes and carrots with milk added for protein.
Puddings with an extra egg added during cooking may help. Applesauce, yogurt, farina with eggs added during cooking, high quality ice cream, etc.
Is there an issue with dentition? Can she breath while she is eating? COPD makes it heard to eat and breath at the same time. If so would she benefit from eating soft goods and nutrient dense soups? Would she benefit from eating a more plant based diet? Is any medication causing loss of appetite or upset stomach? Does she have a dining buddy? Is she suffering from depression or body dysphoria? Is this a control issue? (Has she lost control over many aspects of her life and she is maintaining some sense of control by what she does and does not put in her mouth?)
I think she needs to be assessed by her PCP as soon as you can get her in there?
It does sound like she needs more daily support and stimulation.
I think that an average of 6 of these types of drinks is too much and a vitamins & minerals overload, however if she was weak & frail before and it seems she’s getting stronger maybe she’s absorbing most of the vitamins & minerals (we don’t all absorb all vitamins & minerals The same way). Find out with bloodwork from her Dr if all is okay and as it should be. If she has the funds for this, of course let her purchase them. If my mom wasn’t eating anything at all but at least drinking fluids and being hydrated sometimes that’s what’s best, definitely ask a Nutritionist, Geriatric Dr. What about diluting each can, with water or juice, so that’s it’s 3 a day instead?
Puréed foods, soft foods are the way to go along with these drinks. making them yourself is way more economical than purchasing a delivery system, but whatever is best for you both is the route to go!
I make NutriBlasts every morning for me & my mom, I’ve been doing these for breakfast for 13 years and the only time I didn’t (couldn't really) was when we went on a cruise, the appliance was not allowed on board!
I add 3 servings of veggies, 1 fruit serving (we’re both diabetics), non-fat Greek yogurt, chia/flaxseed, raw pumpkin seeds, raw sunflower seeds, raw walnuts, cocao, turmeric, Ceylon cinnamon (all unsalted), it’s full of protein, healthy fats, fiber & good carbs. It’s expensive but worth every penny and a lot of work every morning to chop and blend lol. I also cook lunch & dinner and provide healthy snacks on a daily basis. My mom does have a choking problem with beverages like water so I bought her a sippy cup (the childrens kind) I’ve tried special cups with the nose part cut out for this type of problem, still choked, even bought a special type of straw that didn’t work with water.
Good luck with this, it’s tough taking care of someone else.
She should be getting regular blood work to monitor her absorbtion. Terumic , wrong spelling, is not good if she has low kidney function or previous kidney disease. It is an NSAID, and though 'natural', can cause kidney damage!
You need a geriatric Counselor/ O.D./ NP! Speech therapist to help with thickening water! Other suggestions.
If you are close by, maybe you can cut the Boost with fresh milk. Buy some drink cups with easy snap lids so the drink opening is similar. Then make up enough for several days, gradually increase the milk...or water/ juice in non-dairy forms. They also make it more palatable and easier on the stomach.
But monitoring her blood, & perhaps urine, by someone who will order tests appropriate for her age and lack of solid food is critical.
She may be just lazy & like the flavor. Or she may be avoiding needing tube feeding by drinking her nutrients. Maybe add some baby cereal to add bulk for her gut. Even baby fruit or puree it. It sounds like you are not near enough, or available to be fixing her meals. So this is something that can be ordered & delivered & keep her in her home.
Realize that in Assisted living she can still just not go down for meals that are paid for. If she is maintaining weight on fluid nutrition, they will allow it.
Hope you can find specialist to guide you. The alternative is forced feeding in a nursing home or hospital. I think she will fight you and since she is competent, she legally can refuse! Even sign out AMA & take a taxi home
She refused to eat anything and said food made her nauseous. That went on for almost a year. The good thing was that she got MUCH stronger. She went from needing the wheelchair when we went out, to using the walker, to the cane and to walking on her own without help. One time when we were out, I told her to wait for me downstairs while I went up to the 2nd floor of the parking garage to get my car. She refused to wait and followed me up two flights of stairs. I was shocked that she had the strength to do that. She was out of breath but she made it up.
Anyhow, this diet was costing a lot of money each month, but her SS money was used to pay for it, plus I didn't have to cook special food for her anymore. So, one less thing to worry about.
However, last January, my mom moved to her own place which she shared with her sister, my aunt. My aunt could convince my mom to do things that I couldn't. So, gradually, my mom started eating food my aunt cooked. My aunt is a very good cook. She used to work as a cook at a casino in Vegas, so everything she cooks is delicious. Also, my aunt tells my mom she can't go out if she doesn't eat and polish off her plate. My mom is still very healthy, and she only drinks one bottle of supplement a day.
For you particular situation, I don't know what to suggest to make your mom eat more solid food. She is getting a lot of vitamins and minerals from the Boost supplements, probably way more than she needs.
To save money, perhaps you can wash and refill the empty bottles with flavored milk or diluted juice and place them in the fridge? Maybe you can puree some cooked oatmeal in with the milk so it has some bulk? Will she eat/drink puree soup?
Oh, I also used to add some water (1/3 bottle) to the supplements I gave my mom because she refused to drink water. Maybe, you can add water and make more drink using the empty bottles, also keep them in the fridge so they don't go bad.
I agree with those who have suggested that you find more nutritionally complete liquid nutrition that would be more like a meal. However, it may be a losing fight to try to cajole or force her to eat more solid food. Ultimately, the struggle will be yours, not hers, and you will probably lose.
I would suggest that you do make sure that she have good, soft foods available to her, like packaged macaroni and cheese and frozen scrambled eggs. Buy things that are real food, but soft. Another good option is little containers of cottage cheese with fruit. These things are not economical and they are not environmentally sensible (so much single use plastic!) but if they are present and easily available your mother may eat a little. Don't overbuy. For my mother, I buy just one or two of something, then check the refrigerator/freezer the next week to see if thy have disappeared. Usually they have not.
If there is nothing that you find that she willingly eats, you may have to reconcile yourself to the idea that her body is simply changing and her interest in the process of eating is failing. Take your time, spend time with her, try to enjoy what you can of her last year or two, and let the process work itself out. Try not to become obsessed with her eating. It will help neither of you.
When my husband's aunt, whom I loved as though she were my own, was in her final months I spent a lot of time in her hospice room. I arranged to work on my computer in her room several days per week (there are advantages to being a computer programmer). One day I was working in the corner and Aunt Dari's sister was by her side, offering her water, juice, applesauce, etc., etc., when Dari finally pushed her away and told me to please come over to her side. She glared at her sister, then looked at me and said, "She thinks that if she can force enough of that crap down my throat I won't die." Then she thought a bit about what she said and laughed. "I'll win this fight. You wait and see. I'll die anyway." Then she laughed again. I held her hand and we talked of times past, walking through Central Park, the flowers by the lake, all the good times. She passed about 4 weeks later.
There is no medical explanation that I have heard, but this happens so often that I think we should think about respecting the wishes and desires of those who are in their final years. The goal is not to keep them alive as long as possible, but to keep their life as good as possible as long as their bodies are willing to live.
I'd suggest, from personal experience as well as empirical observation of numerous others in such predicaments, that it is time to find a professional to help assess mom's need for assistance at least part time.
I struggled with a great many of the same issues you have offered in your own case, and through much agony and trial by fire, I finally realized that cognition and conversationalism does not equate with self-sustainability. In otherwords, simply because mom has all the trappings of a person with the ability to function on her own, she simply does not any longer.
I'm 33, I've been caretaking my late 80s grandparents for several years now who both have very different levels of care, but I knew when they were no longer remembering to eat the food I'd spent much of the weekend preparing for them because they "forgot" or it was "a lot of work to plate and heat" said food, that they couldn't live on delivery which is largely comprised of carbohydrates and 5x the safe daily dose of sodium.
Learn to see reluctance and excuses to neglect oneself as a subtle, albeit perhaps unwitting message -request perhaps- to intervene and increase care as well as your own peace of mind.
It sounds like resources may be quite tight. The bottom line: if mom has the funds, she should be paying for her food her care, period. She can not take that money with her when she's gone. If you have a reluctance to discuss this with her, you must move beyond it and lay out reasonable terms to both fund and alter her lifestyle in a way that suits you BOTH.
This can be a very difficult thing to do for the kind and empathic ones out there, but life does not wait for you to become ready, life moves in sudden and unexpected directions, swiftly and often without subtlety.
Check out the National Institute of Health (NIH) as well as your state and county's local resources and departments Aging. Most have them and they are incredibly useful.
I wish you best of luck, and even better diligence in moving swiftly forward to a reasonable solution. Mom will likely be much less resistant than you fear.
I’m going to be blunt here. It sounds like she could be declining. Do you have paperwork in order now in case her health suddenly takes a turn? We did not realize how fast our dad was declining since he lived alone. Are you on her bank account? Do you have POA? It’s so much easier to take care of that now. My fathers eldercare attorney charged quite a lot to travel to his nursing home and get his signature on paperwork. If she owns her home is all the paperwork in order for you to sell if necessary. It’s very expensive and a long process if not.
Can you spent time and help your mom eat the food you prepare? My dad is in AL and the staff or I have to sit with him to get him to eat. I’ve noticed quite a few of the patients are the same way.
I think you need to provide a very soft diet in lieu of the drinks. If you have difficulty making them, they are available from Hormel's, Nestles, and Thick-It direct or through distributors.
However I run a Nutrition Business ( no not selling products) but educating those who have a hard time with diets and general nutrition advice for elderly.
Through lots and lots of research I came across a 500 calorie a day shake with 22 grams of protein.
I just did some reading on Boost Shakes, They are only to be used as a supplement to a balanced diet , not a meal replacement.. BOOST ORIGINAL NUTRITIONAL SHAKE: BOOST Original provides 10 g protein, 240 calories, and 27 vitamins and minerals to help you get complete and balanced nutrition. Perfect as a mini-meal or snack. ... Chocolate, strawberry, & vanilla flavors make it an easy & delicious way to add nutrition to a balanced diet.
Here is the nutrition label for boost:
https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.boost.com%2Fproducts%2Fhigh-protein&psig=AOvVaw0PBIET_QMicQyr7SfeGT_4&ust=1583160037100000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCMj3rYbB-ecCFQAAAAAdAAAAABAF
Now I order my Moms Nutritional Shakes for Hormel Health Labs www.hormelhealthlabs.com and i have her use Hormel Vital Cuisine Shakes, they are more money then Boost BUT they will probably help her stay full longer as they contain more nutrients then Boost
label from Vital Cuisine : Notice they contain double the calories of boost , and have lots of potassium that seniors need.
Nutrition Facts
1 servings per container
Serving size
1 Container (8.45 fl oz/ 250mL)
Amount Per Serving Calories 520 % Daily Value* Total Fat 21g 27%
Saturated Fat 3g 15%
Trans Fat 0
Polyunsaturated Fat 0
Monounsaturated Fat 0
Cholesterol 30mg 10% Sodium 380mg 17% Total Carbohydrate 60g 22%
Dietary Fiber 0 0
Total Sugars 27g
Includes 21g added sugars 42% Protein 22g 44% Vitamin D 0 0 Calcium 650mg 50% Iron 1mg 4% Potassium 380mg 8% Vitamin A 20mcg 2% Vitamin C 0 0 Vitamin K 0 Phosphorus 0 Magnesium 0 Zinc 0 Copper 0 Moisture 0
* The % Daily Value (DV) tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day
and the ingredients:
Reduced Fat Milk, Water, Maltodextrin, Milk Protein Concentrate, Canola Oil, Sugar, Contains 2% or less of Cocoa Powder Processed with Alkali, Stabilizer (Sodium Citrate, Sodium Phosphate, Sodium Hexametaphosphate, Ascorbic Acid, Carrageenan, Maltodextrin), Propylene Glycol, Soy Lecithin, Xanthan Gum, Ethyl Alcohol, Natural and Artificial Flavor, Ascorbic Acid, Gellan Gum, Carrageenan, Modified Food Starch. CONTAINS: MILK, SOY.
Notice that protein concentrate is the #3 ingredient in this shake.
If you say she only eats meals you prepare continue to do so, tell her these shakes are to compliment her meal, say like a nice dessert. do you buy her healthy options of single servings frozen dinners? They come in handy when time is an issue. Whatever you do get her off those Boost shakes they are not giving her the nutrition she needs... If you need any more help please reach out to me and again I'm not trying to sell you anything I just want to make sure our parents as they get older have the proper nutrition...
Other possibilities that I feel are worth mentioning/repeating....
*mouth hygiene; ulcers can form under dentures that are not being cleaned/removed daily. This is very uncomfortable to eat with. Dentures should be removed at night, mouth and teeth should be cleaned daily at a minimum.
*smaller appetite= smaller portions. Package meals in small containers. Label clearly, maybe add reheating instructions. I use paper medical tape. It is easily removed. Freeze extras in small container to pull out easily when needed.
*limit accessibility to boosts/ensure. Label these also if you want with the day. Explain they are a treat/supplement, not a meal replacement.
*Increase social activity. I read that she didn’t enjoy some of the things you tried, but keep trying. Can a grandchild, nephew, neighbor, friend eat a meal with her once a week? Those visits can add up. It does take a village! If she used to enjoy cooking, definitely include her in the grocery list, shopping and meal preparation. Cooking together is fun. It may elevate both of your moods. Senior cooking class?
*access to high calorie/high protein snacks. I bake sweet breads, add vegetables, protein powder, slice and leave in a visible area in the kitchen. When she goes to the fridge looking for a boost, she can grab a slice of something sweet and (somewhat) nutritional. I also put out salty snacks to encourage thirst. Which leads me to...
*Dehydration/UTIs are so common at this age. I would also purchase Gatorade and push water/fluids/juices. These drinks will help keep her hydrated, giving more energy as well.
Keep up the good work!
Second thing is she should be in AL so she has meals made for her and company to eat them with.