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My dad was always one of those guys who could eat anything and never gain weight...until he got older and was less active.. Then he began to put on weight and then even more when mom died. I believe he turned to food to take the pain away. For the last eight years, he's had a real love affair with food to the point it was the only thing (besides going to the casino) that made him happy.

Problem was, he was also a lifetime smoker and that, along with being a foodie, have left him with congestive heart failure, COPD and liver desease...three reasons he's not living alone anymore. A few months ago, being up to nearly 225 lbs (he's 5'10 tall) he had a real issue with gout that put him into the hospital, and his sugar levels were high, so they told him in front of my brother that he really should try to lose some weight and start watching his sugar levels closely.

My brother has always been a health nut and he's hated the way dad's been eating so he's taken this opportunity to put my dad on a very strict diet of few carbs, no sweets, no salt, and very small portions. At first that sounded ok to me, but now I'm not so sure. The last couple of times I've talked with him he just says how awful life is now that he's not allowed to eat. One of the problems is his dentures hurt him so he won't wear them and everything soft is "bad" for him. So he really is always hungry.

My sister in law, who is the main caregiver, confirmed that he's totally miserable and that when she tries to talk to my brother about it, but he refuses to listen, that he doesn't want to see dad die in pain like he was with the gout, not on his watch anyway.

So what is the answer here? In a few short month's dad's dropped back down to around 190. The way I see it is he's 87 years old with congestive heart failure and COPD... what more damage could this food do? I wonder if the metal anguish he's feeling by not being able to eat what he's loved all his life isn't worse then the physical problems the food might cause. At least with the physical he can take a pain pill...not much he can do about the misery. I did suggest antidepressants, but my sister in law says the Doctor is worried about how they would mix with some of his meds.

This is breaking my heart for dad, and yet I understand why my brother thinks he should eat healthier. but is that practical at this point in his life?? Anyone have any suggestions? Has this happened to anyone?

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Back from trip and I got my brother to promise to lighten up and my dad to promise to try to eat better, if not for my brother's sake, but for his own health. Best I can do I'm afraid. Fingers are crossed.... I also promised brother I'd make the 7 hr trip more often through the year, to give him and sis in law more long weekends away. It's kinda like recharging the batteries.
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You have made some points that brother could be trying to prevent pain. In the case of my brother and mother, it was about control.
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Dustien, to copy the thread, the best way is to copy each post separately.

1. Place your cursor on the thread, highlight it all (it'll show up in a blue background).

2. Hold CTRL + C keys together (copying function)

3. In an open word processing documents, hold CTRL + V (paste function).

Alternately:

1. Same as abovde.

2. Right click, click copy.

3. In a word processing document, right click, click paste. If you're using Word 2013, you might have 3 choices of how to paste: (a) keep source formatting (b) merge formatting or (c) keep text only. You can experiment to decide which one is easiest for you to read.
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Jeanne, you know I love you...its just, well, think of it this way - suppose someone was badly allergic to oh, let's say seafood - but they loved to eat fish and insisted on eating fish and didn't "want to" give up eating fish...and so ended up in the ER six times a month. Then someone talked them into giving up eating fish, and all that stopped...but they started eating shrimp instead because they were so depressed about not eating seafood. And they just honestly felt that they SHOULD be allowed to eat shrimp because they had given up fish. And the person who they live with is told they have no right to quit buying and supplying shrimp OR fish upon request, just because they have to run this person to the ER every time. I'm not sure that's a slam dunk ethics case one way or the other.

I know, this is not exactly the same thing, and yes, brother ought to ease up a bit, but unless you are truly talking about someone's last supper or their time in hospice care, it may matter very much what they eat! Maybe we need a Least Restrictive Environment approach to eating plans...whatever gives a person the most pleasure and choices without wrecking their health?

My patient was someone who too many people considered a short timer - happens not to be necessarily true - but part of the loss of health in the first place was misguided unrestricted eating (and drinking of sugary sodas by the 2 liters a day) born of the same kind of pity. And this guy probably does not want to get sicker and older faster than he has to, but like most people does not connect the dots.

As far as taking care of the gout with medicines, you can't always put out a fire while someone is pouring gas on it. We can treat asthma with every drug in the book, but until someone cleans up the mold and mildew and stops smoking in the house next to them, very little headway will be made. I doubt this guy really "wants" to stop all coaching and limitations on his diet if it means getting his gout back and maybe even becoming immobile. I doubt my poor grandma, really "got" it or really consciously thought that whatever extra pleasure she got from eating apple pie instead of apples every single time, was really worth losing her legs and her eyesight over - and dying of diabetic complications at age 60. But she did not have a coach, she had my mom, who pretty much believed the eat what you please thing. This guy at age 87 - could spend whatever time he has left, which could be a few years, getting fatter and sicker, hospitalized with his CHF or in pain most of the time, versus hardly ever; it really does matter what he eats.

Anyways, FWIW, it is good to hear that other point of view expressed by someone whose opinions I respect... it opens my eyes to the idea that a lot of the rocket-off-the-growth chart cases we see and feel frustration about because the problem is denied and no changes are made - are probably due to people thinking either black or white like this - either I eat everything I want whenever I want or I am miserable; or OTOH, either I restrict my eating totally to what someone else says I should and should not eat, some of which may be completely wrong, and rebel and resent the h3ll out of them, vs making reasonable choices and compromises.
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I'm picking out a sentence from the original post that speaks to me - and perhaps warrants a tiny bit of sympathy for the brother: "he doesn't want to see dad die in pain like he was with the gout". I can relate. My father suffered terrible CHF the last two years of his life. Daddy was also on varing amounts of Lasix which he hated. So the doctor put my dad on a "no salt" diet. My mom almost appeared to be trying to kill my dad with what she would cook for him. When I would try to talk to her about adjusting what she cooked she'd reply "but he likes it" or "it makes him happy". Worst of all were the days mom would take dad out for a drive and end the trip with a visit to McDs for French Fries - and yes, daddy loved them. Problem was - every single time following one of these little jaunts or after a sausage dinner, daddy would be in horrible distress breathing for two or three days. The Lasix would be adjusted, then the potassium- UTIs would develop because of the increased urination in depends- which became problematic to change because my dad couldn't breath to move. Trips to the ER often followed to get dads lungs drained. Of course mom couldn't deal with any of this salt aftermath so it was myself and the caregiver cleaning up the crisis. After it was all over we'd have a peaceful few weeks and then it would all start over again. I loved my father as much as any child can - truely, I adored him and seeing him go through this time after time for French fries or sausages broke my heart! So - maybe give the brother in this situation a break? Maybe it is compassion and love - not control that is guiding his actions. I do agree that there is space for a compromise here but maybe take another look at brothers motivation before you decide how you want to approach this topic with him?
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vstefans, absolutely I would encourage that young woman to make changes, even drastic changes, in her lifestyle to be able to pursue a fulfilling career. I would encourage, explain, educate, cheer her on ... anything I could to persuade her. But I would certainly stop short of forcing a strict diet on her.

This post is about an 87 year old man, with serious chronic conditions, not about a young person with her life ahead of her. You are probably right that he could, if he wanted to, make changes to his diet and still find satisfaction in food (if he were motivated to). But the point is HE DOESN'T WANT TO. What crime has he committed that he has to give up his freedom of choice? Getting old? Being sick?

Maybe Brother is acting in love. Maybe Brother is a control freak. But whatever his motivation, I think it is wrong to force his will on his father. I mean ethically wrong.
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The copy-and-paste option isn't bad at all if you are on a computer. It just takes three copies. If you are on a cell phone, I guess that would be harder.

If you like, pm me your email address, Dustien, and I'll email them all to you in a document.
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Does anyone know how I could copy this whole thread? I don't know if I could get my brother on here to read it all (I've been trying for two years to get both him and my sister in law on here for help). But If I were able to copy all the posts here off, then I could just give it to him to read... An easy way..one that doesn't involved copy/pasting all the answers...though I will do that if I have to, but deadline is coming and I've so much to do between now and the time I leave for Texas.
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At your dad's age suddenly switching his diet is not going to reverse any of his health problems. Your father should have some rights being an adult. In any nursing home he would have the right to choose what kind of food he wants because it is state law.He should have the right to choose what he wants to eat at home too. He would be better off working with a speech therapist and dietitian to find a compromise on some good tasting foods that he may like ...that are also the right texture to make it easy to chew/ swallow. Your brother is probably making your dad very anxious and sad because he has lost one of his few ways to have any control over his life,which would be to choose his own meals. Your brother is actually being really disrespectful of his dad by not giving him choices.
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He is 87. With COPD, CHF , and diabetes, it is a miracle he is still alive. Let the man eat what he wants. Gout can be treated with medication, as can high blood sugar. It is a little late for lifestyle modification at this point. I think brother is a control freak.
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I don't know, Jeanne, I guess I really do think people of most any age could get used to different tastes if they aren't too convinced psychologically that all "healthy" foods must taste like cardboard...I see so many memes and posts that seem almost "brainwashed" in that regard. You can go half the fat or half the sugar first and actually those are basic taste bud/mouth feel things that really do adapt - think about how sweet one thing tastes after you have something sour, or how bad a dry wine tastes after you've had something sweet. I've seen some people who do change and save themselves from disaster when it comes to diabetic complications and some who do not. I have a patient with diabetes and a pretty bad neuromuscular disease who has turned herself around and probably won't lose her eyesight now, and won't lose her chance to have a career that she has been studying for years for...I had a gramma who um, didn't, and we lost her way too young and she was an invalid, bored and unhappy for years, and my own mom of course who lost years of life even though she did manage a little better. It's not self-righteousness, its knowing what the sum total misery can be of obesity-related diseases. I have to admit my heart goes out to the brother who would find it unbearable to just watch him eat whatever he wants, however much and whenever...as well as to a guy who is going constantly hungry, which is obviously too extreme too. On the flip side, people with low appetite also find it hard to meet their nutritional needs and can have serious health problems too, up to and including death, and always remind myself it is just as hard for them to do what they need to do in eating more as it is for someone like me in eating less. I would not be really happy either if I did not enjoy my food, but its a case of staying focused on enjoying things that aren't going to do me in either. I don't really buy the idea that a person simply can't be happy UNLESS they can eat anything and everything they want any time they want - I will never be able to do that myself, but I am determined to to let that ruin my joy in life.
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When my dad was in the advanced stages of leukemia, he mainly wanted to sit on his porch and drink Old Milwaukee. Since he was still on chemo and other meds, we pushed him to stop. Now that I am so much wiser about these things, if I were dealing with this today, I'd do it a lot differently. I'd go out and buy him some better beer and tell him not to over it too much. Life is short. Eat dessert first!
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What good is quantity of life if the quality isn't there? The idea of once a week dad choosing his favorites is a great one.
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I love how family members take over the lives of their parents.
Your brother is quite uncompromising. Watch that. It's a big red flag.
And this isn't his life! It's his fathers.
Let him eat what he wants. There are worst things than death as we all know.
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My Mom was in a similar situation, getting her a new set of dentures (no matter the cost), was probably the best thing I have ever done to improve her health. Now that she can actually chew the food, it opens up the variety of healthy food she can eat...and enjoy. At 91, there is not a whole lot left for her to enjoy, so being able to eat (and digest) has made her life better, she has been able to get off the antidepressants, and just feels better about herself. There are also many delicious sugar-free and healthier foods out there that he may be able to enjoy. I know how tough it can be, and my heart goes out to you for trying to provide the best care for your Dad.
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At 87, he's earned the right to eat whatever he wants, whenever he wants. Why would someone want to make him miserable? For their own self righteousness?
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I can picture my brother pulling something like this on my father. Along with the love can be a great deal of anger between father and son. It's probably a power struggle.

I think that some kind of professional needs to intervene with your men. Ask him questions like "How long will Dad live? Do you think that this restricted diet will prolong his life? Do you think he is enjoying his life right now? Is it OK with you if he is miserable, so long as he eats a healthy diet? What about easing up some after a loss of 25 pounds?" As a sister, I couldn't have that talk with my brother! So they need a bit of family therapy. Does brother go to the doctor's appointments? Maybe he can suggest easing up.

Families!
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Pam, one of the first things we are doing is going fishing. Found out there's a state park only 20 minutes away and no fishing license is needed when fishing inside of state parks in Texas! I so hope it doesn't rain. Brother and sis and law are going on to be spending the weekend out, so I'm also taking him to the Golden Corral after a day of fishing. It's his favorite restaurant and he turns 87 on the 24th so it's my Birthday present to him. And we're NOT telling my brother! LOL!
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Home with me for an extended visit, not for good is what I meant to say.
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You guys are all such a blessing. Thank you for all the great thoughts. I am going into the situation a bit better armed now. I like the idea of physical therapy, getting dad walking more... telling him that if he wants to eat things that aren't as good for him, then he needs to at least work out some exercise program and if it takes some physical therapy, then so be it. Perhaps his dr can work something up so insurance will help cover part of it.

They have had my dad to a dentist and he's not sure he can do much about good fitting dentures at this stage of the game. I have found a number of decent looking recipes for people with mouth problems or no teeth that are soft and look rather tasty. Most aren't going to fit into my brother's strict plan, but I'm going to ask my brother to loosen up on Dad...at least maybe every third day or so let dad have foods he's used to? I just know he needs to lighten up.

This trip I'm only there for 5 days. I have to be back for my granddaughter's graduation from Elementary to Middle School. It's a big deal to her and she and I are closer then most grandparents/granddaughters. It will crush her if I can't be there, so I will be. I want to help brother and dad, but it's going to have to be from afar this time.

Till now my brother and I have always been on the same page. I'm not sure what to expect now though. I know he wants me to bring dad home with me, but I don't see dad wanting to give up all he's known for the last two years and leave his doctors to come home with me. This is going to make my brother mad, because, like many of you, he's really needing a break. But I'm not going to force dad to come home with me...that wouldn't' be good for anyone, would it?

This is going to be an interesting trip, without a doubt.
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vstefans: "I promise you if you retrain your taste buds a little they don't need to be sugared up."

Really? You can make that promise to an 87 year old man who recently lost his wife and for whom eating is a primary source of pleasure? I know absolutely at 35 or 42 or maybe 50 retraining taste buds is entirely possible IF you are dedicated to doing so. I would never presume to promise this to someone 87 year old probably fighting depression and with no interest in retraining his taste buds.

This man is being denied the right to feed himself as he sees fit. I find that outrageous.

Stating the wholesome things you like to eat is totally beside the point. What if you went somewhere to live that only served you deep-fried food and full-fat dairy? Seldom was seen a fresh fruit or leafy vegetable. If you said you missed having fish they battered it and fried it? They didn't know their stove had a broiler. They ate that way and liked it. Why are you complaining?

Food preferences are a very personal thing, and denying someone's right to make choices is, in my book, cruel.

I almost always admire your answers, vstefans, but in this particular case I think your sense of the "medically correct" answer is losing sight of the emotional and psychological aspects of having a diet forced on you. And I think you are offering a promise that you can't keep in this particular case.
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On a more serious note...I very sadly remember my grandma who felt she had no pleasure in life besides eating - and how it destroyed her body and her whole life really - she died of diabetic complications, losing her eyesight and her legs, before she did, which was several years before her mom, my great grandma, who ate a little healthier, lots of fresh farm foods, though still too much and had a lot of the same problems eventually. There has to be a balance I guess.
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Get a nutritionist involved. Eating crap is going to cause pain such as gout, but there are genuinely tasty foods that are not going to be so bad for him. not eating anything you enjoy is just about as bad for sure though, you are right about that!! I can't relate to the heavy syrup and full fat milk thing - skinny blue milk is just right for me and full fat anything does not even taste good, I say that's all what you are used to. Summer is coming and he should chow down on cherries among other things. I promise you if you retrain your taste buds a little they don't need to be sugared up. I treat myself to soft serve and low or non-fat frozen yogurts, and the fancy overpriced nonfat real daily whip topping they sell at Whole Foods too. Smoked salmon or ANY kind of salmon and yogurt with fruit on the bottom, is absolutely fine!! An egg a day won't hurt anyone either. Dang it now I am hungry and I'm going home to get dinner!! Probably a veggie and mozzarella pizza, with fresh strawberries for dessert. :-)
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If he is 5'10" and 225lbs, he is not morbidly obese. Now as for the gout--it can destroy your kidneys. It usually happens when the diet is lacking in vegetables and high in hard liquor consumption.
The wanting to die? That's depression and it is treatable. Ask the MD.
Take Dad fishing. Fresh air on a lake is good for everyone.
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This kind of restriction makes me fit to explode. The poor man is 87 years old and has lost his wife. Does it really matter if he eats himself to death as long as he is competent to make that choice.
Of course no one wants to loose a parent but do you want him to live in misery?
I am 77 with multiple health problems and was put on a soft cardiac diet in the hospital due partly to dysphagia.
I was severely emaciated with muscle wasting and any food I could get down was a plus. No sugar no salt,fat free milk (white colored water) cream ha ha of wheat made with water. A cup of luke warm water and a tea bag. Scrambled eggs made with dried egg powder, no salt or ketchup. offered a sandwich and when it came two slices of plain bread and slices of meat, canned fruit in water, plain fat free yogurt. What did i do? i wasn't hungry so did not care if i ate or not but told them id they brought another tray like that into my room I would throw it out into the corridor. Didn't do any good so hubby brought in a mini fridge stocked with full fat milk,cans of fruit in heavy syrup. Yogurt with fruit on the bottom. smoked salmon. I still could not eat much because of being so sick but i did try. The nurses were merely amused and encouraged me with cups of coffee with 1/2 and 1/2 and as much sugar as I wanted and hot chocolate with extra cream. there were also cans of regular ginger ale not the diet stuff.
my point is that when seriously ill or at the end of life.
How many people write on this forum that their loved one in the end stages of dementia is eating less and less and they are afraid they are starving themselves to death. Dad may be eating him self to death. There is the healthy way to deal with this then there is the kindly way. End of life are is about comfort. Dad is not comfortable. OK I am ready for the bricks to start flying as I know so many people won't agree with my point of view but all I can say is been there done that and it is a rocky road to travel.
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Since you are responsible for advocating for your father but wanting to be respectful of your brother you might be caught in the middle when you go for your visit. A tough spot. Do you have plans to get your dad to a dentist while you are there for the visit?
Does brother have a weight goal for dad? Too rapid weight loss can cause a gout attack. Are dads blood sugars better? Has his uric acid gone down? Remember that it's much easier to get weight off than to keep it off. So his transition and maintenance plan will be crucial if he deviates from brothers program. Gout is a hard disease to manage. Excess Weight makes it worse of course but so do many otherwise healthy foods. It's a catch 22. A plant based diet works but elders have a hard time getting all the protein they need without eating meat. Beans and eggs only go so far. I'm sure vegetarians might disagree. Salt restriction is more important for CHF than anything else and people can really get adjusted to less salt in a fairly short amount of time. I know you are proud of him for quitting smoking. That is so hard to do. Probably had a great deal to do with his weight gain. Some of the popular diets have plans where once or twice a week the dieter gets a free day to eat whatever they want. However if your dad eats salty foods on those days his weight and more importantly his fluid retention will go up.
Walking will make him feel better. It will help all of the problems you mentioned including the depression. Maybe you can arrange for some therapy for him while you are there. Talk therapy is good but also physical therapy. Ask his dr to order it for him. Being there a few days will help you get a better idea of how things really are. Sometimes dad might just need you to complain to. It's hard to hear our parents be so unhappy and not try to help. But having a sympathetic ear may be very important to him. No doubt he has been on a restrictive diet but it might not be as bad as he is telling you. When you see for yourself what and how he eats you might decide he's doing pretty well. It's not easy to manage another persons life or to be managed. It's really not easy to see them in pain like brother saw him with the gout. I don't disagree with the posters who say let him do what he wants but I also know he is most likely grieving for his lost pleasures and if he will give it a chance he will feel better overall. It will probably also help him if he has a chance just to talk out loud about his dissatisfaction with the diet. Maybe you can ask brother to allow him an opportunity to say how he feels. Sometimes that's all we need. Just a chance to vent. After all, he can't go on agingcare.com. Best of luck with all.
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im 58 yrs old and ill eat automobile batteries if you suggest i shouldnt . free will is a big deal in the usa .
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How about having one day each week where he can choose his favourites? It would give him something to look forward to and shouldn't cause any major problems, since he would be eating well the rest of the time.
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I'm wondering if there is a possibility of all of you seeing a family therapist or a dietitian while you are there?? It seems like there MUST be some possibility in between super strict, and eat whatever he wants, which could satisfy all parties -- even if imperfectly. It does seem like your brother also needs to be reminded that your father is an adult, and able to make his own decisions! Professionals are good at getting those kinds of points across without inflaming conflict -- that's their job..... Or if that doesn't work, go to a therapist yourself for a few visits and see if he or she can help you come up with something!!
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My general impression, let an elderly person eat what they want. I use to look at my Mom's grocery list for her and Dad and 75% of it was sweet laden items because one's sense of taste tends to go away but an elder can still taste sweets.

Now the gout is a big issue, but unless Dad doesn't mind getting gout if he can eat anything he wants, it might be worth it to him.

I can understand your brother's way of think being he is big on healthy eating... but would he like it if he was in his 80's and someone told him he could only eat carbs? Bet he wouldn't be very happy.

Can your Dad do a lot of walking? Now that Dad is down to 190 lbs he might be able to maintain that weight by just walking and go back to his old way of eating but without the second helpings and less deserts.
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