CHRISTINE ~ New Issue ~ Please Input

[StephN]

Hello everyone -
Danielle, I am taking the liberty to post your latest news on your mom (our site's founder Christine) here so more eyes will see it.

Chris has a problem with having lost too much weight, and Danielle is asking for ideas here.

"Thanks for all of the cards and letters, everybody. It's been nice reading them to Mom during our visits, and she's very proud to be reminded of all of the people she reached out to and touched by making this organization with my father so many years ago. Plus, it shows all of the nursing staff there that Christine is not 'just another patient' -- she's achieved and accomplished so much in her time, namely in breast cancer advocacy, and although her dementia has made it hard for her to communicate that, she certainly gets a kick out of being able to show her CNAs just how involved in advocacy she was.

Cognitively, she's become much more engaged in conversation. Granted she can only say so much at a time before she's somewhat lost focus on what she was saying, but her memory is good and her reactions are appropriate to the subject, and she can still finish the lines of all of her favorite songs.

The only problem I have is that she's lost a tremendous amount of weight. She was traditionally a size 12 or so, and now I bought her something from Target in a small size and it still seemed a little bigger. The nursing home's social worker asked me if I would want to put her in hospice, saying that because of how much weight she's been losing, many nurses working with her feel like 'it's time'. However, when talking to Mom about it (as, of course, I want this to be HER decision while she's still capable), she said that she still has an appetite, still wants to eat, and doesn't feel like she's ready for hospice at all. Some days when I bring in soup (or sneak in dessert for my 27th birthday last week), she will eat the entire thing, so I know an appetite is still there and this isn't one of those moments where she's 'given up' on eating.

So my question for all of you is: What do you recommend as far as weight gain in patients? I know as cancer patients, I'm sure you've come across circumstances where someone needed to gain weight (unless you've ever been stuck on Decadron -- that stuff is a nightmare!!), and if any of you are currently or have been caregivers in the past, you might know a thing or two about encouraging appetite and weight gain in someone who needs it. Mom's brain has been slowly bettering itself since her strokes this summer, and I don't want weight to be such a scary factor in her recovery. Hopefully, some of you have some helpful advice.

Again, THANK YOU SO MUCH FOR THE CARDS AND LETTERS!! Seeing them coming in from all over the world has been giving both Mom (and me!) a lot of confidence and good warmth."

[StephN]

Danielle -
Sorry to hear this development.
What does the doctor say? I know that in these centers the people who remove the patient's tray are supposed to report on how much food was eaten (in percentage usually).
Does Chris go out and eat with other people where the aides help them along? Even with a room tray the aides are supposed to encourage eating.

Does not seem to be a swallowing problem, as can happen with strokes. Does she get supplements such as Ensure or Boost?

As for hospice, what would be the advantage? Can she get some additional care? Do the staff think she has 6 months or less to live? I thought a doctor was supposed to recommend hospice.

[Lien]

Hi Danielle,

I'm sorry to hear Chris is dealing with all these issues. Re. food: Sometimes the food doesn't smell or taste right, so people do have an appetite, but don't finish their meal. Also, it might be that she doesn't like eating alone? Or she just doesn't like the food she is offered? When my youngest was in hospital with pneumonia, they wouldn't let him go home until he started eating. But he would only take tiny bites and then stop. Until my husband went home and made him his favorite dish. He devoured the fried potatoes with ketchup that we gave him. Ofcourse Chris isn't a small child, but if she does have an appetite, doesn't want to go to hospice and eats the foods you bring her, something else must be amiss. Would it be doable to bring her something to eat every day and be with her while she eats it? That way you might be able to figure out what is keeping her from eating enough. Also, there could be a medical issue. What if she is eating, but for some reason her metabolism has changed drastically? It may take some detective work.

I do so hope Chris will have some more Quality Time with you!

Please know that you are in my heart.

Jacqueline

[Paty]

Steph,

Thank you so much for sharing Danielle's info.

Danielle, I am so sorry that Christine's health has deteriorated to such degree. I cannot recommend anything right now as we are in different countries and have different resources. What has worked very well for us, in my mother's and aunt's difficult times is ENSURE, as a diet supplement. I am sure you have other food supplements available that I do not know of. I think you can get some medical advise from some of Christine's doctors. Please know that I keep you in my prayers. Let your mom know that i love her so much and that I am eternally thankfull for this great board that she creted along with your dad, without her courage, knowledge and proactivity, we would not had been able to encounter. Love to you and Debra.

[Pray]

I'm sorry I don't have advice, I just want you to know your Mom and your family are in my prayers. Gods blesssings to all.

[conomyself]

What comes to my mind is something super yummy, nutritious and caloric like a virgin pina colada smoothie with real coconut milk, coconut butter, and pineapple; cheesecake or homemade custard.

When I was losing too much weight I leaned heavily on coconut/chocolate smoothies.

Rachael

[chrisy]

Believe it or not, I am also fighting weight loss after a lifetime of trying to go the other way!

Despite my doctors orders to eat Haagen Dazs (that's how bad it is!), it is important to focus on high quality proteins if possible. I've been using muscle building shakes( which aren't too bad if chilled) if I don't have the energy to make my own smoothies. But basically, whatever feels good to eat, do it.

The most important thing tho, is that Chris wants to continue recovering her strength and apparently has not just the will but the "appetite" to do it. For me, it has .been helpful to basically break another of the RULES and wolf down my food before my stomachs knows what as hit it. I ate a 3egg omelette with a whole avocado init plus 1 1/2 slices of toast this morning. It was yummy and a lot of relatively good calories.

Chris does, it sounds, need support in this effort, in getting enough of the right foods and finishing them. The waitress/owner of the breakfast restaurant we go to knows I need to gain weight and really had them pile it on. And my hubby was there to make sure I shoveled it in. My situation is extreme right now, so I'm not recommending Chris do this!

Just sharing a strategy that so far seems to be working. Of course it's only been like 3 days

Tell Chris to hang in there!

[Mel3]

Hello Steph and Danielle,

I am experiencing this same issue with a dear friend. She says it is strange because she does not have hunger pains even though she barely eats for days and weeks at a time. I think most of my friend's issue is pain management. Now that her pain is under control she has started to eat and her weight stabilized from the last appointment. Is Christine in pain? When my friend has times of not wanting to eat I bring her milkshakes and she enjoys them. She does not like Ensure and one time I made a high protein shake and she drank it, but didn't enjoy that either. There is a certain brand of Greek yogurt that has the fruit mixture on the side, I cannot think of the brand, but my friend liked it and it was a good source of protein which she definitely needed. If sweets are appealing then it is the best place to start, the main goal is calories at this point. I understand your dilemma and wish you success. You will be in my thoughts and prayers. I am sincerely grateful for your family creating this site, it is a lifesaver for all of us.

[Lani]

there are many causes of unintentional weight loss including (among others):

Gastrointestinal disorders are another common cause of unexplained weight loss – in fact they are the most common non-cancerous cause of idiopathic weight loss. Possible gastrointestinal etiologies of unexplained weight loss are celiac disease, peptic ulcer, inflammatory bowel disease (crohns disease and ulcerative colitis), pancreatitis, gastritis, diarrhea and many other GI conditions can cause weight loss.

Another Cancer, a very common and sometimes fatal cause of unexplained (idiopathic) weight loss. About one-third of unintentional weight loss cases are secondary to malignancy. Cancers to suspect in patients with unexplained weight loss include gastrointestinal, prostate, hepatobillary (hepatocellular carcinoma, pancreatic cancer), ovarian, hematologic or lung malignancies.


Infection. Some infectious diseases can cause weight loss. These include fungal illness, endocarditis, many parasitic diseases, AIDS, and some other sub-acute or occult infections may cause weight loss.

Renal disease. Patients who have uremia often have poor or absent appetite, emesis and nausea. This can cause weight loss.

Cardiac disease. Cardiovascular disease, especially congestive heart failure, may cause unexplained weight loss.

Pulmonary disease.

Connective tissue disease

Neurologic disease, including dementia[*]

In some people, certain medications may cause weight loss as a side effect.

I would think a doctor's job would go be to rule out all other causes of weight loss besides dementia ESPECIALLY weight loss which might be due to other medications she might be taking.

A very likely cause of many problems in the elderly are side effects of drugs they are taking.

Hope this helps.

[chrislmelb]

Sustagen and chocolate

[karen z]

You have gotten some good advice here. My first thoughts (on the weight loss) were supplements- either the kind you can buy in stores (experiment with what your mom might like) or homemade shakes with some good protein and good calories (and tasty). I agree that it would seem like various causes of weight loss should be examined by doctors- thoroughly. Could be any one of the many things (some very easy to fix) raised by others. I would think it is imperative that someone be aound when your mom is eating- for the company and to keep her "on track" with her eating. As for Hospice, if your mom does not want to go (and I am not sure it is warranted) then it might not be a good thing for her to have to go. Going somewhere where she does not want to go could further aggravate existing situations. Your mom is strong-willed and opinionated (I have had the pleasure of hanging out with her) and I would not think it would be good for her to go if she has said "no thanks".

[pibikay]

We re sorry to hear the news .Hema was having weight loss problem. I gave her bananas they are rich in Carbo and Hema stopped losing weight; To augment her protein I gave her lo fat panneer (cottage cheese).It worked here .But in the US I do not know.
Wishing all the best

[KsGal]

I had a lot of success gaining weight with an Ensure or Boost with every meal as the drink. As Steph mentioned, is she getting a supplement with each meal? Ensure and a straw went down easy each time, and didn't taste so awful. And maybe offering it during the day too? High calorie foods...milkshakes, ice cream. I wish I had more to offer. Certainly sending lots of prayers and positive energy. I really don't see calling Hospice in if she isn't ready, and you feel she isn't ready yet either. ((hugs))

[ElaineM]

Hospital and nursing home food can be pretty depressing and is not very tasty sometimes.
I asked my friends to bring me some of my favorite healthy foods and healthy snacks and juices that did not require cooking when I was in the hospital last summer.
Can Christine's family bring in some of her favorite foods for her to eat? She may not be used to eating alone. Does the facility have a dining room where patients can eat with other people? It seems the staff can wheel her to that dining room in a wheelchair if she is not able to walk there on her own. Is her family able to take her for an outing to her favorite restaurant or out for a home cooked meal at least once a week?
Can Christine's family bring her a high protein shake or take out meal once in awhile?
By all means Christine and her family should participate in all decisions about her future if she and her family think she is able to do so. Sometimes medical professionals do not know much about a person's determination and inner feelings when they offer suggestions, because they base their suggestions on a very narrow and limited clinical assessement.
Sometimes people are much stronger in body, mind and spirit than nurses, doctors, therapists and other so called medical professionals think.
All the best to Christine and her family.

[Laurel]

Danielle,

My mother lost a great deal of weight after her stroke and remained quite thin until I began taking care of her and Dad 2 years ago. She has gained nicely. Because she has dental issues and some swallowing difficulties I have learned to finely chop her food. She also LOVES Boost, sold in groceries in several flavors. Mom loves it very cold & in the vanilla flavor. They have a very high protein version that she finds just delicious. Sometimes I throw a scoop of vanilla ice cream in the blender along with a Boost. It makes up like a milkshake.

I think at some point you have to feed them what they enjoy. Like most older folks that means mashed potatoes and sweets! Honestly, mom is worse than a kid. That's how we get her to take her meds. She can have her treat after she takes her pills! Bring her foods she enjoys and do not be surprised if items she once loved have been replaced by things she was never that fond of. Taste buds change it seems. If she enjoys eating, feed her whatever she wants. Her life is short and when you are old (or in my case, middle-aged!) food is something you look forward to!

[Deb33]

Acupuncture was great for my appetite - even acupressure can work well if she doesn't like the idea of needles. And my Naturopath was always waiting to give me Amino Acid IV's but I never needed them.

[tricia keegan]

Its possible Christine either doesn't like the food at this facility or is not encouraged to eat, my friend fed her Mum lunch daily at the hospital after her stroke and was amazed to find her Mum did eat when fed by her this way and if she refused everything else she would eat jelly. I think the nurses gave up too easy but in fairness they were so busy they had no option!

[Joanne S]

Danielle, Please know you, Christine and your family are in my thought and prayers!

As far as for weight gain, this might be worth a try. You might consider using a VitaMix or similar smoothie juicer. The consistency of most fruits and vegetables will remain good after blending. I found that avocados are not---better to make guacamole with them. In addition to the fruits and veges, there lots of other things you can blend together for more nutrition and calories intake and to make the smoothie blends more palatable; for example, soft cheeses like cottage cheese, oils like hemp oil or olive oil, nuts, dates, figs, you can also include ensure/boost/supplements in the mix instead of (or in addition to) water. Maple syrup or other flavored syrups, salad dressings, and spices like ground cinnamon or salt can really make them more palatible. In addition to fruit/vege smoothies that might be beneficial especially if she doesn’t like chewing or has difficultly chewing, you can make a smoothie meal by blending meat, potatoes, gravy, vegetables, and/or soups. If you would like, I’d be happy to share some combinations I’ve tried.

I personally am not trying to gain weight but have increased my intake of natural foods and have smoothies/juices instead of regular meals. I have not had any meat and potatoes smoothies, but I imagine they would be pretty good. You’ll be surprised how much more you can consume at one time when processed like this. I could not even come close to eating 1/2 the amount of vegetables I eat in one meal if they weren’t processed/blended. And consuming more fruits and vegetables, I feel better instantly!
Of course, please continue to offer your mom different foods and snacks – especially her favorites.
I hope this helps with her appetite and strength. Please keep up posted.

Hugs and best wishes, Joanne
PS (These smoothies/juices are best when consumed immediately following blending as some will separate and oxidize over time. And there will probably be a change in bowels. You probably already know, complete loss of appetite and desire to eat is a sign that it is time...)

[Jackie07]

When my late Mother-in-law was in the nursing home because of progressing dimentia and other heart-related issues, she was losing weight as well. It turned out that the nursing home was short of staff, so Father-in-law began to visit at lunch and supper time to assist Mother-in-law at the dining room. We took over the weekends and any other holidays when we can. (Sister-in-law spent a long weekend there every other week)

Anyone can lose appetite after staying in the nursing home/hospital over several months eating the same food (the menu rotates every 2 to 3 weeks) Does she eat with other residents in the dining room? A more social environment might help.

[sarah]

protein milk shakes. when my mom was in the hospital, sweet people but they didn't have time to cut up her food so when I wasn't there or my brother, she didn't eat. I asked the nutritionist about this and she said milk shakes. My mom loved them and started to gain weight. Honestly unless food is cut into tiny morsels, small enough to eat in one bite, a patient can't eat. A nice tasty protein milkshake with maybe a banana in it is good. Anyone visiting her could make up some yummy milk shake to take with maybe cashew nuts, banana and other goodies in it.
I don't get why hospitals seem to want to serve really ill patients solid food in portions that need cutting up when it's obvious that the patients are too weak to cut up their food.
Hugs and love to Christine, she and Joe are precious to us all and will always be thought of and loved.
hugs and love
sarah