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It's Vascular Dementia.


The Ensure upsets her stomach and causes her to throw up. She's taken her dentures and thrown them across the room, which caused them to break. We got them fixed but now she won't keep them in her mouth.


She's ALWAYS been thin but now she is so skinny it's hard to look at.

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Joni, what does her doctor say about vomiting after drinking ensure?

Has she had a swallow test? Has she had her mouth checked for sores?

Have you tried soft foods like mashed potatoes and gravy, yogurt, ice cream, soups?

There are many reasons why a senior stops eating. Only her health care professional can really help you.

Dementia is a very difficult journey and a constant battle to stay ahead of the broken brain.

Best of luck getting to the bottom of this issue.
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Throwing her teeth is a very clear message to you she does not want to be be forced to eat.

I'd suggest seeking medical advice into the stomach upsets.
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Could you start introducing food into the Ensure (blended cooked rice, fruits, grains, mashed potato, carrot, etc), starting gradually to help assimilate? I know it sounds disgusting, but it's a case of 'mind over matter' and what grandma thinks, grandma will believe!
I turned a whole chicken casserole into soup - thick and delicious, where just the day before my dad (also VasDem) wouldn't touch the plated dinner with its constituent parts presented before him.
Eating gets to be hard slog (and I'm sure dentures don't help either) and the 'joy' of chomping dimisinishes as the sensory feedback fades.
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Katefalc Jul 2022
Why ? The ensure makes her vomit. I’d suggest a real milkshake with milk and ice cream.
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maybe she wants to die (by eating minimally; starving herself). she has a right to end her life, if she feels it's unbearable.

we might also when we're elderly, under certain circumstances, not want to live.
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Grandma1954 Jul 2022
generally with dementia there is not a conscious decision to stop eating. It is part of the process of the disease and the body shutting down. A person can "forget" to eat. "Forget" how to eat (chew and or swallow) but it is not a conscious decision to end the life.
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Get dr script for Seroquel & she’ll be more cooperative. Hugs 🤗
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You cannot 'make' a person eat; ie: force your grandmother to eat if she doesn't want to. If she's vomiting after drinking Ensure, she needs to see the doctor; that's not a normal thing to be happening. She may need a hospice evaluation so she can be kept comfortable as her body is shutting down.

When my mother with advanced dementia got to the end of her life, she cut WAY down on her food intake and was also vomiting a lot. I had her start taking more Prilosec for GERD which did help with the vomiting, but didn't help with her appetite, which naturally decreases as death approaches.

You don't say how old grandma is, or what other health issues she's suffering from. It sounds to me like a hospice evaluation is in order, after you call her PCP to get advice about the vomiting after drinking Ensure. Try offering her a real milkshake made with ice cream and whole milk. Ensure tastes like chalk, imo. If she doesn't want to keep her dentures in her mouth, you won't be able to force that issue either. In reality, there is very little you CAN force with dementia at play.

It may just be time to leave grandma alone and to make her comfortable instead of forcing her to adhere to your wishes. There comes a time when dementia gets SO bad, that it takes the elder's life. I watched it with my mother, and hospice was a huge blessing in the final 2 months of her life.

I'm sorry you are going through such a difficult time with grandma. Sending you a hug and a prayer for acceptance.
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Katefalc Jul 2022
My husband of 53 years just passed away last wee from vascular dementia. He just turned 73. I’m heartbroken. As a loving wife and his POA, I made the “ loving choice” to put him on comfort care and not force food and drinks on him. He enjoyed popsicles until he became unresponsive and passed 2 weeks later. This is a sad, lonely road to travel. 💜😭
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The question starts with "Grandma has dementia and...." From that point on caregivers need to understand they are dealing with medical issues, not behavioral problems.

As another responder said: a dental check up, a medical evaluation, and a swallowing test are all necessary and no other answer should be acceptable until these are done.

*I feel it important to add that I am increasingly concerned about AgingCare supporting a Q&A platform that ignores the medical needs of loved ones simply because the caregivers do not understand dementia and interpret changes as stubbornness, manipulation, or intentional. Our elders are fragile and frail, and care givers need to give them the best care and protection - and might I stress - if you hold the Medical Power of Attorney you are legally bound to provide the needed care! A sounding board for misinformation about medical issues, or filled with casual Rx recommendations which do not come from a trained practitioner (because no one with training would make such recommendations without assessing the patient) is neither helpful to the elder nor the caregiver. Are there not any moderators here??
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reallyfedup Jul 2022
I too am concerned, but from the legal end. Most of the questions posed on this site require the advice of an attorney not the thoughts of people kind enough to reply but who really aren't trained and sometimes are quite wrong. I am particularly distressed by the degree of misunderstanding that crops up around powers of attorney.

I also wonder how much the person with the question is operating from emotion and not facts. The best way to test this is to gather all the information you can about the problem and then decide whether or not to pay an attorney to go over it. If you don't want to spend the $200-$300, that may be your answer.
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This is a matter to take up with Grandmother's MD.
I myself would not attempt to prolong the life of someone with vascular dementia who doesn't wish to eat. I would supply food, or see to it that food is supplied. Whether or not a person wishes to eat should, to me, in all circumstances, be their own wish or not.
I encourage the POA or guardian to discuss with MD.
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TakeFoxAway Jul 2022
Yes AlvaDeer is right. When people are in the process of dying, it is natural for them to not want to eat. It's bad to force them.
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First I would try a different brand of protein drink for her. Look at ones that are made with alternate products other than dairy. There are soy based, almond based and other plant based drinks that might not upset her stomach.
Have you tried processing other foods so that she can eat/drink those rather than relying on packaged product.
NOW...
I would contact Hospice. It sounds like she would qualify and they can provide some guidance and information.
If she is getting to the point where she is refusing to eat or drink it may well be that her body is not processing food. When you reach a certain point you do not require the nutrition/calories that you did previously. To try to make or force someone to eat can do more harm than good.
(Please do not entertain the idea of a feeding tube)

As to the dentures with weight loss it is very possible that they do not fit and are painful. Fixing them does not make them less painful. And if she is not wearing them all the time the shape of the mouth changes so they may not fit due to that.
I think at this point it would not be worth putting her through getting another pair. Just puree food for her so that she does not have to chew.
One more thing.
If she is coughing when she tries to eat or drink it is possible that the food or water is entering her trachea rather than the esophagus. If this is the case any food or liquid entering the lungs can cause Aspiration Pneumonia and that can be fatal.
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Dementia is ultimately fatal. You can love them and ease their way, but you cannot fix it.
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She may have tasting problems. Are you able to make her brush her tongue? How about puree her food? How do you approach her? My grandma had a special shoe she had to wear and one day she said NO, I had to baby talk her at times and treat her like a child and sometimes it would work, I went to buying her another shoe, unfortunately it didnt fit quite well. Maybe buy her another brand of protein drink for sensible stomach.

I must add, have her doctor take a look at her and rule out any stomach bug. I wish you, grandma, and yours the best!
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Try regular milkshakes, puddings, popsicles, ice cream ect. Her mouth might hurt from denture that DONT fit well with the weight loss or maybe having them in her mouth makes her nauseaus
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She may have an allergy or sensitivity to the ingredients in Ensure or any other protein drink. They are often soy based and not everyone can digest soy. The same caution applies to powdered protein supplements--many have ingredients some people are sensitive to.

You may need to stick to foods that she can process, perhaps rice and rice-based, and make soft meals from scratch. Not as "easy" as buying a pack of Ensure, but necessary to find foods she can tolerate. Try rice (white is most easily digested but brown is healthier--You can mix the two as appropriate.), baked or boiled chicken. Avoid commercial products for a while.

If you can create some soft enough combinations of basics, don't fight about the dentures for now. The dentures probably do not fit well anymore and cause her more pain than they are worth.
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MaryKathleen Jul 2022
For myself I am lactose intolerant and allergic to onions and garlic. Any of those will make me throw up and have diarrhea.
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Boost and Ensure have very different formulations. My mother had problems with many of them. Finally found Boost High Calorie which she was able to tolerate. Turned out to be a lifesaver.
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I don't know what your Mom main illness is but if it's any type of cancer she won't want food. I'm saying this from experience.

All that you can do isake sure she's getting the necessary liquids. Maybe try jello or ice cream in addition.

Goodluck. It's hard to make someone eat when they don't want food.
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Dealing with the same thing here for two plus years. The wife got full dentures and is suffering the consequences of having brain tumors that were radiated and is now cancer free. She just will not chew anything. Cooked oatmeal is about the only food that she will tolerate without special consideration. Several visits to her dentist, med and therapy interventions have not convinced her to chew. I have resorted to putting any and all foods into a blender. Soups, frozen dinners, fruit, veggies and deserts; you name it, I've blended it. Some she will eat with a spoon; others thru a straw from a cup. Her daily favorite is a variety of different yogurt, fruit, ice cream and almond milk smoothie served in the morning. I also give her a daily multi-vitamin along with her regular meds, So far, so good.
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Same problem here eating is not as much of an issue as drinking. I think she lives in a dehydrated state. She drinks but not enough. I think eating and drinking are not on her list of things to do,
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Anyone who has ever lost their appetite knows that to try to eat when you don't want to is very difficult, as is having others constantly pushing food. Having worked as a hospice nurse for many years, I know how difficult it is for families to see this. I've found a person will eat (maybe not a lot) if they have the opportunity to ask for it and have anything they want. Grazing is best because their digestive systems have problems with an overload. She is in hospice, food will not prolong her life, just perhaps make her feel miserable. Try to think of natural living and letting her have control. She's lost so much of it.
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Joniisalive13: She really needs to visit her physician. Perhaps her gastrointestinal tract cannot tolerate Ensure and/or perhaps she has an allergy. Perhaps her dentures are not fitting properly. This, in conjunction with her vascular dementia, requires a medical evaluation.
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So sorry to hear about gram … Dementia has a hold on her .. Her teeth might be uncomfortable and her body my just have turned off her appetite because it can no longer process what she eats . My moms issue was cancer. We used to brow beat her because she would not eat .. The hospice people were the ones that really help us understand what the process was . We learned a lot from them .. The frustration the family had went away and allowed us to just spend that energy on just love her and keeping her comfortable. Prayers are with you .
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My mother stopped wearing her glasses when she had advanced dementia. She found everything like that irritating. Try giving your mother soft foods that don't require chewing. Start with smoothies, protein drinks, pudding, ice cream, yogurt, scrambled eggs, and also try baby foods if you don't want to prepare soft foods from scratch. You can't force her to wear her dentures. You also can't force feed her. Talk to her doctor about this. I've spoken with people who said that if they can't feed themselves they don't want to be fed. I put this into my advance medical directives. Do you know how your mother would have felt about this?
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The dentures may be uncomfortable. Switch to pureed and soft foods that she can "gum". If need be, ask her doctor for a referral to a speech therapist to recommend the best textures to feed her AND a registered dietician to help with recommending foods and menus that can meet those needs.
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Hospice warns me that as my mom gets weaker and weaker, she’ll come to a point when she will eat less and less, even refusing meals. It is part of the aging process and eventually, their end of life. The body begins to prepare for the end. I would give her meals as she desires, but not force her to eat. It is incredibly difficult to watch our LO become a pile of skin and bones, but it is life.
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Ensure is an artificial heavily processed beverage with a lot of chemicals. Many can't tolerate it.

Real, made from scratch soft foods are usually tolerated.

I'd also get a swallow specialist involved.
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I know someone who has worked in a facility, and she said it was common for the elderly to not want to wear their dentures, even to the point of hiding then in a box of tissues or just dropping them on the floor in the hallway. Maybe they just don't feel good anymore. Have you tried putting a plate of cottage and canned peached in front of her? Don't ask, just do it and see if it looks good to her. She may not know what she really wants until she sees it.
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Debstarr53 Jul 2022
Left out the word cheese, try cottage cheese and peaches, pears or banana. When my stepmother was in her last days, my stepsister was asking her about a hamburger, chicken and other things. Mom kept saying no to everything, then I asked her, "Mom how about some cottage cheese and canned peaches?" She perked right up and said, "Yes, I'd like that." My sister did the gesture of throwing up her hands.
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