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She is in assisted living where she has to eat restaurant style and go to a dining room. We have been providing cereal, milk, bananas, bread and peanut butter. We just found out she is not going down for lunch either because she eats breakfast late. The only meal she is going down for is dinner. They quit serving breakfast at 10 which is the time she gets up. We are concerned about nutrition, She does have dementia. Suggestions please!!!

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Did she sleep in at home? If not, is it because she is depressed or bored? Does she have assigned seating with people she doesn't like? Is she maintaining her health on the meals that she's getting? If she is sleeping a lot she may not need the extra calories. Also going down for meals is one thing that she can still control. If she is adequately nourished, don't worry about it. Unless, that is, the cost of providing snacks is a problem. Besides, how long do we really want our loved ones to live on in this condition? How long would they want to, anyway, if they could choose?
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I would let her do as she pleases. As pediatricians assured us when our kids were little, hungry people eat. I'd check into the possibilities that Michele suggested – incompatible table mates, boredom, etc. And, I'd leave some favorite snack in her room - chips or cookies - something she doesn't have to prepare in any way and that she could snack on at will. But, if she's really not hungry, it's likely a sign that she's winding down and I'd step out of nature's way.
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Why would she go downstairs to eat when she has the comfort of her room with the food you have provided? People with dementia don't like to talk much, can't find the words, and others around make them frightful. I used to work at Brighton Gardens so I know about assisted living life. Is there a way to bring up a plate of food breakfast and lunch (maybe for a fee) and mom can eat more of a variety. I see no protein except the peanut butter and that gets old fast. Her muscles are starting to lose their strength and needs more protein. Does she have trouble walking yet? She needs a regular routine whereby she has staff awake her by say 7 a.m. to make it down in time for breakfast. I don't know what type of facility she is in, so it is hard to comment any further. Good luck!
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Instead of the snack food, buy her some nutritional shakes such as Ensure or Boost. These have lots of protein and nutrients and are palatable for most people. She will get tired of having nothing but shakes for breakfast and go down for real food eventually. Keep some tasty juice or flavored water available to make sure she stays hydrated. Skipping breakfast for more sleep isn't too bad. For lunchtime try to join her or have someone else come in for an hour every once in a while to help.
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Thinking about the situation you describe, I would do exactly as your mother does under the circumstances. I don't have dementia but am an introvert. I function well in society but have to limit contacts in order to maintain mental balance.

Your mother's diet sounds fine and it might ease your worry if you buy for her the high-protein varieties of cereal and bread. And if she's eating cereal, does that mean she also can tolerate milk? All good.

Under the circumstances you might want to celebrate that she goes down for the evening meal. This is impressive. (I wish my own mother were as functional as yours.)

Relax, enjoy visits with Mom and don't bug her about meals. Sounds like she's doing very well. Blessings to all of you for peaceful relationships.
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I agree with Gigi11, some people, not my mom, but myself, really appreciate my alone time. When I get up in the morning I don't want to be sitting across the table from anyone, that is me, we are all individuals. Don't they have kitchenettes in assisted living facilities? Why can't she have bananas, blueberries and bran flakes with skim milk and toast in her own spot? If she watches tv late into the morning she'd get up later and sounds like what she is doing is having brunch. She does go for the main meal so that is good. I'd provide everything for her to be comfortable, she is going to main meal and can be social there, the only thing is she is paying for these two meals, so in the scope of things how much does that really matter.
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As Gigi says, not everyone would want to have restaurant style meals three times a day, every day. Eating brunch in her room and dinner in the dining hall sounds perfectly acceptable to me. If she'd like it you could consider having her lunch delivered to her room at the earliest time it is available, and consider that her breakfast. But if she prefers the independence of making her own brunch, I don't see that as a problem.

She wants to sleep until 10? Sounds good to me. She is "retired" -- I think having a schedule that suits her should be a goal!
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I agree with Gigi11 and Madeaa- a lot of elderly people have a decrease in appetite, and it just doesn't take as much for them to feel full. For some folks, not sleeping well at night often results in them getting up late, so they wind up eating breakfast nearer to lunch- but she is going down for dinner, so perhaps the two meals a day are enough for her.
It seems to me that you don't need to worry too much at this point. I think the other suggestions of keeping her fridge stocked with healthy, nutritious snacks, juices and flavored waters would be a smart way to go. Watch her weight- if she appears to be losing weight or getting weaker, then you know something's going on. If she seems to be maintaining well, then it would seem that whatever she's doing is working.
Several years ago, my mom and aunt moved my grandmother into an assisted living facility. She was in the beginning stages of dementia, but not to the point where she was eligible for the facility's dementia unit. My aunt started noticing that the treats she was leaving for Grandma were going fast- specifically the ice cream treats. Well, we figured out that my grandma was forgetting to eat, so when she felt "peckish" she'd root around in the freezer for a treat. We wound up upping her care level so the staff would come and get her for meals. She'd often tell them she wasn't hungry, but she was social, and the staff would tell her that she would be missed at the table. She'd get down to dinner, "just to visit a spell" but the smells and sights of the food would stimulate her appetite, amd she would wind up eating the meal eat just fine.
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Add my mom to the list of people who don't want to get dressed for every meal. My mom is up at 7 AM but her place doesn't start serving breakfast until 8:30 AM. She didn't want to wait that long to eat. Mom doesn't have dementia and lives in independent living, but she spends many days in her jammies and was missing too many meals. She also has a LONG way to walk to the dining room. So I ramped up bringing her food which she can heat up in the microwave. I finally asked for a credit on her bill, which we got. So not everyone wants to get dressed and go down to eat by a certain time or sit with a bunch of people they're not crazy about. I think your mom is fine and the snacks are fine. Fresh fruit, nuts (if she can eat them), peanut butter like you mentioned, chips or crackers, etc. are fine.
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I learned from a Ph.D. nurse practitioner - who specializes in seeing people with dementia - that studies show people with dementia do better if allowed to sleep until they awaken on their own. In fact, some nursing homes that are geared to people with dementia now do not wake residents for breakfast but allow them to eat whenever they wake up. Now, my mom lived in a retirement complex (not necessarily the best place for someone with dementia but that was the POA;s doing) and I was her 24/7 caregiver. I never EVER woke my mom so we could make it downstairs to breakfast. I let her sleep until she woke up naturally. So - while some still adhere to the "early to rise" idea, please know that for a person with dementia, early to rise is not the best option!
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Actually, cbhillman, there are studies that show we would ALL be better off sleeping until we wake naturally. Unfortunately for our complex inter-dependent society to work, many people need to wake up to an alarm clock. I hope to heck nobody is setting alarm clocks for me in my old age, whether I develop dementia or not!

I have already told my kids that if they place me somewhere that I have to listen to televisions blaring all over the place I WILL come back and haunt them. Now I am going to add another threat: You place me where they get me up at 7:00 am for breakfast, and I might not even wait until I die to start haunting you! :-)
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I'm not sure that not being hungry is always natures way of winding down. My husband has later stage Alzheimer's and no longer has an appetite, but it's because that part of his brain doesn't work anymore. He also has a difficult time articulating his needs and wants, so I have to figure most things out on my own. I prepare three meals a day for him and he eats everything I give him, so I'm pretty sure he does get hungry. If he didn't, I think he'd push the food away or just not eat it. I work from home two days a week and got busy one day and worked right through lunch - and he didn't say a word about being hungry or wanting to eat. I don't think he would ever ask for food, since he doesn't feel hunger. So it's my job to ensure he gets proper nutrition. It's harder in a facility, since they're usually understaffed, but I agree with the others about not needing to go down to the dining room to eat with the other residents. It's not necessary. As long as she's getting nutrition, that's the main thing. Also, two good meals a day may be ample for some seniors. And by all means, let her wake up when she wants. She's probably earned it (I sure wish I could - lol!)
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My mother (in a NH) will go for breakfast and occasionally supper but increasingly not lunch and snacks away on cookies and chocolate. Fruit is ignored and thrown out. I'd take her a nice lunch from time to time but she eventually refused it. She's 87, unable to sit up or stand by herself and her mind is completely gone. She may not have long left and her munchies are the only thing that seems to give her some comfort. If she wants to go out in a blaze of cookies & chocolate so be it.
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Have any of you tasted Ensure or soy drinks like that? They taste like chalk! Better to blend fruits and veggies with water and a little Stevia in a Nutri-Bullet and those are powerful drinks. I mix a batch, and pour out what I want and save the rest. One can always add more water when you reblend.
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Ashlynne can I just say that I also want to go out in a blaze of cookies and chocolate like your mom??? That's one of the best things I've read in a while on this site!! YAAAAY for cookies and chocolate!! :)
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Yes, I agree I want to go ankle osteoarthritis and all, on roller skates, a martini in one hand and a chocolate bar in the other, wahoooooooooooooooo
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Actually, one of the best - and tastiest - alternatives to Ensure and Boost is Carnation Instant Breakfast. Yes, you have to add your own milk but it is definitely pretty delicious. I used to add ice cream for added calories and depending on the CIB flavor, sometimes added fruit. By the last month of her life, my mom was existing on Carnation Instant Breakfast shakes and smoothies.
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She is in an assisted living facility. There is no assigned spots. You sit wherever you want. I make sure she has a banana a day. The concern is that she forgets to put her milk away and it is souring and she is using it anyway. She has always slept in until she wants to get up. She doesnt get hungry until about 10:30. I take her medicine doses daily and sit with her for about an hour or so. She is in assisted living because it was the only place she could keep her dog and it would make her depressed to not have him. She doesnt appear to be depressed. There is someone there every day and her granddaughter works there. I appreciate the idea of the protein drinks. I did not think about that for some reason. Thank you for all your responses.
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If she just doesn't like getting dressed for breakfast or lunch, or sleeps through them, cereal is fine. I eat my cereal with Greek yogurt to improve the protein content. There is also a fairly new "breakfast biscuit" called BelVita that's like having a healthy cookie. I eat them myself if I have to go someplace wight after I get up (I too am a night owl, although I *think* I'm not yet demented). They're a bit hard to find because our local grocery stores can't decide whether they're a cookie, a cracker, a breakfast food, or a granola bar, all of which are on different aisles. Yum! The blueberry ones are my favorite.

Ashlynne and blannie: My father-in-law went out in a blaze of McDonalds chocolate shakes. We figured he was old enough and sick enough that he could eat what he wanted. Even though my husband and I are milkshake snobs and don't consider McD's "shakes" to be even marginally drinkable, we let him have them. We made him some real ice cream shakes at home, but he preferred McDs. It was his comfort food.

The funny part was that he wouldn't tell anyone he wanted a shake. (Too many people told him he shouldn't have them.) He would invent a need to go to the hardware store (although he didn't do anything that required hardware by that time). He "couldn't remember" which hardware store he needed, but he knew the way. Then he just happened to direct his home caregiver to drive past the McD and suddenly tell them to turn into the drive-through because he needed a snack. Stealth McDonald's worked because they didn't have time to think up an argument and didn't have a handy alternative to offer him at the moment. :-)

I think my husband wants to go the same way, only with Ensure and shakes from the handmade ice cream store in our town. Too bad for him that he has lots of years left in him, so I make him eat real food too.
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My idea of heaven on earth is: sleeping in until I want to get up; not having to eat anything but what I want (chocolate, fried foods and salty snacks); drinking the finest wine and bourbon; hanging with the people I want to hang with (no one else) and not have to work. Let the poor woman enjoy the rest of her time on earth. We are too focused on physical nutrition but at 82, 89, 92 who cares?...lets enjoy the end of life1
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Our 86 year old if left on her own devices
would never get out of bed or eat.
Longer she goes without eating the more she will not eat.

Everything for her is according to schedule.
Sugar doesn't help dementia from what read,
but we do give her chocolate from time to time.
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Ours has dementia
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It is an expense for her as they charge for 3 meals a day whether she eats or not and they do not take meals to their rooms. It is not that type of facility. I will continue to take her food and snacks. I also believe she should be able to sleep in and do what she wants. I just dont want her to get ill in the process. We will just have to see what happens.
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I am 73 and my health is good other than age related conditions. I lost my mom and husband this year, six weeks between them. I was my husbands caregiver for 12 years he was a considerate man and tried to make it as easy for me as he was able. My only consolation now is being able sleep and wake up when I need to, eat when I am hungry and eat what my appetite wants at the time. I plan more for a day than I accomplish but follow up the next day I feel up to it. For me this is one of the blessings of old age. May everyone have this opportunity.
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Mom likes the taste of ensure so we are getting her chocolate for drinking and vanilla for her cereal.
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