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I'm the primary caregiver for my 94yr old grandmother who is diabetic and basically has no appetite anymore. I have talked with her doctor, but she hasn't lost any weight and we've already exhausted the two appetite stimulants she can tolerate with no improvement. I'm careful to make sure she eats something three times a day, even if I have to sit there at the table with the same thing on my plate (even if I hate it) and tell her she has to match me bite for bite....she usually has a good sense of humor about it and tires. But I was wondering about making smoothies (high protein, maybe) that won't spike her blood glucose levels but will give her some nutrition and calories.

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This is actually my grandmother, but my mom was only 15 when she married my dad, 17 when she had my sister and had just turned 20 a few weeks before I was born. My mom and dad are both only children and we grew up next door to my dad's parents and my mom's mom was less than two miles away. So my grandmothers and my grandfather (dad's dad, mom's father died before I was born), were like our parents in many ways. My grandpa died in 1998 and my sister took care of our Nana (dad's mom) at that point. In 2007, when we learned that she had severe COPD and her rheumatoid arthritis had destroyed her poor hands and feet so badly that she could no longer cook or do much of anything, I moved back from Atlanta to my hometown in North GA to help my sister. (BTW, I'm a guy, a rarity among family caregivers it seems and that's a shame). She insisted on living alone in the home she and my grandfather built, but my sister and/or I spent several hours with her every day for the last few years of her life.

She was a tiny woman, only 91lbs and about 4'10" regularly, but she stopped eating in early 2011 and dropped down to 76lbs! I panicked and we tried all the drugs to stimulate appetite and every possible food I could think of with no luck. She was hospitalized with pneumonia (a regular event for us) while she was at her lowest weight. I stayed with her in the hospital from 7pm to 11am every night/morning and my sister came after work every day and stayed all weekend to give me some rest. The Charge Nurse came in one day, looked me straight in the eye and said, "You have the weight of the world on your shoulders and it's time you let me help you carry some of that burden!" I had barely met this woman, but she read me like a book. I broke down crying, which I have never done in front of anyone unless someone had died, and told her about the weight loss and not eating. I told her how angry and frustrated I was just standing by watching her literally starve to death....she sent me to the store to get some Haagen Dasz Vanilla Ice Cream (the highest fat and calorie content brand) and a pack of BOOST Vanilla nutrition shakes. We made her some super-high-calorie BOOST Milkshakes and THEY SAVED HER LIFE! In less than a month, she was back up to 82lbs. She eventually got back up to a high of 85lbs and I was so excited by her progress. Then on Thanksgiving morning 2011, I went to pick her up to bring her to Thanksgiving lunch/dinner at my mom's house and found her lying the floor, semi-conscious and vomiting blood. We found out that evening that she had a tumor the size of a grapefruit in her stomach and, at best, she had about 8-10 weeks left. My sister and I both moved in with her the next day and stayed with her every day until she passed (very peacefully) on 02/08/2012. The last thing she told me before she lost consciousness on Feb 5th was that if she died on the 8th, I had to promise to hold off her funeral until the 11th (a day longer than usual) because the 10th was my b-day. On her deathbed, she was worried about my stinkin' birthday...I lost my grandma and my best friend at the same time.

But it was amazing how peaceful and calm I felt after she was gone. She could have suffered horribly (and the oncologist and hospice folks warned us just how bad it could get near the end), but she didn't even ask for pain medication until six days before she died and the end was quick and merciful. That was the most I could ever hope for (and I'm not a religious person, but I did some praying begging for an easy death)...

I went so far off course there, sorry....I just felt like sharing, I guess. I'll post a separate response that is actually on topic and relative to what you so kindly shared with me...
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My mom is 94 and her appetite is pretty much gone. It's very frustrating! My mom is down from about 165 to 128 lbs. You could make a smoothie with peanut butter, a banana, milk and protein powder that should be pretty good. But I think your mom is where my mom is, their bodies are just slowing down and there's not much we can do about it. My mom isn't diabetic, so I don't have to deal with that. But I'm giving my mom deluxe mixed nuts and as many high calorie snacks as I can (potato chips, cheese, ice cream, cookies, fruit pies). I just made her banana bread, which she loves with full butter to bump up the calories. At this point, my view is any calorie is a good calorie. You could also try the Glucerna shake that is for diabetics.

I find with my mom that if I'm there, she eats more. She also loves beans, so she gets a lot of those, since they're good for protein and keeping her regular. But it's still frustrating. When I took her the banana bread, which was still warm, I tried to entice her to take a slice. She had just eaten a small bowl of split pea soup (her lunch) and didn't want any. That's hard on me!! My mom has really changed. I think it's harder on us than it is on our moms. Sigh.
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Too cool, my mom is a lacto-ovo vegetarian too! I stopped eating pork and shellfish and bottom-feeders (catfish) back in 2006 as part of a deal I made with my Pakastani former assistant (and still my dear friend). I told him if he'd go to bar and have his first beer with me, I'd give up non-halal foods for six months! I told everyone else that I was considering a conversion to Judaism and giving the kosher thing a trial run. I wasn't sure how it might go over with some idiots if I said I was following Islamic dietary laws for six months. And anyone who liked the fact that I was following Islamic dietary laws would probably NOT be very happy that my assistant had to violate said laws by consuming (3) alcoholic beverages in trade! Just for fun, I also talked him into going out to lunch during Ramadan when Muslims are required to fast from dawn to dusk every day for a month.

I decided to research the reasons why pork was forbidden by Jews and Muslims alike. It only took me a few hours of reading to give up pork forever. Pigs are omnivores, they eat ANY and EVERYTHING including parts of other pigs, human waste, carrion (rotting flesh).....to be so intelligent, they are truly vile creatures....but the same could be said of many humans, I suppose!

I buy my beef from a Kosher market whenever possible. They require that animals be treated humanely while they are alive and growing, they thank the animal for giving its life so that they may live and be nourished and they also specify that the animal must be killed in the quickest and least painful way possible.

I also have a shop where I buy organic chicken and turkey that is free of steroids, antibiotics and growth hormones. They're free range and cage-free, so they're happy little cluckers right up until the end....and their eggs are great, too.

I love most kinds of fish (tuna, salmon, halibut, mahi-mahi, snapper) but I don't eat it nearly as often as I should. I only eat it at restaurants because I prefer it fresh (not frozen) and it's impossible to find fish that hasn't been frozen in North Georgia. I'm too lazy to drive 60 miles into Atlanta to go to the fish market and then there's tons of prep work once I get it home....no thanks! I also refuse to eat any fish served with the head still on it and the eyes intact....gross! I've always had a rule that I don't eat anything that requires me dig it out of its home or carcass....the latter applies to fish with heads, IMO. The former is one of the reasons I don't do shellfish...that and they lack the sophistication to rid their flesh of any toxins they filter from the water they live in, so the person who eats them eats all the pollution they have absorbed....again, no thanks!

I wish I could say that giving up pork and shellfish made me feel like a new person physically, but it didn't. But I do get to feel morally superior and that's kinda fun sometimes. =)
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I just realized it's your grandmother and not your mother...oops.
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I totally agree with you about them eating better when someone is eating with them! When we go to the doctor (at least two appts per week usually), if it’s near lunch or dinner time and she’s up for it, I take her to a restaurant. Sometimes she will clean her plate, it’s amazing! I also get her to try new foods that I think she’ll like whenever I think of anything. Her initial response is to turn up her nose and protest that she doesn’t want to try it or she knows she won’t like it. Meanwhile, she gets angry at me now if I don’t pick up Chinese at least once a week! =)

Her diabetes is well-controlled and she wasn’t even diagnosed until she was 85! When she turned 88, she became the oldest patient her endocrinologist has ever treated and remains so. The doctor and I both agree that it’s more important for her to eat SOMETHING, regardless of the the impact on her blood sugar levels, rather than not eating.

But the diabetes is probably one of the culprits in her loss of appetite. Her sense of taste (especially sweets) is all but gone. Loss of taste is very common at her age, but the disease only magnifies that. I use Stevia or Raw Sugar in everything I make/cook, so I double or triple it for her and she still doesn’t think it’s sweet enough….we laugh about it, but it’s really not funny at all….

I push high-protein snacks, especially mixed nuts and ‘natural’ peanut butter (on anything). She has always loved something I make called Squash Dressing. If you’re not from the South, Dressing is our version of ‘stuffing’ only we make it in a pan or skillet instead of shoving it into a turkey. =) My Nana (that died in 2012) would always save any ‘Squash’ recipe she found and gave it to me because I love all things squash. So I make it for her at least once or twice per month (and it lasts for several days). Our precious Salvadoran friend, Lucia, introduced her to homemade tamales (wrapped in real corn husks and everything) and she loves them! (Sidebar- I hired Lucia to clean the house once per week a few years ago and she quickly became part of our family! Now she comes over and spends time with Nanny while I clean the house- seriously!)

It’s funny that you should mention beans. She eats Pinto Beans at least 3-4x per week and never gets tired of them! I buy Bush’s Pintos by the case from the grocery store.

An additional complication to the situation is my own eating habits and preferences. In the words of my Gastroenterologist and the #1 Colo-Rectal Surgeon the Southeast, I have ‘a form of Inflammatory Bowel Disease (IBD) that is similar to Crohn’s Disease in many ways, but isn’t Crohn’s”….but that’s the closest they can come to a diagnosis. I live on Organic Yogurt, various cereals that taste worse than the box they come in and veggie burgers, organic teas and a few other not-so-yummy things that don’t trigger pain that I imagine is second only to childbirth in intensity! I’m not complaining by any means….

I definitely agree with you about it being harder on us (as caregivers and ‘spectators’) than it is on our love one. My great-aunt (sister of my grandma who passed in 2012) was diagnosed with Alzheimer’s Disease in 2003. My great-uncle took wonderful care but neglected his own health to the point that he died in March 2009. Her daughter (my dad’s 1st cousin) lives in Los Angeles and struggled with deciding whether to move her out there or put her in a nursing home here in Georgia where her remaining friends and family were and where she had lived her entire life. My cousin (1st cousin, once removed, technically) is 15 years older than me and I hadn’t seen her since she moved to Cali in 1989. But we connected instantly the moment we saw each at her dad’s funeral. I fly out there at least once every 3-4 months for a week to get a break and hang with her and her three (adopted) children. I went thru the ordeal of finding a facility for her mom and talking with numerous doctors who were experts in the field. Every person we consulted, all of them, said that they see the family suffer far more than patient! I learned how true that was as time passed and she no longer knew me, then no longer knew her daughter and the last years or so of her life she lost the ability to speak….she died last August and it was a blessing, to be honest. But the same is true for those of us watching our loved ones slowly fade away just from old age alone.

Something that scares me is that my mom just turned 60 last month and she is already having several health issues of her own. I’m seriously thinking about moving far, far away from here when Nanny is gone…..I hear Australia is pretty nice…..
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You sound like a wonderful caregiver and grandson. I'm sorry about your gut issues. My favorite Doctor is Dr. Gregor, who puts out daily videos on diet and nutrition. If you go to nutritionfacts.org, you can see what he has to say. I've been an ovo-lacto vegetarian for 47 years (I'm 63) and am watching my meat-eating friends around me either drop (two have passed away) or have all kinds of medical issues (bad backs, arthritis, knee replacements, etc.). I am overweight, but very, very healthy. Like my mom, I eat a lot of beans and now a lot more veggies and fruits after listening to Dr. Gregor.

My mom is kind of going back in time and only "likes" stuff she ate on the farm growing up that her mom raised in their big garden. So the stuff she fed my brother and I when we were kids is now on her "doesn't like" list. I'm floored! So stuff like asparagus, spinach, squash, raspberries, fish, mushrooms, etc. she won't touch. I try to reason with her, "Mom, you didn't have pizza or pop/soda growing up on the farm, but you love that now", but she won't budge. LOL. So it makes my life a lot more difficult because things that I like and would make for myself (and to give her some), she won't like. Sigh. When I go over to her place, I sneak some of the high calorie stuff I have bought for her. I tell my friends she's eating my ideal diet - high fat/high calorie. But I'm gaining weight and she's losing. :(
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Under-nutrition due to lack of eating is a common problem among elderly people. It is also dangerous. Under-nutrition and extreme thinness can lead to higher mortality rates, according to a study published in the American Journal of Clinical Nutrition. It is a problem that can't be ignored.
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Smoothies made with yogurt are good. Put a carton of yogurt the blender, then use the empty carton and add two cartons of crushed ice, and finally your FLAVOR, which can be frozen concentrated juice, like orange, cherry, apple or grape- 1 carton of that. Enough for two.
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