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We moved my MIL from Florida to Michigan in October in 2023. I know for a fact that she was losing weight and always telling us how bad the food was there. Well she is 96 and in a nursing home. She has lost 11 lbs since we moved her in. And not one person caught this. I was asking every nurse and cna. I seen the menus for the next day and she was able to circle the items that she wants. She would circle tomato soup for lunch and dinner along with hot tea. Also maybe a pudding. She would get a few spoonfuls and say she has to watch her girlish figure. She wants to be a model. She can’t eat anymore. There have been so many reasons…. She ordered a hot dog with no bun and took one bite and said it’s too cold. I reported this to the nurse of the days ( each day that we go up there). I always asked about her weight. And they would she is about the same. Finally I asked the exact question….. how much did she weigh when we moved her in …. 129 they said. What does she weigh now. …118 they said. I said now how is this ok? They said oh a red flag should have been up. I said I have asked everyone in here. No one seemed to care. So I demanded a meeting with her doctor. Whom I have not met or spoke with yet. I have an appointment tomorrow to meet with him.



Since researching this. I am learning that 78% of elderly with this disease dies without treatment and people even realizing.



Any input from others?
Thank you.

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This post is from February. OP has not posted since March 15.
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There are other health consequences to actual anorexia, not just weigh loss. It can cause hair loss, cardiac muscle atrophy, organ shut down, etc. I knew a close friend in high school who wouldn't even lick a postage stamp for fear of calories.

Your MILs weight loss is a concern. As we age, we lose our sense of taste, which makes food unappealing. The tongue's sweet sense is usually the strongest one.

I was reading online someone who worked in a clinic for people with eating disorders and said the oldest one was 70. I don't think the human body can live with true anorexia for long.

The facility should be having quarterly family conferences with you like they do with my MIL in LTC facility. The nurse reports on her weight and any other issues. Be sure to request conferences. It's true that the facility cannot force her to eat. My MILs facility wouldn't agree to "withhold" her dessert until she ate some of her entree. You may need to go there and encourage her to eat.
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I have had a difficult relationship with food.

My mom taught me that men eat first, men get to have seconds , and you only do if there are seconds after the men get there's. The snacks in the cabinet where for my brothers.

Then got married to a very hungry man, and had 4 boys. My lowest was 105, I'm 5"5 my X is 5"7 his highest was 350


I would stop eating when my life was out of control. When I couldn't control anything, I could control food what I was taking in.

I've learned when I have to much stress, how to keep eating, so my not eating doesn't get out of control.

I have my go to foods that I can eat, and I just make myself snack constantly. And the last 20 yrs or so it works very well for me. Also CBD or THC helps my appetite

But the one thing that really works
For me if nothing else does is accuputure. And I found this out by completely accident. I was going to an accuputurest for my back. And was coming home . With an endless whole in my stomach, couldn't get enough food for nothing.

When my dad passed, I lost a few, went to the accuputurest a few times and it helped.

So maybe an accuputurest or even maybe a massage may help relax her stomach and give her appetite back.
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Unless your MIL had an eating disorder when she was younger, I doubt she does now. She's 96 years old and her body is failing her.

You cannot force anyone to eat if they do not want to, so let her eat what she likes. If she will drink food replacement shakes, or similar, it would help. But, don expect miracles.

My mum has always had a difficult relationship with food, so it wasn't immediately obvious that the brain damage caused by a major cerebral hemorrhage had affected the part of her brain that governs appetite. Now, having no sensation of hunger, recently diagnosed with vascular dementia, and having a history of unspecified eating disorder, there is very little that the doctor, dietician or psychiatrist can do for my mum. And they've tried for 13 years, believe me.

My mum is only 76 years old.

I have had to accept that malnutrition will probably cause my mum's early death before dementia does. Acceptance and making your MIL as comfortable as possible will bring both you and her peace.
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She will need a psych eval to diagnose the disease you are concerned about. Ask for a thorough medical eval in case there is a medical reason for her decreased weight.
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I have never heard of anorexia nervosa except as a problem for young girls. I had a pre-pubescent daughter diagnosed with juvenile anorexia nervosa. It was very unusual in one of her age, and treated as unusual and to be checked on carefully by specialists at a major hospital. Whatever is going on with your elderly mother, I doubt if it will be classed as anorexia nervosa. Go for the other explanations first!
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The main underlying issue with the condition of anorexia is the deep need to bring order into their life when they feel they are in a situation that they have little control over. Additionally, people with this thinking have had high standards and expectations set for them, usually in their childhood by their parents that affect how they see themselves . You might consider asking the Doc if a trial of an antidepressant might help to increase her desire to eat. Some antidepressants have the side effect of increasing appetite, and of course, greatly relieve the depression that occurs in people with this illness. Furthermore, perhaps the doctor would also allow you to bring food to her that is more appealing, and perhaps has more calories, such as restaurant food. I hope this helps. Good luck and God bless.
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Christine44 Feb 18, 2024
Nikita: Yes, I think you have explained quite well the main psychological dimension of anorexia nervosa: the need to have some form of control over one's own life. Many years ago, I was employed briefly as a "sitter" (the term has since changed I believe) for a spell on a psych ward of a hospital. A young woman I grew quite fond of was a patient who had this condition. As I was assigned to her for a while, I did some reading on what was going on with her and it was impossible to put her in front of a mirror and tell her she was not "fat." As someone here pointed out, this condition most often affects young adolescent girls or even females in their late teens. She was literally wasting away, and all I could do was try to make sure she was eating regularly and not secretly taking over the counter meds that made her food intake go right through her.

Much more recently, I visited with an elderly woman who was a former resident where I live (a senior residence). She was very unhappy with her new living situation and had lost a lot of weight. As she was always very thin, the family was worried. Then they moved her to another facility where she was much happier and "miraculously" she began putting on more weight. And yes, I agree that if restaurant food is what it takes to increase the calorie intake then this may be one possible solution.
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Blackmonlori819: Eating just soup "for lunch and dinner?" cannot sustain nourishment and/or add pounds. Bear in mind that she is 96 and appetites decrease with age.
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There is a problem with the elderly and anorexia. Food doesn’t taste as good as it once did. Plus the less you eat the more you don’t want to eat, stomach shrinks. Make sure she get’s Ensure or Boost Drinks for nutrition. You can even freeze them to make a smoothie.
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My mother lived to age 95. She picked at her food about 3 weeks before she died. She had a type of wasting condition and was down to about 90 pounds. Mom got stomach cancer but died of heart failure.
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My Mom could Not taste or smell she got down to 93 Pounds . She Just could Not eat . I wouldn't worry too Much about It - I dont think it is Anorexia. Ask her if there is anything she would Like you to bring her . She May Not eat that either .
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My 95-year old mother who suffers with dimentia lost a lot of weight since she didn't have much of an appetite (5 ft. 5", 80 lbs). She has been with hospice since November and in December they gave her a pill for people with anorexia. That increased her appetite and she has gained about 15 pounds. I'm not at her place to see the name of the med. She's a very picky eater now compared to what she used to be. In addition to her meals I keep cookies around for snacks which each has 125 calories and give her Ensure complete (350 calories with 30 grams of protein).
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I think several of our newer members would benefit from reading this article.

https://www.todaysgeriatricmedicine.com/archive/JA22p14.shtml

It can be hard to change our focus as end of life nears because it goes against everything we've done and believed up until then. We've spent our lives encouraging ill loved ones to eat to "keep up their strength" and devote time and energy creating food that we hope will tempt them - food often equals nurture and love.
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MiaMoor May 12, 2024
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I wish i could help ! Im going through the same thing with my mom at home ! She is 95 with later stages of dementia.She had balemia through most of her life , it’s an ugly disease! she stopped when she started getting dementia… anyway my thoughts are at this age they don’t want to eat … my mom was a good eater then lately im having to spoon feed her. It’s a big fight ! Another issue she won’t stay awake even to eat ! It’s such a struggle at this point ! I know our situations are not the same, could it be one of her medications?? Im just learning there are medsor vitamins that can stimulate their appetite, does she have dementia? Talk to a nutritionist or philologist outside the place, get their imputs ! Wish i could be more helpful !! Thoughts and prayers are with you !! Just saying , your wonderful !
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AlvaDeer Feb 17, 2024
Our elders lose appetite over time and stop eating. You should consider a geriatric MD consult. I think it would be reassuring to know this is a natural progression toward the end of life.
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Mom moved into an AL in August. Soon after she lost 5lbs. Right after the first of the year, another 5 lbs. 10lbs in 5 months. She had graves desease and was on medication that should have put weight on her. I told the nurse that by continuing to lose meant her meds needed adjusting. I was told she ate well. Was also told that if over 5 lbs are lost, a nutritionist is brought in but she was counting only the loss since the first of the month. So before you except that weight loss at 96 is OK, have labs run. No, the aides can't force her to eat but they can coax her. Maybe you will need to be there for a meal. Ask if Ensure can be given to her. Me, I let it freeze till its the thickness of a milkshake. Really good.

If labs say everything is normal, and you witness how she eats, then chalk it up to age and a sedentary life.
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MiaMoor May 12, 2024
Hi JoAnn,
My mum used to have Aymes and now has nualtra Foodlink Complete. These are powder sachets that you mix with milk. They are a lot thicker than the readymade bottles of ForteSip or Ensure. They also taste better (smell better!).
My mum has never liked milkshake and we couldn't get her to drink the readymade bottles, but she will drink the ones that are freshly made with the powder sachets and 100 ml (I think that's 4 fl oz) of milk.

You could try those and see if they're better. They contain all the same nutrients, proteins and calories.
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I hope she enjoys the casino tomorrow. That’s awesome that the NH takes takes them on outings.
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AlvaDeer Feb 13, 2024
Oh, CHA-CHING. I love it. When I visit my daughter in Washington State once a year for a month we always hit a few Casinos. Bad girls, bad girls, whatchagonna do.
I hope for receptive slots. I love the wolves that howl, and will hate when they take them off the floor as two old fashioned.
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Ok. I think that I did not get a broad enough outline of what my intention was here. 
my MIL loves to go to bingo… would love to be taken out as often as possible…. She likes to play dice and cards. She is active. We had her one boost that was 40 grams of protein a day. The facility med pass ( generic) is 18 gram of protein a day. So her not wanting to eat … I get. But she wants to keep living. She has a list of things she wants to do and go. But she is on a liquid diet basically so that causes her bowels to be the runs basically. So I was looking for ways to get her to eat. 
they don’t allow air fryers. 

just want her to live as long as God allows her to and in a healthy way. It I see her giving up on life…. Then I understand. 

she is begging to go to the casino after her cataract surgery tomorrow heals up.
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Anxietynacy Feb 13, 2024
I would really try accuputure, I went for a neck issue actually, left there and just couldn't stop eating.
Not sure but maybe a massage might have to same reaction
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My husbands grandmother was skin and bones and looked like a walking skeleton and thought she looked great for her age (I think she was 90). She would make a can of soup last for 2 or more days.

At 96 your mother is not going to be treated and cured if she does have anorexia. It is a complicated disease that takes a lot of therapy to try and treat and cure - if that is in fact what your mother has. Her comments about wanting to be a model and having to watch her figure could be cognitive decline or an eating disorder.

How was her eating when she was younger? Has she always been prone to eating little to nothing or is this something new? If it is something new it may be that she is not really hungry - though in your comments she says the food tastes bad. Have you brought her food she wants to eat and does she eat it? If she won't eat anything - even food she likes then she may very well have disordered eating.

But what can you do about it if she does have an eating disorder at 96 years old? Bring her to therapy? Would she even agree to go?
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She is 96.

Elders, approaching end of life, lose their drive both to eat, and to drink in the final stages of life.
That will not be what takes your mother, however, as these same elders (witness Joan Didion) can live weighing 76 pounds for quite some time.
What will take your mother is the normal aging process, which she is well progressed in at 96. Her heart, lungs, kidneys, brain are now 96 years old. To be blunt, they are worn out.

How long do you want your mother to live in her nursing home?
To age 100?
To age 110?
Forever?

Let us assume (and I do not BELIEVE) that you are right about your diagnosis? What would you choose to do at this point. Put down a feeding tube? Force food that will cause diarrhea and further wasting, infection and sores? Give her psychological counseling.

I think you are overly enmeshing here in the caregiving, and worrying too much about something that to be honest, in my opinion, seems to be going well. I would suggest you see a cognitive therapist or a licensed social worker in private practice (often best at counseling on life transitions) for a few sessions.

I wish you the best.
Meanwhile you have what sounds like a decent facility here, that is caring, and a relatively content mother, who is not expressing hunger or a wish for more sustenance or different sustenance.
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Your mother is 96. Stop obsessing over her eating habits.
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I agree that people over 95 don't typically eat as much - because they aren't expending energy - aka burning calories.

During COVID lockdown - my then 94 year old grandmother lived with us for the duration. I was cooking for 6 people during that time - for dinner. For breakfast and lunch they fended for themselves because I was working. Because things were so stressful due to the lockdown - I tended to try to fix things everyone loved. And we would plate it for my grandmother.

She gained 6 pounds. But she was also taking short walks with my mom and our college aged daughters. She was engaging in interactions with all of them during the day - playing games, watching the girls play video games or whatever they were doing. She was much more active.

As soon as she went home she lost that weight quickly - because she wasn't hungry and would grab a yogurt and swear it held her over for the day until she had cheese and crackers for dinner or whatever.

My mom eventually moved in with her and started cooking. She eats more on the days she is engaged and "active". On the days mom is out of the house for a few hours - she won't eat a thing until mom comes home and brings it to her. Her weight is leveled off now.

My MIL - on the other hand - most definitely had an eating disorder. She would NOT eat in front of anyone in the entire time I knew her. We would go to restaurants and she would eat a bite or two and say she was full and take it home with her. When she got older, she got even more secretive about food. She would cook huge meals for everyone else, and never sit down at the table with us to eat. She would plate monstrosity plates to the point that I told her I was handling my own plate and then our girls plates because she used a ladle as a serving spoon and gave out way too much food. She thought other people should eat way more than a normal portion. But she avoided eating until she was in private so we couldn't tell how much she ate. When she passed away (lived at home with FIL until her death) - I think she weighed less than 100 pounds. Her relationship with food was very unbalanced. Everyone else needed MORE food but she needed LESS.


Does she like something special? Milkshakes maybe or a burger from a favorite place? My grandmother would say she wasn't hungry but clear a plate of fried shrimp all along saying it was too much food lol. If we offered my MIL anything like that she would just say "no thanks".

Maybe try bringing her something you know she loves and see how she does. Institutional food is not typically anyone's favorite thing. My FIL lost a bunch of weight when he went into SNF (he weighed 300+ lbs - so he had it to lose) simply because he hated the food. (he complained literally every single day he was there) But if they brought him a specific sandwich or we brought outside food - he would eat every single bit.
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No doubt her weight should be monitored in a managed care setting. But also be aware that appetite often declines naturally with advanced age. Both my parents ate less and less after a lifetime of healthy appetites. Plus as people move around less, they have less need of food. Your mom will not be forced to eat in a nursing home, nor should she be. She may be on a new path with food now
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ElizabethAR37 Feb 17, 2024
Yes, possibly a new path. . .what's happening may be a form of VSED (Voluntarily Stopping Eating and Drinking). To me, that would be totally understandable at 96 Y/O. (I'm 87 and it could be a future consideration for me depending on circumstances. My old body and I have NO desire to be around at 96!) IMO, very old/ill/debilitated elders may, perhaps unconsciously, employ that method when they are simply "done". Tempting/favorite foods can be offered, but if there is no interest, that may be the new path.

In this case Mom appears to have an ongoing interest in living and doing (visits to the casino at 96!). VSED may not apply in this situation; however, I think it may when very old, debilitated people refuse food.
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I also wanted to say, as a person with eating disorder issues that one thing that really helps, when I feel a reoccurrence coming is accuputure. CBD if it's leagle in your state may help.
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Might be easier to understand where eat disorders come from, they are not about looking thin or good. They are about control, your moms life is out of her control and the only thing she can control is what she puts in her mouth.
I'm sure this is hard, at your mom's age I don't know if much can be done about it.
My heart goes out to you
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Your concern is totally understandable but no facility can force someone to eat. At my MIL's LTC facility we discovered she was eating her dessert first then not eating the rest of her meal. I asked the admins if the staff could first serve her the tray of main course, then a little later give her the dessert. Nope. They said this is considered "withholding" food, so they couldn't do it.

There are some medical issues for which there are simple tests and fixes, like for thyroid. Is it possible to test hers?
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My mom was obsessed with her weight. She got on the scale daily. She was like your mom and never wanted to lose her ‘girlish’ figure. When her doctor told her not to lose any more weight, she ignored it.

It got worse as she aged. She lost her appetite and barely ate. Somehow, she lived to be 95 years old.

I understand how you feel. My mother was skin and bones.
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Your MIL may be failing to thrive, at 96, rather than suffering from anorexia. Not to mention, what sort of "treatment" are you hoping for her to get for a condition that falls under an eating disorder, which is a mental health issue? Speak to her doctor about an appetite stimulant, perhaps, and bring her some food she misses eating. I know of no SNF that wins awards for their cooking.

Most elders at 96 eat a few bites of food a day and that's it. By the time my mother reached 95, she'd gone from eating like a lumberjack to pushing food around on her plate.

Best of luck to you.
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A lot of 95+ people don’t eat much because they don’t need a lot of food. Their energy expenditures are low. What are her activities each day? How much does she exercise? Walk miles? Do you feed her when you are there? Does she eat for you?
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