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He is 89 years old, good physical health and takes very little medication. He has been taking medication for his memory for about 7 years. He know me and a few of our friends and business partner. Recently he has started to sleep a lot and refuses to eat much and drink. It is hard to get him to drink, as he is laying down. He seems happy and smiles at me, and he can walk to the bathroom, however he is using Depends and should use a walker. He has lost about 8 pounds in the last 6 months and appears to be continuing. Not skinny, but about 5'5" and 158. My concern is if I let him dictate his wishes to not eat, and he looses more weight, will I be considered neglecting him. I am able to look after him as I do not work outside the home and several years younger then him. He saw the doctor last month and She noted his weight loss and didn't seemed alarmed. I have tried to be creative in feeding him. I hand feed him fruit and breakfast cake when he is bed, and can usually get him up in the early evening for a small meal and ice cream. He has never drank water, so it is coke or orange juice. I don't want to fight with him about eating and drinking and it is very difficult to reason with him about the advantages of going so. He doesn't seem to have much strength and not eating isn't helping. He has a health directive, but at what point does one follow it?

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Isabella, Your husband's body is telling him something. How could you force feed him? I say this with respect and sympathy, but you may need to contact hospice. His Alzheimer's has been going on for quite a few years. Sleeping a lot and not eating would cause me to be thinking of hospice. Call them for a consultation. They can be very caring and considerate of your husband's needs and yours.
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There could be a lot of things going on, but one thing I see immediately is the consumption of coke, which is one of the worst things anyone of any age could drink. The sugar spikes alone could cause him to be fatigued.

Try to ease off of that and substitute with something more healthy. Since he likes OJ, maybe he'd like cider. It's at least more healthy than the chemicals and water of coke.

I suspect also he may like being hand fed. And not being active could cause a reduction in his appetite. Not eating well is such a complicated factor for the elderly.

Have you tried Ensure Plus or one of the nutritional drinks? We deal with the weight loss issue as well. EP is one of the few nutritional drinks my father likes.

At some time, though, the body begins to shut down, and your husband may be reflecting entry into that stage.
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Oh please, no forced eating! At this point he should eat and drink anything he wants, including Coke and other non-nutritional. He is 89 years old and he has had dementia for several years. Giving up Coke or eating a well-balanced diet is not going to cure him or improve the quality of his life at this point. (This is NOT the advice I give to young people!)

Keeping up his weight may improve the quality of his life, so if he is willing, give him high-calorie foods. My husband liked milk shakes, sometimes with bananas or berries, always with ice cream. He also liked scrambled eggs with cheese.

One thing concerns me, and that is feeding him while he is lying down. Choking and aspirating food is a high risk for persons with dementia. Having him sit up as straight as he can while he is eating is safer.

As others have said, as the body shuts down there is less and less interest in food and more and more sleeping. I called in hospice when my husband's sleep pattern reached 20 hours a day.
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Agree with above advice especially a hospice consultation. they will give you the support you need to let him do what feels best to him also provide equipment as needed. A hospital be may be helpful in having him sit up while being fed
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Listen to all of the above, especially the part about contacting hospice. I did. The hospice team of a nurse, social worker and home health aide helped me keep my husband home until the last four months of his life, when I had to place him in a long term care facility because I was 84 and stressed out. I bought him Coke by the carton. I don't drink it. Hospice will help you keep your husband at home as long as possible for both of you.
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Ah, the coke addiction. My 86 yr old father has never had a drop of water in his life that I'm aware of. He has dementia and I've given up on trying to get him to change. Garden artist is right, the stuff is horrible for anyone. My dad will go through 4 cans per day. I tried Diet Coke on him. Would have thought it was radioactive. So here we are. Sometimes there's only so much you can do.
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Alzheimer's patients crave sugar. At 88 mom's doctor and I let her have what she wants. We're thrilled she's eating. Maybe you can prop your husband up and sit or lie on his bed with him and watch some movies with him. Include snacks or sandwiches. Definitely prop him up to eat and drink. Alzheimer's patients lose weight. Its all part of it. You take him for doctor visits. You are doing everything you can. Its obvious to me you love him very much. Make him happy. Make him comfortable. Call his doctor with your concerns. He will guide you as to your next steps.
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Isabella1, You are a truly wonderful Lady, and I know from Your post that You are worried sick, and You Adore Your dear Husband Who is 89 years, hence You must be 84-85, where do You get Your strength from. My Mother had Alzheimer's but Mom had a terrific appetite and loved Her food up till the end. My guess is that We are all different and as We become older We desire less food.
Blessings and {{{HUGS}}} to You Isabella1, and Your dear Husband.
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I can see why your doc was not alarmed over the weight loss. Eight pounds in six months...do the math. Men, at any age, might gain or lose much more than that just from athletic activity, pizza parties, change of environment, or retiring. Older men typically lose muscle mass. Even if they are healthy and fit, it is inevitable. Inactivity means he is not using these muscles as he used to. Less activity will most likely lead to lowered appetite, except when folks nibble out of boredom. As for the coke, it provides calories, fluids, and a small amount of caffeine. Many people find caffeine helps not only depression, but counteracts medication side effects. Also, sometimes it feels awesome being a bit "naughty" and breaking other people's rules now and then. I remember my dad loved being sneaky by turning up the thermostat when my mom's back was turned.
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If he continues to lose weight he will become frail and start to fall. I find magnesium helps my muscle strength. I tried to take my daddy high calorie things like Chocolate Malts and Banana Shakes. He loved them. And making food more tasty. Of course, I'm a fan of butter. A loaded baked potato is w/ butter, real bacon bits, chives, sour cream and shredded cheddar cheese. Blessings through the Yuletide.
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Isabella I think you are doing everything just right and no one would be critical of you. It will eventually come to the stage where he is not safe to be left alone.
All older people tend to crave sweet things as the taste declines with age whether they are demented or not. Of course you are worried but this is the way life goes. Even if you don't feel the need for hospice or simply don't want them at least talk to them and see what they have to offer.
Do you think he might nibble on things like chocolate if you left things beside the bed. i agree that soda is far from an ideal drink but at least he is getting some fluid intake and that really is all one can ask at his age.
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Hi Isabella, a lot of great comments above worth listening to, this is a great group of people with a great deal of wisdom. I take care of my mom who is 81, I am 59. I know how you feel on the weight loss, my mom has lost 60 plus pounds in about 6 months. The doctor does not seemed concerned at all. Part of her not eating was she developed swallowing issues that I was not aware of. Once I was told that, I could make the necessary adjustments. Has you husband been seen by a speech therapist? That is who told me my mom had swallowing issues. However, mom has continued not to eat or drink much. It's a personal call but for me to force her to eat doesn't work, she won't even open her mouth when she doesn't want to eat. Because she is not eating well she is becoming weaker. She also has a lot of issues with not sleeping for days, or not wanting to get out of bed for a few days. So because of all this she has now become a high risk for falls. She fell 5 times in a matter of hours last week plus walked right into a door frame and has a whopper of a black eye. She doesn't understand nor does she remember any of the falling incidents.
From my research, weight loss can be very common at certain stages, for some people. So perhaps that is why the doctor does not seem concerned. As caregivers we do what we can do and we do it with love in our heart. Take care of yourself, it is so easy to let our own self care go during these times. Please take care of yourself. Keep doing the best you can, that is all you can do.
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I would first have him checked by a doctor to see if this is the first sign of him starting the dying process because some people will eat little to nothing during the dying process. I'm not saying all dying processes will be alike because they may differ. One option you do have if needed is the option of a feeding tube. Feeding tubes can actually be bypassed right into the stomach. A friend of mine had a special needs daughter who went on a feeding tube toward the end of her life, hers was plugged directly into the stomach through the middle abdomen and not passed through her nose like in old days when I used to pass them down the person's nose and into the stomach. Her parents had to sit down with her for a few minutes at each feeding and slowly introduce the nutritional fluid through the X ternal attachment and into their daughter's stomach. No one knew she was nearing the end until it actually happened.
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Isabella, I agree with most of the people here. At age 89, your husband's body is telling him something. Since the doctor isn't concerned I don't think you should be either. I can't imagine forcing him to eat against his will. If you feel you need backup, use the POA but I doubt that you'll get an argument from anyone. It sounds as if you're taking good care of him.
Take care of yourself, too.
Carol
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