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It seems like you don't have much respect for those of us who feel that eating organic, unprocessed food is healthier. If your mother senses that, it may make her more obstinate about this. May I suggest that you find nutritional advice for her from people who do respect this way of eating? You will probably not find that in a hospital or in the office of most M.D.'s. A starting point might be a visit to a good naturopathic physician. A functional medicine M.D. could also be helpful, but there aren't a lot of them around.
I understand that your mother needs to eat a more balanced diet and a larger quantity of healthy food. If someone wanted me to take Ensure or eat bacon, I would refuse it too. I don't think all of us who want to eat a healthier, lower toxin, diet are mentally ill. A naturopathic physician might be able to address whatever mental health issues your mother has via diet and supplements. She might be more willing to listen to someone who shares at least some of her dietary concerns. Maybe don't go with her, or just listen.
I never said that "all people who want to eat a healthier, lower toxin diet are mentally ill." If that were the case, then I guess I'm mentally ill too. I eat mostly organic foods and as natural as possible, so it's not that I don't have respect for that approach.
What I do believe though is that there is a type of eating disorder that causes people to become extremely fixated on this sort of thing, to their own detriment - and I think my mother falls into that category.
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Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with “slip-ups.” An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.
Eventually food choices become so restrictive, in both variety and calories, that health suffers – an ironic twist for a person so completely dedicated to healthy eating.
For instance, her aversion to healthy fats. My mother NEEDS healthy fats - most people with common sense, especially those who are naturally and easily slim and have never fought a weight issue in their entire lives, know that. But my mother fights eating even the most healthy fats.
For instance, she used to love peanut butter. Well, somewhere along the past year or so, she has decided it's not healthy. So I took her to the local natural food market (the one I frequent in fact), and showed her that you can grind your own peanut butter there, from nothing but raw peanuts. I even got some for her. She claimed she "doesn't like it," even though she has eaten natural, unsalted peanut butter most of her life.
Also, she hardly eats any fresh vegetables other than lettuce. This is because she is afraid that they have been sprayed or genetically altered. It doesn't matter if they are from Natural Grocers or Fresh or declared to be organic and unaltered - she is still overly suspicious of them.
The Ensure and bacon were not my ideas or suggestions. My suggestion (which she agreed to) was for her to make smoothies out of whole milk, rice protein, flaxseed, a multivitamin (made specifically for smoothies), and frozen fresh fruit and maybe even local honey and unsweetened Greek yogurt as a dietary supplement, rather than taking a probiotic (yogurt based) pill and a multivitamin supplement in pill form. She has agreed to that and even drunk one since yesterday but time will tell on that.
Her doctor is a "natural" type doctor and when my dad and I described what we were proposing she eat more of (avocados, natural peanut butter, baked potatoes with sour cream and cheese, broccoli with cheese sauce, brussel sprouts tossed in butter, that sort of thing), he said, "ABSOLUTELY." She thinks he hung the moon, so if hearing him tell her to do it rather than us works, I'll take that. He even followed it up with, "These two people who love you make good sense. How bout this - how bout you eat what they tell you to eat?" She agreed to that as well, but like I said, we'll see.
However, I am very surprised that they did not address her weight loss in the hospital. When my husband was in the hospital, for six weeks this fall, I was told that it was a requirement that he be weighed each and every day. And they noticed immediately if there was a fluctuation of even a pound or two and addressed it by discussing it with me, the doctor and/or the nutritionist
When my elderly aunt broke her hip, two years ago, she was also weighed every day in the hospital and the doctor was immediately concerned when she only lost, I believe, only two pounds in several weeks and put her on Ensure twice a day, extra calories, extra desserts.
These are the only two cases that I was involved with recently and in both cases, I believe, the doctors & hospitals would never, ever, ever have allowed the patient to lose ten pounds in two weeks.
Kathryn, did they not weigh your mom in the hospital or did they ignore her weight loss or did she just refuse to eat even in the hospital? Something is strange.
BTW, were her mental heath issues ever addressed in the hospital?
PS. We must have been typing at the same time, as I just saw your additional post that stated that the hospital & doctors were concerned about her weight loss and were trying to fix it.
LOL no problem!
She just refused to eat hardly anything in the hospital. She ate maybe 400 calories a day max. I know - I was there. They were concerned but told us to follow up with it when she was released and over the hump when it came to her hip. Which is now, I guess.
Her mental health doctor was supposed to come visit her while she was in rehab, but he just didn't. He did call and say he needed to see her but it would have to be in his office. I think the rehab hospital just figured he had this under control so they passed the buck so to speak.
I was SHOCKED to find out she had lost ten pounds in two weeks, while in a hospital!!!!! All they did was try to make her drink more Ensure. That was basically it.
FWIW know that you want to help but
It is Dads job to take care of his wife if he is mentally and physically able to do so.
Given everything you have said on this, suggest you let Dad take over and let your role be to simply enjoy whatever, Easter, your Mom, your Dad, your family etc. Really you have earned a step back role after all you have taken care of through the years
Not saying this in a vindictive angry way toward your mother or anyone. Just the cycle of life and where we stand in it at the moment. Know you love and care for Mom and want to help her but sometimes help can be different than the old paradigm. A new role is waiting for you KofA. Enjoy the ride, it may get bumpy but you can do
Good luck. And I like the idea of introducing your Dad to a blender and nutritional smoothies. Imagine if he made one for your Mom extolling all the natural health benefits...
He made one for her yesterday and apparently it was a pretty big hit! Thanks for the kind post.
My daughter will not do anything more than gently say, "Oh _______, you should eat more!"
My mom has asked that I go to doctor meetings with them. That surprises me but I'll gladly go. And my dad is even more insistent that I go with them to any sort of doctor appt that may be the slightest bit uncomfortable or confrontational or where we may have to discuss my mother's mental state. It's like he needs backup or he gets flustered and can't stand up to her, but if I'm there and if I bring things up then he will back up what I'm saying.
And it is a good thing I was there today because if I hadn't said anything about getting a prescription for a mood stabilizer (Paxil, Prozac, that sort of thing) my dad simply would not have pressed the issue, even though the RN checking my mom in had already brought it up prior to the meeting with the doctor and my dad had said, "Yes, that's one of the things we're here for." At the end of the meeting with the doctor, and a lecture to my mom about better nutrition, and a series of tests ordered for an even more indepth look at her nutritional deficits, the doctor was about to get up and leave and I looked over at my dad with a "Well, go on" expression, and he just gave me this blank look and finally I said, "Wait - what about the mood stabilizer to address the appetite issue (they are the same ones used to address bipolar disorder, which my mom has already been diagnosed with)?" and the doctor said, "Oh that's an easy fix - I'll call it in right away," and then he turned to my mother and said, "And you are to take one of these every single night," and she meekly agreed.
If I hadn't pressed the issue or been there, my dad would have been calling me tonight saying, "Well, I thought they were going to prescribe something for her bipolar disorder and appetite but I guess not."
See why I worry about these two? It's like my dad talks a big talk but then get him in a slightly uncomfortable or what he perceives as confrontational situation and he just melts away. Sheeze!
We came home and the doctor had already told her to eat some ice cream when she got in as an afternoon snack. So she said, "Well, I guess I should get my ice cream," and my dad said, "You know how to get it." Come on, Dad - yes, she knows how to get it but if you leave it to her, she will get about a tablespoon, eat about half that and then get on the phone telling everyone she ate at least a cup of ice cream. So I said, "I'll get her situated and you get the ice cream, Dad," and he did so, and as I came back into the kitchen, he showed me this tiny amount of ice cream in the bottom of a bowl, and said, "You think that's enough?" I said, "No, Dad - she's not on a diet. You're trying to fatten her up. Give her at least half a cup of ice cream - not a couple of tablespoons!" So he did so. And you know what? My mom likes ice cream and she ate every bit of it.
It doesn't seem like this should be so difficult.
Oh, and my mother had lost ANOTHER pound since yesterday. So now she weighs under 120 pounds.
But the good news is that she seemed grateful for my "bossiness" today and yesterday, and even did something very much out of character for her when I left today - she reached out and grabbed my arm with both hands and began caressing my arm and got big tears in her eyes and said, "Thank you - you are being such a help to both of us." Wow, THAT was a sweet moment and a rare one too, so I admit that it felt good. And I said, "Well, I know I'm bossy, but God knows you need someone bossier than you are right now, so I guess God put us together."
So - we'll see. She's in a weakened state right now so she's likely to be more compliant. We'll see how she cooperates as her strength improves!
There are patient advocates that can navigate the medical appointments with your parents, if your dad is too meek to address her issues while talking to the doctor.
You could find someone to help around the house, prepare food and do their best to get her to eat it. She's losing weight whether you're there or not. If they are affluent, there's no need to take it on yourself. Perhaps someone trained in this kind of caregiving. That would take pressure off your dad, when he obviously can't cope, and you can stop being the nagging bad guy.
I get the feeling you don't want to relinquish control of the situation. But perhaps that's what they need you to do.
Kathryn, please re-read what you wrote in another thread, which is GREAT advice.
My mother was very much like yours. Untreated mental illness, dementia, denial, fixated on the ridiculous. And my sister is very much like you.
My mother did not respond to my sister at all. In fact, my sister just made things worse when she told my mother what to do. My sister couldn't even suggest something without my mother becoming oppositional.
I didn't have a good relationship with my mother either, but I was able to subtly influence her now and then. Telling her what to do simply wouldn't work, even if it came from me. I accepted that it was my mother's life, and she never asked me to be in charge of it - although I was, as a caregiver, and my mother hated that.
Thank you. Yes, it's hard for me to step back. I admit that. Especially when my dad seems to be so afraid of confrontation with her.
She adores my brother (who is severely mentally ill but in a successful treatment program - hmmm, wonder why she finds it so much easier to relate to him than to me? ). I have begged him to be direct with her about the need to address her own mental illnesses, but in order to do that, he would have to be confrontational with her and the conversation might not be pleasant and she might not like him as much afterwards, so he finds it very difficult to be direct with her (as does my dad, but he's getting better).
If the meds for bipolar disorder don't work - if she's simply got too much brain damage (stroke) and dementia (stroke and old age) for it to be effective, then I am giving up the fight, so to speak because it truly will be impossible to reason with her. But I do want to get those meds prescribed (they are now) and her taking them (she promised the doctor she adores that she would). Frankly, this would not have happened if I hadn't been involved and pushed the issue, because no one else is willing to do so.
So you see why it's hard for me to just say, "It's your life, do what you want," when there may be a TREATABLE condition at play - one that just needs an extra push to get the meds going. Today was a break through - we've been trying to get her to agree to take a mood stabilizing medication for literally decades.
But I do agree - I need to be less a caregiver and more just a daughter. I actually talked with my dad about this yesterday - in pretty hard terms - and told him that after today's doctor appt, I was going to reel it way back and that he would simply have to take charge because frankly it's not my job - it's his.
And it is his.
I will not be going over there tomorrow, and probably not the next day either. I've agreed with my dad to "spell him" for four hours once a week and to drop by a couple of times a week just to say hello. So we'll see how that plays out!
It might change things if she is told that part of her confusion may be related to her poor nutrition. And it might be! The doctor needs to tell her this...not you! And maybe she needs to hear the plain unvarnished truth. If she doesn't change and start taking care of herself properly, she is headed towards the nursing home.
This is basically what happened today at her doctor appointment and she became immediately meek and compliant! YAY, DOCTOR!
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A psychiatric social worker gave me this idea for my mom and it worked amazingly well. We made up a contract stating what mom had to do to come home. We sat down and discussed every point and got her agreement. I signed it, the SW signed it and my mom signed too. Then we posted copies of the contract all over mom's room and we kept copies too. I made sure she read it every day and the SW went over it with her often too. It was just simple stuff but somehow it helped to have it written down so mom knew exactly what she had to do. Here's what I remember.
1) Gain 1/2 pound a week. Eat more!
2) Shower/bathe at least 3 times a week.
3) Eat in the dining room at least once a day.
4) Attend group therapy at least 4 times a week.
5) Attend all private therapy sessions as scheduled.
6) Take all medications and vitamins.
7) Fresh underwear every day.
8) Walk outside for 20 minutes every day or inside if the weather is bad.
9) Spend no more than 12 hours a day in bed. Up and dressed for the other 12 hours.
10) Read something every day.
11) Go to occupational therapy, arts and crafts, at least 3 times a week.
What a great list. I will share it with my dad (with some modifications since my mom is at home and not in a facility), and see what he thinks of it. If he likes it, he can present it to her without me involved at all.
He initially prescribed risperdal, but when my dad and I looked it up, it specifically said that it holds higher risk for elderly patients with dementia so my dad emailed the doctor asking about Paxil instead. The doctor responds quickly to emails, so we should have an answer in a day or two max.
There are patient advocates that can navigate the medical appointments with your parents, if your dad is too meek to address her issues while talking to the doctor.
You could find someone to help around the house, prepare food and do their best to get her to eat it. She's losing weight whether you're there or not. If they are affluent, there's no need to take it on yourself. Perhaps someone trained in this kind of caregiving. That would take pressure off your dad, when he obviously can't cope, and you can stop being the nagging bad guy.
I get the feeling you don't want to relinquish control of the situation. But perhaps that's what they need you to do.
It's not a control issue. It's a deep love and concern and fear for my Mom issue. It's very difficult to watch someone I love self destruct.
My dad has a housekeeper lined up (yay!). He is actually a pretty good cook and in fact, made red beans and rice for my mom for lunch today (yay!). I am not going to be cooking for her. All I did was give my dad some smoothie recipes for in between meal snacks. I didn't even make one for her. He made it, she drank it.
Yes, I admit to getting a bit frantic when she got on the scales yesterday and she had lost ten pounds in two weeks - and her blood pressure had plummeted to 88/51 (from her usual excellent BP of 120/70). That rattled me pretty badly. I did get adamant and probably strident in fact. But the doctor did back up every single thing I told her today, and even told her to quit fighting the people who love her the most and want to help her the most. I appreciated that, whether she goes along with it or not.
I'm wired together like this - I am pretty relentless with myself and situations until I know I've done all I can do to better a situation. I feel that way now - we've finally got the attention of a medical professional about her weight (this is her regular doctor who has been tracking her weight now for a year and was already concerned about it), and we've finally got a prescription for a mood stabilizer and her agreement to take it. Honestly, those are HUGE successes - so I feel more able to relax.
I was just about rattled out of my own skin yesterday when I realized she weighed 120 pounds (119 today). Sheeze!!!! She looks awful! My mother is a naturally beautiful woman and the difference in her formerly vibrant looks, health and wellbeing from just a year ago is distressing.
She just refused to eat hardly anything in the hospital. She ate maybe 400 calories a day max. I know - I was there. They were concerned but told us to follow up with it when she was released and over the hump when it came to her hip. Which is now, I guess.
Her mental health doctor was supposed to come visit her while she was in rehab, but he just didn't. He did call and say he needed to see her but it would have to be in his office. I think the rehab hospital just figured he had this under control so they passed the buck so to speak.
I was SHOCKED to find out she had lost ten pounds in two weeks, while in ahospital!!!!! All they did was try to make her drink more Ensure. That was basically it.
That was so very different than when my aunt was in the hospital for her broken hip. They told her that if she did not eat more they would give her "more calories through her IV" or something like that. They made a special point of bringing her extra desserts and scheduling extra snacks of cheese and things like that. In addition to her regular meals she had mid morning, mid afternoon & bedtime snacks.
I just remembered that when my husband refused to eat enough when he was in the hospital, with complications from colon cancer, his doctor said to him point blank. "If you do not eat more you will die. If you are trying to die under my watch I will be forced to transfer you to the psych ward and put you under suicide watch!!!" Trust me, my husband started to eat more. Heck, I wasn't even the patient and the doctor was so forceful that he almost scared me into eating more, too!
I can not believe that the hospital let her lose that much weight so fast. Did they mistakenly think that she was terminally ill or something?
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). I have begged him to be direct with her about the need to address her own mental illnesses, but in order to do that, he would have to be confrontational with her and the conversation might not be pleasant and she might not like him as much afterwards, so he finds it very difficult to be direct with her (as does my dad, but he's getting better). 
