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My mom is 86 years old. Her and my 83 yr old dad have enjoyed an independent life. My mom has always been a small, fragile looking lady most of her elderly life.Probably never weighed over 130 lbs ever. But in her 80's, she was under 100 lbs. The joke in our family was that Nana ate like a tiny bird.
I live in Arizona, they live in Texas with one of my brothers living about 20 minutes away.
On Thanksgiving 2016, my mom had pneumonia and we had to force her to go the hospital. She didn't want to work the doctors on Thanksgiving Day she said, lol.
Within 2 days, the doctor said she did really well responding to the medication.
We decided to make her go to a rehab the following week to gain some strength back. She walked with a walker the last couple of years.
The day before she went to short term rehab, she told me on the phone that she was having some trouble swallowing. So when she was in rehab, they sent a big van with testing machines on it to test her throat, and they did find weakness at the bottom of her throat, apparently where the throat blocks liquids and food from going in the lungs, hence giving her pneumonia.
So the following doctor appts in December suddenly had her eating only specific things, and having to chew a certain amount of times, etc. They even told her that she couldn't even eat her beloved Jello.
This in turn depressed my mom and gave her anxiety when she ate thinking she was going to choke, so she was eating less than normal.
It was February 2017 that my mom told me the doctors were on to her about her weight, that she now only weighed 82 lbs. She had chronic constipation and she would complain of having nausea in the middle of the night. All this time we had to keep telling her to eat to gain weight. She did get up to 85 pounds and sustained that for a while. My mom last summer 2016 weighed 97 lbs.
She went to the ER at the end of March for feeling unwell and weak. She said she was shocked when they told her nothing was wrong with her other than being underweight.
2 weeks later, mid April, she was in the ER again with the same complaints. Again, nothing found. We decided to put her in a rehab again to hopefully gain weight and strength back.
She was in for 10 days doing exercises every day. She hated the mush food and barely ate it. She lost 1 1/2 pounds in there. But two days after leaving the rehab, a nurse came by and weighed her on a scale at home and it said she was 80.5.
May 7, she went back to the ER for extreme weakness. Apparently, the day before she had horrible diarrhea. She said she was in and out of the bathroom with constipation so she took some Milk of Magnesia at 5 am and it started explosive diarrhea.
We were all shocked when the ER doctor said they found a massive fecal blockage and said, "no wonder she hasn't been feeling well the last couple of months."
They weighed her that night in her hospital bed and said she weighed 87 pounds. No way, we thought, she weighed only 80 the previous week at home.
So for 5 days straight, my 86 year old mother had enema after enema, even some sort of enema machine nonstop, to some sort of colonoscopy type procedure to loosen things up. Most of it had been released, but still had a fist size amount still in there. The hospital said that was all they could do and said for her to go to a rehab to do exercises and the movement would hopefully loosen the last bit up. The doctor said the fecal blockages can cause a person to lose their appetite and lose weight. When they weighed her before she left the hospital, they stood her on the scale and it said she weighed 94.6. No way, has to be the fluids from the IV.
She was sent to a rehab Monday night. Here we are Wednesday afternoon and my dad is saying she is in bad shape and just not eating. They took her to physical therapy this morning, but she only eats a few bites of food.
My mom has no terminal illness, and her issues stem around this thing with her throat, and it causing her to be scared to eat, thus causing this weight loss that has brought her down physically.
Now she feels so bad psychically, she has no appetite, so that puts her in grave condition at her age.
What about feeding tubes? If her being scared to eat is causing this weight loss, why can't she have a feeding tube? Her nurse told me a couple of weeks ago that it's because the medical community approves them for people who can't eat from obvious reasons, and that my mom can still feed herself.
But the stay in the hospital for 8 days and all the horrible procedures she had over and over really wore her out, and I feel a feeding tube could help her. She's so weak now that she doesn't have an appetite.
You've left out the most important question of all: what does YOUR MOTHER want to do? Pushing a feeding tube on her if she doesn't want one shouldn't be done.
I've never asked her. My daughter and I are flying in on June 7th for a week for a family visit and she's looking forward to it. But I feel if things keep going the way they are, she won't make it to June 7.
My husband was in the hospital throwing up blood. They started to put a feeding tube in him and he could not stand the procedure. He refused to let them put it in. He went without food for several days then was all right. They used the IV solution to keep him from being dehydrated.
We both think we would rather die than have a feeding tube. Find a food she really likes so she will want to eat. His feeding tube was so painful he could not take it along with everything else.
Um, a feeding tube won't address the issue of her bowels not moving. Sounds like she still has a fist size blockage. How is a feeding tube going to help that?
Her symptoms were a slight speech problem and slight difficulty swallowing.
They advised her to get a feeding peg inserted into her stomach surgically before she absolutely needed it.
One of the wisest decisions she ever made!
It allowed her to eat a portion of her nutrients orally and take the balance via feeding peg.
As the paralysis of the throat got worse, the percent taken by peg increased.
In November of 2012 she was taking 100% via peg .
The ALS killed her off a year later in November 2012.
I ( and my wife ) were very grateful for the advice given on having that feeding peg installed.
My mom is 86 years old. Her and my 83 yr old dad have enjoyed an independent life. My mom has always been a small, fragile looking lady most of her elderly life.Probably never weighed over 130 lbs ever. But in her 80's, she was under 100 lbs. The joke in our family was that Nana ate like a tiny bird.
I live in Arizona, they live in Texas with one of my brothers living about 20 minutes away.
On Thanksgiving 2016, my mom had pneumonia and we had to force her to go the hospital. She didn't want to work the doctors on Thanksgiving Day she said, lol.
Within 2 days, the doctor said she did really well responding to the medication.
We decided to make her go to a rehab the following week to gain some strength back. She walked with a walker the last couple of years.
The day before she went to short term rehab, she told me on the phone that she was having some trouble swallowing. So when she was in rehab, they sent a big van with testing machines on it to test her throat, and they did find weakness at the bottom of her throat, apparently where the throat blocks liquids and food from going in the lungs, hence giving her pneumonia.
So the following doctor appts in December suddenly had her eating only specific things, and having to chew a certain amount of times, etc. They even told her that she couldn't even eat her beloved Jello.
This in turn depressed my mom and gave her anxiety when she ate thinking she was going to choke, so she was eating less than normal.
It was February 2017 that my mom told me the doctors were on to her about her weight, that she now only weighed 82 lbs. She had chronic constipation and she would complain of having nausea in the middle of the night. All this time we had to keep telling her to eat to gain weight. She did get up to 85 pounds and sustained that for a while. My mom last summer 2016 weighed 97 lbs.
She went to the ER at the end of March for feeling unwell and weak. She said she was shocked when they told her nothing was wrong with her other than being underweight.
2 weeks later, mid April, she was in the ER again with the same complaints. Again, nothing found. We decided to put her in a rehab again to hopefully gain weight and strength back.
She was in for 10 days doing exercises every day. She hated the mush food and barely ate it. She lost 1 1/2 pounds in there. But two days after leaving the rehab, a nurse came by and weighed her on a scale at home and it said she was 80.5.
May 7, she went back to the ER for extreme weakness. Apparently, the day before she had horrible diarrhea. She said she was in and out of the bathroom with constipation so she took some Milk of Magnesia at 5 am and it started explosive diarrhea.
We were all shocked when the ER doctor said they found a massive fecal blockage and said, "no wonder she hasn't been feeling well the last couple of months."
They weighed her that night in her hospital bed and said she weighed 87 pounds. No way, we thought, she weighed only 80 the previous week at home.
So for 5 days straight, my 86 year old mother had enema after enema, even some sort of enema machine nonstop, to some sort of colonoscopy type procedure to loosen things up. Most of it had been released, but still had a fist size amount still in there. The hospital said that was all they could do and said for her to go to a rehab to do exercises and the movement would hopefully loosen the last bit up. The doctor said the fecal blockages can cause a person to lose their appetite and lose weight. When they weighed her before she left the hospital, they stood her on the scale and it said she weighed 94.6. No way, has to be the fluids from the IV.
She was sent to a rehab Monday night. Here we are Wednesday afternoon and my dad is saying she is in bad shape and just not eating. They took her to physical therapy this morning, but she only eats a few bites of food.
My mom has no terminal illness, and her issues stem around this thing with her throat, and it causing her to be scared to eat, thus causing this weight loss that has brought her down physically.
Now she feels so bad psychically, she has no appetite, so that puts her in grave condition at her age.
What about feeding tubes? If her being scared to eat is causing this weight loss, why can't she have a feeding tube? Her nurse told me a couple of weeks ago that it's because the medical community approves them for people who can't eat from obvious reasons, and that my mom can still feed herself.
But the stay in the hospital for 8 days and all the horrible procedures she had over and over really wore her out, and I feel a feeding tube could help her. She's so weak now that she doesn't have an appetite.
I deal with this issue every day.
I the question is not what you want ... what would she want.
She has lived a full life.
What quality of life does she have?
Why are you trying to extend her life? Is there a purpose or a desire on her part or is the family doing this for their own desires?
Old is terminal.
An enteral feeding tube is not complication free.
Most of my patients of enteral feeding tubes that are frail and elderly eventually die of complications associated with it's use such as sepsis.
She also needs to be fit to have the procedure done.
You also need to pay for all the equipment and supplies.
If she is cable of answer the question as to if she would like to use an enteral feeding tube you should ask her and respect her wishes. If she is cognitively impaired has dementia then again what is the purpose of extending her life and potential suffering when there is no quality of life. There is NO cure for dementia. An most people with this type of dx eventually die as a result of failure to thrive ex not able to eat and drink enough as their stop being able to swallow.
It is extremely cruel to keep someone alive just for the sake of keeping them around just because. I have never have a patient that was elderly and frail of an enteral feeding actually seem comfortable or happy as a result of its use.
So I would suggest to take this in to consideration before hand.
They don't just insert a feeding tube in anyone. This is a surgery and has complications associated with it.
Is she is scared to eat because she is scared to have an accident there is something wrong and that needs to be sorted out. She could still have the same problem if on an enteral feed. If things are not getting absorbed when they are consumed even if it is formula she can still be loose weight.
Usually if someone is not eating they would try an naso-gastro/ NG tube first for 2 weeks before considering a enteral feed as it is not meant for a temporary solution. It is a last resort and comes with many other complications and a huge negative impact on quality of like. Also a huge risk for infection.
Her symptoms were a slight speech problem and slight difficulty swallowing.
They advised her to get a feeding peg inserted into her stomach surgically before she absolutely needed it.
One of the wisest decisions she ever made!
It allowed her to eat a portion of her nutrients orally and take the balance via feeding peg.
As the paralysis of the throat got worse, the percent taken by peg increased.
In November of 2012 she was taking 100% via peg .
The ALS killed her off a year later in November 2012.
I ( and my wife ) were very grateful for the advice given on having that feeding peg installed.
Sorry for your loss.
ALS is NOT the same thing.
Also I am assuming your wife was not in her 80s.
ALS is terminal and the use of an enteral feeding only prolonged her life for around a year.
With a diagnosis of ALS, Parkinson's, MS, Huntington's or Alzheimer these conditions all progressively lead to someone no longer being able to swallow food and fluids orally as the disease progresses and they usually die as a result of that. Use of enteral feeding tube is not a cure for any of these conditions and it is very debatable if use of an enteral feeding tube is only prolonging their suffering. Anyone who has these diagnosis should be ask about their desire for possible use of enteral feeding when the disease progresses. It is more important to respect the person's with the disease's wishes as they are the ones feeling the pain associated with the condition.
Um, a feeding tube won't address the issue of her bowels not moving. Sounds like she still has a fist size blockage. How is a feeding tube going to help that?
Exactly. The loose bowel movements/ watery stool can be cause when someone has a severe blockage and the stool is seeping around it. The use an enteral feed will not change this situation. Also if the issue is not addresses she could actually have a bowel obstruction which is extremely painful and can lead to death is not addressed. The blockage could be stool or a tumor, but she need to test for this. The procedure to test for this is very invasive. Have a bowel resection in your 80s also has many risks associated with it. Most people just don't stop wanting to eat. This is often an illness associated with the fear of eating.
Does she feel comfortable drinking thick liquids? Boost or high protein smoothies might be a way to go to help her put on weight. She can also try perhaps fiber supplements that she can drink (benefiber?), to help with the blockage. A feeding tube will really restrict her---she just needs to figure out what she can tolerate & regain her confidence
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