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My cousin, 62 years old, who is in Memory Care Unit, (wheelchair bound,but can feed herself.) has lost 10 pounds in the last 2 months. She has Vascular mixed with AD. Symptoms hit her fast and she has gone downhill in the last year. Complete incontinence, no real memory, (still knows me and my parents) but still verbal and can push herself with her feet in wheelchair.

Her blood sugars are excellent, so that's not it. She sees a doctor regularly and he is not alarmed. She gets regular blood tests and checkups. We have discussed palliative care for her. I can see physically that her health has declined.

I have watched her eat her meals and snacks and she always demonstrates a hearty appetite. Eating is not an issue. She chews and swallows fine. I have discussed this with the Memory Care staff. She is eating the same meals and snacks she had since her admission there 9 months ago. During that time she maintained her weight.

Is the weight loss a normal progression? I have read that at some point, the ill or dementia patient, even when consuming enough calories, will drop weight. I don't want to try to force extra food on her if it is not helpful.

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Aside from losing muscle mass from inactivity if she eats enough she shouldn't lose weight.
How often are you there at mealtime? How certain are you that the staff is really paying attention to her dietary intake? Some places will note that someone was at the table at mealtime, but not necessarily keep track of whether or not they actually eat.
If there is something else causing the weight loss it sounds like you would not be willing to treat it at this point? Either way it can't hurt to try adding some supplements like boost/ensure if she will take them.
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I appreciate your response. I usually see her eat meals at least once per week. Other times, it's for snacks. I have also talked with the staff and they confirm she always eats well. It's not a very large place, so it's not that difficult to note if she's not eating. Their dining room has about 20 people and some of them receive assistance.

At this point, it's palliative care that I think is appropriate. That's the route she took with her mom and we had discussed it many times before she became ill. We are not doing cancer screenings and my primary goal is to keep her comfortable. Besides, if the dementia is causing her to lose, because that's just the progression of the disease, then we will accept it. I know that she cannot recover from this.
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My MIL had vascular dementia. What you are describing is exactly how her weight loss occurred. As she had gotten older she had put on a good deal of weight. While still eating really well, weight began to just fall off her. Her digestive system was failing. She had anasognosia - was totally unaware that she had dementia, and was thrilled with the weight loss. Your description sounds so much like my MIL, even with the feet propelled wheelchair. MIL never did lose speech. Just months before she passed she developed the swallowing issues as internal failures continued. Impacted bowels also began to be a problem.
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My, now 87 year young, mother was diagnosed several years ago with dementia. Her M.D. put her on aricept which kept it at back burner with just some forgetfulness. Then about 2 years ago she went in to full onset dementia she is now into last stages and her degression has been quick and each time she decreases it is almost overnight and of course she looses more of herself. She went from being in chair paddling along with her feet to bed ridden in a week. She has total incontinence , trouble chewing and swallowing. Even with those problems she still has a very hearty appetite and eats well. She is home with me and I have 3 other ladies that help me to c after her every need round the clock. She too has lost weight though she out two farmhands. She is always hungry as she forgets she has eaten no matter how much she eats. I was told that it is part of the disease. Especially in later stages. Comfort and giving her as good of quality life as possible is now all that I can do because as you say she can never recover. With all the tragedy and loss she has withstood in past 11 years the memory loss is all that has kept her here surviving this long. I wish you, your cousin and family all the best. I wish you all comfort and peace. It is such a hard thing to watch a loved one go thru and hard for them as well. They know things aren't right but don't know why or how to fix it. They live in total confusion. We loose the person we always knew long before they are gone then loose them many more times as they degrees each stage. Luck and best wishes, Daphne
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My mom is currently losing weight although she continues to eat at least 3 meals a day. We have an appointment with a GI next month to see if he can find a cause, however your case sounds very similar to my mom.
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My Mom has also begun to lose weight, she eats well with help. I'm having a hard time getting her to drink enough not sure why that is, her Dr. is also not concerned. I have always been told it is part of the process but I also worry about it.
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As people age, their bodies become less efficient in absorbing nutrients. Add a serious illness or two and this is generally a bigger problem.

I'm only guessing, but if she's eating well but still losing weight it seems as though she's not absorbing the nutrients from the food. Her doctor is the best source of information here, but one thought is that supplements that are made to be absorbed without depending on the digestive tract may help.

Good answers from every one here so read the whole thread and see if you pick up on something that may help.

Take care,
Carol
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Normal progression or not, weight loss can be a part of a neurological disorder. My spouse has Progressive Supranuclear Palsy—said to "mimic" Parkinson's and dementia—and went from over 180 pounds to under 140 in a couple of years despite eating quite a lot of food, especially at dinner time. His neurologist says it is part of the disease and that extra protein might help. Bill is now in assisted living and I keep his mini-fridge stocked with protein shakes and cheese sticks. He also has a supply of granola bars.
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My Mom is going through the same thing with her disease as well. I left the corporate world to care for her - (she also has caregivers come who help me) I know what she eats and how much. She eats 5/6 times a day - I too think it is just part of the disease - would I treat her at 84 if it wasn't "no" - I am just letting nature takes its course - she has had dementia/Alzheimer's now for 9 year's. All of her blood work is "normal" as well - good luck to all.
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I have experienced rapid weight loss with two of my dementia clients. It seems to happen almost overnight. Now I weigh my clients weekly and track their weight so I can see changes more clearly. A digital scale with large numbers will make this task easier. I think it is easy to over estimate how many calories someone is eating , unless keep track of them rigorously.
You might try the red dishes routine, as suggested by the Alzheimer's Reading Room blog. I am not convinced that red dishes work for everyone. Find really cheap red china and transfer her food onto it. See if she eats more.
The previous commenters are so right. You need to rule out a medical cause. Perhaps you need a second opinion.
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As the disease progresses, the muscles will atrophy and the ability to absorb nutrients from food will diminish. With early-onset dementia she has a genetic component to her dementia and there is nothing to do. My best wishes for your family.
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My husband is also hungry ALL the time. But I think it is just because he's forgotten that we ate already. I keep lots of fruit and yoghurts at home for times like that. His nose is also running a lot. Mostly when he eats. I have not spoken to a doctor about that yet. Some days he is more confused than other days. Yesterday he wanted to go to school. I was only able to destract him after I took him outside in the sun and shaved him. After that, he totally forgot about going to school. Some days he ask me when is his Mom coming home. She passed away 20 years ago!!! Then other time, he asks me where my husband is, but he knows me and my name???
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Dairy products will produce runny noses as most are sensitive to cow's milk. Try goat's milk products or make sure the cow's milk doesn't have hormones and antibiotics (given to the cows). We tried Fairlife a new milk without the hormones, but is pricey. Experiment. If one has a hay fever allergy, any of the fruits like oranges, melons, (usually fruits with seeds), will produce a runny nose too. See what your body can tolerate.
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The weight loss can be a normal progression of the disease, My mom is 88 with advanced AD and eats 3 really good meals a day and plenty of snacks and continues to lose weight, they get to a point in the progression of the disease where the body can no longer absorbs the nutrients from the food.
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cwillie mentioned muscle mass. My dad has been losing weight and eats great. He's 93 and in fairly good condition (no dementia like mom) but is now down to 114 (he's only 5' 2" maybe. of course has shrunk over the years. use to be 5'6" and 140?) His doctor just told us to eat as many calories as possible to put some weight back on him and I did get him some light weights to use to try to build up his muscles again. He's still pretty active and drives :( but just can't put any weight back on. My mom has been losing weight also but is in alz/dementia facility and is declining. Not eating as much so I know that means her organs are not functioning the way they should be. As long as I know she is not hungry and not suffering (which is what they tell me) that's all I can do. Can't force her. Getting old is not for wimps!
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I was confused by my mother's weight until I spotted her throwing out food when she thought I wasn't watching. With her dementia - she thought I would be mad. I don't know if explaining to her that I wasn't upset, just needed to keep track of portions being consumed.

62-yrs seems a little young for weight loss, but then again - medical conditions and medications can alter absorption functions.

Just because it's "part of the process" doesn't mean it isn't difficult to watch and make you want 'to fix' it. Maybe adding easily digested nutrients as Carol suggested.
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Last 2 yrs before my mom died she did lose some weight and she also ate very well. After routine bloodwork from the doc for homebound (her 2nd visit) she said my mom was slightly malnourished. I was in shock because she ate so well. I fed her so I knew what she ate. The doctor basically said if you don't use it you lose it. My mom was unable to walk at this point and could only stand. She suggested ensure/boost in addition to her meals, not in place of. Sometimes I would warm it and give in place of her tea in the morning or would give with a pbj sandwich at lunch. After discussing it with the doctor and me saying I wouldn't put her thru any GI testing because if something were radically wrong I wasn't putting her thru an operation, chemo, etc and the doctor agreed that our goal was to keep mom happy and comfortable as long as we could. Good luck.
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I really do appreciate all of the responses to my question. It has given me a lot to think about and to research. I've learned about something called cachexia. I've also reviewed much of the older material that I have reviewed about advanced dementia and nutrition. Since all her lab work is fine and she's not in pain, I'm going to monitor it. She's weighed weekly at the facility. I'll discuss it with her doctor again when we are in. This last time I pulled him aside and asked if there is something I need to know, out of her earshot, but he said no.

I will admit that there is something about her that says she is progressing. It's not just the weight loss. It's more. I can just see it. What I want to do is to keep her as comfortable as possible and if that means extra food that she enjoys, I'll try that, though, I don't think the extra calories will be absorbed.

Oh, she has been seen by a Neurologist and diagnosed with Vascular mixed with AD. It is interesting that she is so limited physically, but her verbal skills are excellent. She can say the words, but she can't really carry on a conversation. She only answers yes, no, and mostly, I don't remember.

She knows me and my parents when they explain who they are, as well as a few staff members at the Memory Care unit and her roommate. She doesn't use anyone's name though, except for me. She does still call me by name.
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My mom has had vascular dementia for atcleast 15 years and now 94. She is in a memory care facility, incontinent, wheelchair bound but does move around quite a bit by moving her feet . She isnt too aware of much of anything and no memo at all. Her language skills are going. She usually can no longer recall our names instead referring to us family. She has lost 10 pounds in the last 2 months yet she still eats well. I am wondering if this is a part of the normal decline with Dementia. They are offering her protein shakes along with her regular meals
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Kwriter, From what I have read about vascular dementia, the 15 years you describe does surprise me. How old was your mom when she was diagnosed? My cousin was 62 at the time. It's shocking how rapidly she went downhill.

I have noticed that not many people in Memory Care are verbal. I"m so glad that my cousin has her roommate. They are the most verbal of anyone I have seen on their wing.

I suppose there is no harm in adding extra calories. If she stops losing, I guess that is a blessing. If not, then maybe we have the answer to our question.
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Mom was about 80 when we really started noticing problems with short term memory. Then it was just short term memory if we told her often enough it would get into long term memory and she would remember. It probably startrd before that. She went downhill very gradually but it has accelerated a lot on the past two to three years. Most of the people in her memory care are pretty far gone before they get there. Its expensive and families cope for as long as they can before they are put in memory care.
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My dad lost a lot of weight at mid/late stage Alzheimers. He was not eating. He was putting the food in his pant pockets and the staff was reporting he was eating 100%. Don't take for granted what the staff tells you. My dad loved ice cream and milkshakes and that's all he would eat . Eventually he stopped eating. He was 130 pounds when he passed...so sad..he looked like a skeleton. It's the nature of the disease and it's pure h*ll.
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I was diagnosed with Frontotemporal Dementia about 18 months ago. During the first year after diagnosis (although I've obviously had it for much longer than 18 months) I lost about 40 pounds although I was not dieting. I was thrilled to go from 170 pounds to 130 pounds without trying but what I'm reading here is kind of scary to me. I gained back 12 pounds and have remained pretty stable. My gastroenterologist did not find any issues with my digestive tract and is not concerned. My most recent blood test came back with all good numbers. But it is still scary reading the above as I am hoping to be able to stay functional and active for a long time to come. I just don't know what to expect.
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Thanks for sharing that Freakedout.It sounds like you are doing quite well and are not in the late stage of dementia like my cousin. I suspect that that is causing her weight loss as her health is otherwise good.

I do hope things go well for you and that you do stay functional far into the future. I would be interested to hear more of your story, when and if you feel like sharing.
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Freakedout......it could also be one of your other medications that you are taking. I know that Aricept is bad about upsetting stomachs so a person doesn't feel like eating. Check into your medications. Any new ones?? And may God Bless you on your journey.
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Thanks for the responses. Aricept does not help FTD so I only took that for a few months. The first time I posted I mentioned what a difficult time my husband is having with my diagnosis making him extremely difficult to live with..... life goes on.
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Freakedout, I can only imagine that you and he are having a difficult time. I'm glad you're coming here to read, share and just unload. I hope that helps.

I need more advice. I'm planning on taking my cousin a high calorie, favorite meal this weekend. I've called the Memory Care to clear it. I'm arriving with the lunch before her lunch is served to her. I know what she likes, but want to keep the portions not too large, for fear of her over eating and making herself sick.

She has no difficulty chewing or swallowing by what I have seen and by what the facility reports to me. Any dishes I should avoid?

I know she would love a milk shake and french fries. Is chicken or beef better? I"m going to tear it in small pieces, even though I know she can chew okay. I'm doing that for my own piece of mind.
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I forgot to add. I don't want to upset her tummy. What foods are likely to do that for a wheelchair bound person?
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My mom is abke to eat anythong ahe wants and is wheelchair bound.
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Thanks. I have watched my cousin eat and she seems to bite and chew well. Still, the Memory Care facility appears to serve all their meals cut into small pieces. They do serve the bread in one piece, but the meat, veggies, and fruit are cut into small pieces. I think I'll do the same.
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