Unintentional Weight Loss | Sometimes It’s Just About Calories
Malnutrition and unintentional weight loss may be observed in people with many conditions including dysphagia. According to the National Institute of Health, cachexia or wasting syndrome is characterized by persons with substantial weight loss or reduced skeletal muscle mass. These patients often experience decreased appetite resulting in weight loss, pain and fatigue which can ultimately result in a negative effect on their quality of life.
An Unexpected Risk
Some studies have shown that more than 86% of residents with advanced Alzheimer’s Disease living in nursing homes experience eating problems (Mitchell, Teno, Kiely, et al) which include not recognizing food, decreased sense of taste and over chewing.
Cancer and its treatments can dictate changes in eating habits and decrease appetite. Not eating can lead to weight loss and cause weakness and fatigue (cancer.org). Some patients may experience changes in taste and smell that can also affect their desire for food intake.
And, when someone is seriously ill and nearing the end of life, the body’s need for food is dramatically altered and begins the process of shutting down. If the illness is causing persistent pain and nausea, the desire to eat and/or drink can greatly diminish.
Finding Calories Can Be A Challenge
If loss of appetite is an issue, as it is in late-stage Alzheimer’s, offering a sweet treat may encourage eating. Many suggest using finger foods reminding loved ones of their childhood. Set out snacks in clear view, encourage eating together and serve calorie dense snacks.
Eating as well as you can is also an important part of taking care of yourself when undergoing cancer treatments. According the American Cancer Society, it is best to try to eat several snacks during the day rather than large meals. To make eating more enjoyable, keep calorie dense snacks on hand and eat your favorite foods anytime of the day.
Overcoming Unrealistic Expectations
According to Mayo Clinic, following specific dietary guidelines may not be practical in some cases. Sometimes caregivers or family can add unintentional stress by pushing certain foods. They recommend keeping snacks handy that are easy calories and require no preparations. Include bedtime snacks as well.
Adding calories is the most important thing until your appetite returns. During this time, suggestions of more sugar shouldn’t be a concern. You may even want to pair a snack with a nutritional drink as a way to maximize snack time.
The goal of feeding toward the end of life is often to provide food and drink as long as eating remains enjoyable, comfortable or safe. This is often referred to as comfort or pleasure feedings. “After months or even years of eating mushy, unidentified meals, a favorite food can seem like heavenly manna.
Sometimes at the request of patient or family member the doctor orders pleasure feeds, because the purpose of food at this time is enjoyment, not proper nutrition.” (Dolan, S 2015) Hospice experts advise families to avoid “food struggle’ and allow loved ones to eat what they want and when they want. Dignity and comfort should be the guideline
Life is short Make It Sweet
The inability to eat or reduced desire to eat can have a profound effect on patients and their families. The stress brings with it negative emotions. Many times, I would walk into a patient’s room and see an entire tray of food virtually untouched. And, distraught caregivers desperately try and offer various foods to patients to no avail. Sometimes the only things a patient can control is what they eat.
If you are in the hospital or residing in a care facility, snack time is an opportunity to have something special and connect with pleasant memories. Having a snack that is tasty and satisfying that everyone might enjoy is so important. The EAT Bar is a delicious snack that brings joy back to eating and provide easy calories when they are needed most. What better way to demonstrate dignity and provide joy than with an appetizing treat!
Mitchell SL, Teno JM, Kiely DK et al. The Clinical Course of Advance Dementia. N Engl j Med 2009
Mayo Clinic Staff. No Appetite? How to Get Nutrition During Cancer Treatment. Retrieved from mayclinic.org
Dolan, Susan R. How to Feed a Dying Person September 10, 2016. Retrieved from Huffingtonpost.com