Losing Weight

My husband has always loved to eat and was happy to consume anything that was placed in front of him. I was happy about that and flattered myself that he liked my cooking, which I worked diligently to improve as time went on. But the truth is that he liked everybody's cooking. And that's a good thing, since institutional cooking isn't always what you'd call "gourmet."

But he can't feed himself now and is dependent on others for his nourishment. Would you like him to have a sandwich (and here I mean nut butter and jam, not turkey and bacon and lettuce and tomato, all of which would fall out and make a mess) or drink a glass of water at snack time? He might be looking at what you're offering, but sometimes it's as though he doesn't see it. He may or may not reach for it. You will have to place the item in his hand and wrap his fingers around it, encouraging him to raise it to his lips, open his mouth, and take a bite or a drink. Step by step. Happily, he can still chew and swallow.

At mealtimes, he may or may not approach the table when encouraged to do so. He may or may not shuffle right past you as you offer a chair. He may sit down, or he may walk away. Is he refusing to sit, or is he unable to understand? Does he forget what he's doing as he's doing it? It's hard to say. It's impossible to know whether he's confused about the whole thing or whether he knows what to do but can't, or won't. He's unable to verbalize his needs.

He can no longer navigate silverware and must be fed, one mouthful at a time. The caregivers tell me that they often simply follow him around with his food plate, offering a bite now and then until he's eaten everything. I know this is true, because I have seen them do it. And I have done it, too.

Even though his appetite is good and he is eating well at mealtimes and at snack times, he appears to be losing weight and muscle. His clothing is now too large and hangs on him loosely. Perhaps this is because he generally paces intermittently when he's awake, burning calories.

Or perhaps it's just the normal progression of Stage 7. Your body eventually stops being able to absorb nutrients the way it should, even though you are eating plenty of food. Here's a pamplet I found about that, if you'd like more information. And here are some photos, so you can see the progression for yourself.

October, 2017
One Year Ago
Looking perfectly healthy. Looks can be deceiving.

End of March, 2018
Just before initial placement, just over 6 months ago.
Still looking healthy, but a sea change in the dementia from
same time the year before.

End of June, 2018
Just over 3 Months Ago
Recovering from sepsis and adjusting to new surroundings.
At his 4th place in 3 months.

October 10, 2018 - Yesterday. Heartbreaking.

Middle of July, 2018

Middle of September, 2018

October 10, 2018 - Yesterday
His leg on the left, mine on the right.

Have I Eaten Yet?

I think I have figured out why my husband is gaining weight, seemingly for no apparent reason.

Thursday morning:

This morning, he had a large helping of cold cereal and a small bowl of strawberries for breakfast. That was about two hours ago, at the usual time. Since then, because I have been in the kitchen on my computer, I have spotted him going to the cupboard to get a bowl with cereal box in hand. Twice so far.

"Honey, why are you getting a bowl?"
"I want some breakfast."
"You already had breakfast."
"Oh."

And the bowl goes back into the cupboard. Until the next time.

Is it that he's actually hungry? Is it that he doesn't remember having eaten already?

Thursday evening:

It was a friend's birthday, so we all met up at a sidewalk restaurant to enjoy the beautiful summer evening and grab some eats. It was a very informal affair, and people were joining the group intermittently, causing the food orders to arrive helter skelter. Some before ours, some with ours, some after ours.

We'd already eaten a light meal, so I ordered a carne asada quesadilla to share. It was smothered in sour cream and delicious guacamole. It was fabulous. There were chips and salsa on the table, too. Anyway, we emptied our plate, and rightly so!

More food arrived at the table for those who had ordered after us. My husband seemed distressed, so I asked him what was the matter. He was upset because he'd been patiently waiting for his food, and when was it going to arrive? I reminded him that he'd already eaten, pointing out the empty plate. But he wasn't having it. Thankfully, someone else had an extra burrito. That seemed to make everything okay.

Sunday noon:

A group of us went out for Chinese food. Unfortunately, most of the orders looked pretty much alike, which was kind of confusing for all of us, but especially my husband. How are you supposed to know whether or not you've already tried a dish? So, that part was understandable. But making sarcastic remarks because no one told you there was rice available when you, in fact, have already just eaten a large helping of rice? That's somewhat less understandable.

So, I think I've answered my own question. When he fills up his plate again at a potluck, it just might be because he doesn't remember having eaten the first plateful rather than because he's still hungry.

What am I supposed to do? He's a grown man. If he wants something to eat, he should be able to have something to eat. Sometimes, I feel like the food police, and I don't like that. I don't like it at all.