Should Mom see a nutritionist?

Coordinating the care needs of people in later life is often complicated by multiple diagnoses. Your mother's primary care physician should be the one managing her medical care and making referrals for her physical care. Physicians usually limit their scope to physical and medical needs, leaving spiritual, emotional, and psychological care needs to others.

What a person eats affects the physical body but also has tremendous emotional impact. Anyone who has been on a restricted diet is familiar with the difficulty of maintaining it. While your mother might benefit from weight loss physically, the process of limiting what she eats could make her life miserable.

In my opinion, 'eating' is a quality of life issue. Is your mother willing to restrict her diet in order to lose weight? If she has not visited a nutritionist, an appointment is a good idea. By discussing what types of food would be limited and in what quantities, your mother would have a clearer understanding of the changes she would have to make. This visit should be coordinated with her cardiologist in order for your mother to understand the amount of weight loss she would need to achieve in order to benefit her heart condition.

Your mother's kidney disease complicates the situation. Often people with heart disease and renal failure retain water that causes swelling and weight gain. A physician may prescribe a diuretic to reduce the amount of fluid the body retains. An effective diuretic can achieve dramatic weight loss but it must be monitoring by her physician.

Ultimately, the decision is your mother's. At age 87, with heart and kidney disease, would the benefits of possible weight loss outweigh the psychological difficulty of a restricted diet? Help your mother get the medical facts that she needs to fully understand her medical situation, then allow her to decide.