My aunt has decided not to eat, what can I do to help her?

A fellow caregiver asked...

My Aunt, 89 yrs. last week , has decided not to eat.... I know she is depressed..Lives in a HOME , where now no people to talk or eat with. They have passed....Her son lives thousand miles away. when he visits she degresses....memory going so fast and wont eat anythin.. trying ensures but still fighting it... what can i do? move her closer to me? have the home blend food? how long can one go without food? i want to help ...please what can I do?

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Expert Answer

Helene Bergman, LMSW, is a certified geriatric care manager (C-ASWCM) and owner of Elder Care Alternatives, a professional geriatric care management business in New York City. She consults with nursing homes and daycare programs to develop specialized programs for Alzheimer's patients.

It is not uncommon for an older adult to stop eating but there are many reasons for this behavior. It is imperative that the 'why' be identified immediately. If the individual is cognitively intact and has insight into her behavior, than she can answer the question. She would be able then to say, "I don't want to live any longer" for instance. If, however, she lacks that insight and as you say her memory is failing, then it is incumbent on others to discover the reason. Does she have a medical condition that might be a precipitant? Therefore, an immediate medical evaluation is indicated to rule out any condition causing the behavior (i.e. UTI, cancer).

If an evaluation by a psychiatrist indicates depression, then treatment is necessary. Again, her cognitive status will be an indicator here of the type of treatment. If she has signs of Early Dementia, it is possible that the observed behaviors indicate that she might be forgetting about eating....or even how to eat. While this is not usual behavior for early dementia, it has been known to occur. Thus, by having professionals involved, you will be ruling out the affective or neurological disorder.

If all possible medical or psychological reasons are ruled out, and she still refuses to eat, you then need to decide whether relocating her would be a solution. This act would infer that where she is contributes to her malnutrition rather than any other factor. Pureeing or using supplements do not really target the problem. If she is 'refusing to eat' then she will refuse these too. As a long distance family member your role is more difficult. I suggest you liaison with a staff member who knows your aunt for a longer time and can give you all the answers to the above. Of course, if this can be done in person it would be much more effective.

Good luck.