My mom has had to be on a pureed diet for a little over a year due to pocketing her food previously. She has lost a lot of weight and I'm certain it's because of not getting enough calories. Everytime I see her at her memory care home, she is eating a bowl of pureed vegetables and water. One time she was having pureed vegetables and chicken. I asked if she was getting a balanced diet long ago and was reassured by the director she was. However, I just saw my mom again, and for dinner they were feeding her pureed beans and water. She has gone from a size 14/16 to a 12, and I had to buy her new pants. They are open to suggestions. Where do you get a meal plan for your loved one if they're on a pureed diet? Do I get a referral from her doctor to see a nutritionist for her or is there something online I can print out? Thank you for any ideas!
But over all this amounts to the body giving up and giving in to time that takes it's toll on everyone. And the truth is that underweight is better than overweight in terms of general health, diabetes and complications and etc.
Speak to your doctor if you require further guidance or more info.
Bottom line is if they have the ability to puree one type of food they have the ability to puree anything and if they don't that's a problem. And my mom's NH was also on top of any weight loss, residents meals were supplemented with calorie dense puddings and drinks (and they definitely should know all about these products).
I also "boosted" some of his breakfast a bit. Making Cream of Wheat I would add an egg the last few minutes of cooking,
Lots of soups and stews
He loved Key Lime Pie so I would make the filling and bake it in a ramekin without a crust and he would have that.
Your mom should be getting anything on the menu just pureed.
Ask about the Hormel Vital Cuisine 500 Oral Supplement Shake, or other Hormel products
https://www.hormelhealthlabs.com/brand/hormel-vital-cuisine/
(And at this stage of life don't worry too much about a balanced diet, desserts are calorie dense and usually appreciated 😉)
Like already said, whatever the memory care is serving for breakfast, lunch or supper, it can all be pureed, so shouldn't be an issue.
And you mentioned that one time your mom was eating "pureed vegetables and chicken." What is not balanced about that? She's getting her protein and her vegetables.
My late husband after almost dying from aspiration pneumonia had to have all his foods pureed, and his drinks thickened with the product Thick It, and he seemed to eat less and less as time went by, so I don't think what you're describing is all that unusual. Just make sure that the memory care facility is only serving your mom thickened drinks as well, as she can also aspirate on those too if not thickened.
Best wishes to you and your mom.
She may need Ensure or Boost milkshakes to up her calorie count, but ask them to give her the diabetic formula because they're loaded with sugar. My mother developed severe gout from drinking those sugary milkshakes, but they were also her only source of nutrition and she was drinking three a day.
It's also possible that she's simply taking in fewer calories because she needs fewer calories and her body is just losing weight naturally as a result.
First meet with the dietician at the facility and see what her trays should contain.
Ask to see the records where they are suppose to record how much of the tray has been eaten. (This is not always a true picture). I know for my father we sometimes put his tray on the cart and no one asked how much he had eaten. However, just asking may let them know you are aware of procedures and encourage them to pay more attention.
You should not have to supplement her diet, they are already being paid for that. However a nice treat brought in would be nice.
Maybe a second opinion with an outside dietician may be in order.
A swallow test may be in order to see if what she is given to eat is still appropriate.
Difficulty in swallowing can be a sign end of life is near, but like in our case it is not always because my husband’s issues began about 10 years ago. For those who are otherwise reasonably healthy there are a lot of options.
When my father was in a nursing home and began choking, his doctor refused to order a swallowing test because he had said he did not want a PEG Tube. There are lots of swallowing therapy techniques that can help those with swallowing issues. A swallowing test identifies the muscles that are affected and having a test does not mean someone has to have a tube placed. You can say no then pursue possible therapy.
This was before my husband began having swallowing issues… I wish I knew then what I’ve learned from caring for my husband. I have learned a lot about swallowing in the ten years of caring for my husband… the last seven years have been using a PEGTube for his meds and to supplement what he ate by mouth… and he is still very mobile.
https://www.hormelhealthlabs.com/products/
You don’t have to purchase from the manufacturer… check other websites and compare prices. Being Italian, the only one he refused to eat was the lasagne. I mainly used the Thick and Easy puréed meals for convenience on hectic days.
" level of care needs" which includes nutrition and, feeding options
( which can include assessment for risk of aspiration while eating any consistency of food).
Call PCP
Practice self care.....
Remember that often a loved one will not want to eat or may lose interest in food or their ability to eat as diseases progress. This is a very anxious and grief provoking time for loved ones and, one may have challenges acknowledging pts needs/ desires vs family needs/ desires to see the patient " eat".
1/2 plate with produce (fruits and vegetables)
1/4 of plate with protein (dry beans, dry peas, nut butters, meats)
1/4 of plate with starchy carbs (potatoes, pasta, rice, bread)
She should also get 3 servings of calcium rich foods or drinks daily (milk, non-dairy milk, yogurt, cheese, tofu, and most drink supplements)
Make sure her drinks are thickened to the consistency recommended by her speech therapist. There are commercial thickeners that can be added to soups and all drinks.
Depending on her height, you can look up her weight on a BMI chart to see if she is at a healthy weight for her height. She might have been overweight before; the weight loss could be a good thing. American Diabetic Association also have charts to recommend good diets based on the amount of calories needed for people.