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I’m interested in hearing your experiences with your loved one’s weight loss associated with Alzheimer’s. My FIL is in the moderately severe stage of Alz. He doesn’t know us any longer, is mostly continent, can feed himself (the visual cues of community dining have helped tremendously!), needs help with ADLs, etc. His weight has been steadily dropping over the last few years, but lately he’s been losing a couple of pounds each month. Currently, he’s about 145lbs, 5’ 9”. I understand that this is part of the progression of Alzheimer’s, so I’m not worried necessarily about stopping the decline, as I realize that’s ultimately a losing battle. He is in a FANTASTIC memory care facility, seems content to be there, is reasonably active and “participates” in their programming, eats a variety of foods, doesn’t skip meals, and eats the snacks we bring him, so we don’t feel that there is much else we can ask of anyone. My question is more about what to expect next. He’s on several meds, but has no major health problems other than advanced Alzheimer’s. As I said, I’d really appreciate learning from y’all about Alzheimer’s and weight loss. I am SO THANKFUL for this community of support and understanding!!

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I haven't been the direct care giver for an ALZ patient, but I have cared for a father with vascular dementia and a mother with MCI and major short term memory loss. My understanding is the weight loss process is similar so hopefully at least some of these will be helpful.

First, a part of the brain that dementia can "break" is appetite; some people want to eat everything in sight or a select group of foods constantly and some people will basically stop eating at all without prompting or may stop eating as much. Second, memory issues mean the person doesn't remember if he/she has already eaten, what foods are in the refrigerator/cabinets, how to prepare the food, how to use utensils, etc. Third, that broken brain can change the taste of some foods so old favorites are now disliked.

My suggestions to reduce weight loss:
(1) Make foods visible;
(a) place fruit, crackers, and other favored snacks on cabinet or chest/table tops within reach;
(b) prepare watermelon, cantaloupe, berries, banana pudding and other ready to eat offerings in clear containers and place in the refrigerator in clear containers at eye level; and,
(c) place single serving ready to heat and eat foods into clear containers placed just below eye level.
(2) Serve/Offer food often and on some kind of schedule; three meals a day isn't enough, so offer snacks between meals. If your LO doesn't eat a particular offering, ask yourself why. Does the item need to be cut into bite sized pieces? Is it different than the way your LO is accustomed? My dad stopped eating mac and cheese (a life long favorite) because it wasn't peppered. Even though the pepper shaker was sitting on the table, someone else had to pepper his food.
(3) Join them; even if you just drink a cup of coffee, sit with your LO during meals and snacks.
(4) Add calories; milk shakes and smoothies are good tasting and can add enough calories to slow or stop weight loss. Some people use the canned ensure and similar offerings too.

When my dad moved into MC, I prepared single servings of favored snacks and meal entries and took them to the MC weekly. The MC had a 24/7 kitchen and the staff would dish out his favorite snack (ice cream and peanut butter with chocolate syrup) or reheat something in the microwave I provided. I'm sure Dad enjoyed having some home cooked food he recognized but I think he also liked the attention.
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Try searching "cachexia and dementia" online FarmJelly.
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The memory care should have a protocol when weight loss is rapid and consistent, at mom's nursing home they added Resource® supplements to their diet. And are you sure he is actually eating when he is in the dining room? There were several people at the NH who needed supervision because they simply couldn't remember to finish their meals.
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I agree with Willie. There usually is a dietician associated with a facility. Weight loss should be monitored and when large, suppliments are usually introduced.
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Thanks for your responses! Yes, he is being monitored. His MC facility is really amazing. There are only 12 residents in his wing, so the resident/caregiver ratio is low. When I asked the DON about this at our last meeting, she showed me the record they keep of his food preferences, intake, etc. I was pleasantly surprised at the level of detail at which his eating was being monitored. We do supplement with Ensure and high calorie snacks between meals. He seems to have a good appetite. My question is more about the wasting that seems to accompany Alzheimer’s. His appetite is good, and he’ll eat anything we give him, but I’d like to know more about what happens when his body just won’t put it to good use any longer.
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