Monday, January 14, 2013

Why does a resident suddenly stop eating?

Why did my Dad, placed in long-term care against his will, refuse food for two weeks?
At the time I felt it was anorexia, an issue related to parental control faced by teenaged girls.
I was not so far off the mark. He was angry, and didn't understand his situation. He didn't know what he didn't know.

Residents in LTC, removed from their home for issues that revolve around safety, inability to manage their ADLs; toileting, mobility, or managing basic needs like feeding themselves, have psychosocial, emotional issues around losing friends, neighbours, and their homes. A lot of this is a result of being unable to determine what they want to eat, how much and when. Doesn't this sound like the control some parents wield over teen daughters?

I have found in many of my hospice clients that they begin to need or want food less. There are many issues around food and many rituals peculiar to cultures and individual families. We have comfort food; we break bread together during religious and secular holidays; we meet friends for lunch. It is out mothers who often we associate with feeding.

Dysphagia--choking and swallowing issues, a previous post.
When a resident or client begins to avoid food, or experience a lack of appetite, are unable to swallow food without choking.

Cachexia = KAK-ex-i-a

Cachexia Anorexia Syndrome

Tumor growth is associated with profound metabolic and neurochemical alterations, which can lead to the onset of anorexia-cachexia syndrome. 

The cachexia anorexia syndrome is a complex metabolic syndrome associated with cancer and some other palliative conditions. Cachexia has been defined as involuntary weight loss involving both fat and muscle, due to shifts in metabolism caused by tumour by-products and cytokines. 

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