When an aging parent refuses to eat and begins to lose weight, there can be serious cause for concern. Malnutrition and undernutrition statistics are hard to come by, as many cases go unreported. Estimates from studies show that although malnutrition can occur at any age, it is especially prevalent in people over the age of 60.
Jump ahead to these sections:
- Why Do Aging Parents Typically Refuse to Eat?
- What Can You Do If Your Aging Parent Refuses to Eat?
- What Should You Avoid Doing If Your Aging Parent Refuses to Eat?
An aging parent can refuse to eat in any setting from home to a nursing home. You may not notice the slow loss of weight if you see your loved one infrequently, but regular doctor’s visits can track weight loss. Weight loss is not the only concern with an aging parent refusing to eat. Malnutrition can contribute to:
- Risk of infections caused by a weakened immune system
- Compromised wound healing from a lack of enough protein and calories to facilitate healing.
- Muscle weakness and decreased bone mass that is complicated by lack of activity. If someone doesn’t have the energy to move, they become more sedentary.
- A higher risk of hospitalization due to difficulty fighting infection, illnesses, and falls
- An increased risk of death
As a concerned family member, there are things you can do if your aging parent refuses to eat. The first steps involve finding out why your parent is not eating, and there may be several causes.
Why Do Aging Parents Typically Refuse to Eat?
An aging parent may refuse to eat for a variety of reasons. If you are unaware of any obvious concerns, it is worth investigating possible causes so that you can address the problem(s) and hopefully restore your loved one’s appetite and desire to eat. If things reach the state of malnutrition, it can be challenging to reverse course, but not impossible. Try to start noticing changes early on so you can intervene in time to prevent decline.
If you are a long-distance caregiver, find ways to evaluate your aging parent’s situation by sending someone into the home to check the fridge and cabinets. If there is very little food, then this might indicate a more significant problem.
Loss of taste and smell
Taste and smell have a significant effect on nutrition. The number of taste buds decreases as you age, and any remaining taste buds can also begin to shrink. Sensitivity to tastes often declines after age 60. Your mouth produces less saliva as you age that can cause dry mouth, which can affect your sense of taste.
Lack of access to food
If your aging parent lives at home, you may want to consider the fact that they may have trouble getting out to buy groceries. Perhaps driving has become an issue, or they are afraid of falling. Nutritious and fresh food is challenging in more rural areas, and many people rely on fast food and other nutritionally deficient foods.
Dementia
If your aging parent has dementia, they will often forget to eat. As dementia and Alzheimer’s worsen, many people stop eating and drinking. Indeed, people with dementia will struggle to cook for themselves and can be unsafe in the kitchen. But, even with others preparing meals, an aging parent with dementia may forget or refuse to eat.
Depression
Depression is not a normal part of aging, but medical conditions, isolation, and loneliness contribute. Many older adults are misdiagnosed and undertreated for depression. Loss of appetite is one of the symptoms of depression, along with apathy and fatigue.
Isolation and loneliness
If you live alone, you know that it is sometimes hard to get excited about eating. For older adults who can’t get out and don’t have access to group meals, loss of appetite is common. Loneliness and isolation are also strongly associated with depression and cognitive impairment.
Problems swallowing
Problems swallowing, also called Dysphagia, can affect anyone of any age, but older adults are more likely to suffer from this problem.
A medical diagnosis is necessary to diagnose this disorder, and there are many causes. Wear and tear on the esophagus and conditions such as Parkinson’s and stroke put people at higher risk for Dysphasia. When someone has Dysphagia, they worry about choking and avoid eating because it is uncomfortable.
Medication side effects
If your aging parent is on several medications, it is not unusual for there to be side effects, some of which can affect appetite. Common side effects are nausea, rapid heart rate, dry mouth, diarrhea, or a bad taste in the mouth.
Dislike of food
Dislike of food in senior living communities is so common it is a running joke. Regardless, if your loved one doesn’t like the food, they won’t want to eat it and will refuse meals.
Although most senior living communities try to cater to differing tastes, some older adults aren’t comfortable speaking up for themselves. Don’t discount the fact that your parent may also not like where they live, and this is their way of expressing their disapproval.
Dental problems
Dental problems can be a significant deterrent to eating. Decaying teeth or uncomfortable dentures contribute to loss of appetite and refusal to eat.
Medical problems
Medical problems such as cancer, kidney disease, and heart failure are just a few of the medical conditions that affect people’s desire to eat. Any terminal illness can profoundly affect appetite and the inclination to eat.
The end of life
At the end of life, people stop eating. For many family members, this can be quite disturbing and hard to accept, but this is a normal part of the dying process.
Voluntary stopping eating and drinking
Voluntary stopping of eating and drinking (VSED) is an option that some people choose to end their life. This practice can be controversial due to the ethical and legal implications of such a choice.
What Can You Do If Your Aging Parent Refuses to Eat?
Tackling the problem of your aging parent refusing to eat will take some time and patience. Chances are you will get to the source of the problem, but if you don’t, do what you can to keep your loved one comfortable.
1. Get a complete medical evaluation
The first step is to get a comprehensive medical evaluation to rule out medical problems that contribute to appetite loss. This evaluation should also include a dental exam, a swallow test, and any necessary lab tests.
As part of this evaluation, ask about the medications your aging parent is taking and if they could be causing side effects that affect appetite. If so, suggest alternatives or the possibility of eliminating some medications altogether.
2. Talk with your aging parent
Talk with your aging parent about the problem. They may be willing to communicate with you what some of the challenges are. In the process of discussing the issue, ask what kinds of foods are appealing to them. Once you know, make sure they have those foods readily available. Make certain food is appropriately seasoned to make it more appealing.
3. Ask for a depression screening
A simple depression screening can be a part of the medical evaluation. Most Medicare annual exams will include a basic depression and cognitive screening. Get additional testing if the screening tests indicate possible depression or dementia. Depression is treatable with medications and counseling.
4. Hire a caregiver
If your aging parent struggles with getting groceries and preparing meals, hiring a private caregiver can help. A caregiver can shop for groceries, prepare meals, some of which can be frozen for future meals. Suggest foods that have more flavor with herbs and spices. A caregiver can also dine with your loved one, increasing the likelihood of them wanting to eat.
Give specific instructions to a caregiver, such as cutting food into smaller pieces, and if there is a swallowing problem, making foods that are easier to swallow.
5. Order home-delivered meals
Whether your loved one is in senior living or at home, ordering home-delivered meals offers more variety. Home-delivered meals also relieve the boredom of senior living food and, at home, eliminates the need for shopping and cooking.
6. Assess the entire situation
Is refusing to eat part of a larger problem of self-neglect? Look for signs of poor hygiene, hoarding, and home cleanliness. Perhaps your loved one feels neglected by you and the rest of the family. Try to make time to visit and eat meals with your aging parent.
What Should You Avoid Doing If Your Aging Parent Refuses to Eat?
In your frustration and desire to help your parent eat, there are things you should avoid doing. You don’t want to make the situation worse. Remember that once you have done all you can but your aging parent still refuses to eat, continue with your efforts but don’t push.
Avoid getting angry
When your aging parent refuses to eat, it may be in their control, and it may not.
Either way, getting angry will only make them feel worse. Anger is expressed in several ways, including tone and the words you use. You can’t force someone to do something they don’t want to do.
Avoid being pushy
Continuously pushing your aging parent to eat probably won’t work. A better approach is to encourage gently. Reinforce small steps towards eating and have a compassionate and caring attitude.
It may also be difficult for your aging parent to deal with this problem, and they may be feeling down as well. Compassion goes a long way when dealing with any issues related to eating.
Avoid threats
There are consequences to refusing to eat. It is far better to explain those consequences (like increased infection, weakness, and mental decline) than to threaten. Threatening your aging parent will more likely lead to increased resistance.
Avoid invasive procedures
If your parent has end-of-life directives in place, you should honor those. If your parent states they do not want artificial feeding, then don’t suggest those procedures. End-of-life invasive life-sustaining efforts may not make sense and can prolong suffering.
How to Help an Aging Parent That Refuses to Eat
As distressing as this situation is, when an aging parent refuses to eat, there are valuable and compassionate things you can do. Take a proactive approach to overall health and well-being so that your aging parent feels cared for and loved.
Sources:
- Haines, James, David LeVan, and Michele M. Roth-Kauffman. “Malnutrition in the Elderly: Underrecognized and Increasing in Prevalence.” Clinical Advisor, 7 February 2020, clinicaladvisor.com
- “ When Someone with Alzheimer’s Won’t Eat or Drink.” Web MD, 22 September 2020, webmd.com
- “Depression is Not a Normal Part of Aging.” Centers for Disease Control and Prevention, 6 January 2021, www.cdc.gov
- “Dysphagia.” The Mayo Clinic, mayoclinic.org
- “Aging Changes in the Senses.” Medline Plus, 8 October 2021, medlineplus.gov
- Jox, Ralf J., Isra Black, Gian Domenico Borasio, and Johanna Anneser. “Voluntary Stopping of Eating and Drinking: Is Medical Support Ethically Justified?” BMC Medicine, 20 October 2017, bmcmedicine.biomedcentral.com