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My mom is losing weight but Ensure and Boost tend to cause bowel incontinence. Are there other products similar to those that would provide calories without the terrible side effects?

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Could be the milk protein causing the unhappy gut. It seems there are nondairy products available. I did a quick search online and found two websites - MaxHealthLiving and ShakesLab - that have a review of 8 meal replacements targeted to seniors.

MHL is so clogged with ads, I find it hard to read. ShakesLab gives pros and cons of each.

maxhealthliving.com/best-meal-replacement-shakes-for-elderly
shakeslab.com/best-meal-replacement-shakes-for-elderly

Hope you find something good!
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Msblcb Sep 2022
Thank you SO much!
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Be sure to speak to the dietician at her residence, too.

My LO happens to have a VERY GOOD dietician, so your mom’s be have someone good ideas.
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Lots of nondairy and gluten free drink products available at a health food store. If your mother rarely drinks the whole container anyway, how much is this one product really helping? Keep offering as many food and drink choices as possible. It's really tedious sitting there watching her eat and prompting her to eat at every bite, but that's what works. Going to a restaurant or eat-in market works too, especially buffet style where she can choose from the foods in front of her. Group dining in memory care can be chaotic instead of relaxing. Residents in group dining are constantly bickering with each other, until they finally remember the one thing they agree on--the food here is terrible!
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IDK about nutrition so much as just the fight for hydration. We find that smoothies are a favorite of my Moms, and concoctions using a magic bullet at home with protein powder and fruits, etc. Lots of recipes free on line and now they make prepackaged ones you can do at home (more expensive but convenient).
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Ensure has a plant based. I’m sure it is the dairy that’s causing the issue. Imodium really does work.
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Getting advice from her physician and workup from a geriatric diatician would be best. Based on her medical conditions, one or the other product may be recommended. For example, diabetics would need something different from those w/o diabetes. Her physician can also prescribe a Rx to stimulate appetite.

My mom lost 25 lbs in about 3 months because she was not eating in the nursing home. The Rx appetite stimulant helped.

The regular Ensure or Boosts also caused her loose bowels, but "Ensure Clear Nutrition Drink Ready To Drink" in "Blueberry Pomegranate" as recommended by her MD was tolerated better. Some of these "supplemental store-bought drinks" can also interact with Rx medications, another reason to have the MD and dietician involved.

Lastly, there are prescription type drinks (not available in regular stores) the MD can prescribe that may be better.

The other problem we and the dietician figured out, is w/my mom "finger foods" worked best as she was having a hard time managing "larger" food options. My mom really only has the use of one arm, so a sandwich -- even cut in half -- was too hard for her to handle. Instead, "meat roll ups" just roll a slice of turkey sandwich meat -- sans the bread and other stuff -- she could manage that. Ditto for things like a "hot dog" (one of her favorite foods), a full hotdog with condiments was impossible for her to handle, but "pigs in a blanket" (individual pieces or individual sausages) and w/mustard and catchup in little "dipping" containers was soooo much easier for her to handle. Ditto for pasta, the long spaghetti pasta was impossible, but small bite sized ravioli was easier for her to handle w/a spoon.

I am not sure (she has dementia) if she just could not figure out how to tell the NH folks she could not handle larger food items (forget it if anything needing "cutting" even w/the side of a fork) or she was too embarrassed to say something. But food would come and she could not eat any of it because she could not handle the larger shapes/sizes -- duh put clear soup in a small mug w/a lid so she can drink it rather than trying to manage getting soup on a spoon to her mouth and not all over everywhere.

I sat and watched her try to eat in her nursing home room one day. And it all became crystal clear. She was trying w/one arm/hand to take apart a nice sandwich and grab the individual parts because she could not hold half of the sandwich in the one hand and not have it all fall apart all over her and the bed.

She refuses to go to the dinning hall to eat, so all meals are in bed (they allow that, forcing things only causes a meltdown). So now we -- MD, dietician and the NH staff -- have a workable plan. They also let her pick out what she want to each, the week ahead. And they do not care if it is the same thing for each day. She can have her "pigs in the blankets" or small sausages every day if that is what she will eat. These sausages are of course NOT the sodium, and fat laden type from the grocery store, but better/healthier ones actually made of turkey and they have a "beyond beef-like" (no meat) option she likes to get some veggies in her.

Good luck with this.
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Msblcb Sep 2022
My mom will not go to the dining room either. The crowd, noise etc just gives her anxiety. I did try the ensure mixed fruit drink and she loves that! I am also getting a full glass of white cranberry juice in her each day. The ALF has tried very hard to provide soft, easy to swallow veggies. She is a vegetarian so it is a challenge. I think I am getting about 1000 calories in her a day but she still seems to lose weight. No complaints of pain or discomfort. So, we will see. Thank you for the wonderful advice.
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The best way to increase calories is through regular meals but I see from your profile that she is now in an AL facility, that will make any dietary changes more complicated. First I would meet with their dietitian to discuss her needs and what strategies they recommend to slow her weight loss, nothing you try can succeed unless it is part of her care plan. There are supplements available that are very calorie dense and a good facility will know all about them and will probably have their preferred supplier. Perhaps all she may need is assistance with her regular meals and encouragement to eat the snacks offered throughout the day.
There are a lot of reasons people begin to have trouble eating enough - problems with their teeth or mouth can make chewing difficult or painful, problems in the digestive tract can cause upset stomach or feeling of fullness, or sometimes medications can make food taste different. Getting used to AL menus and foods may also play into it. Many of the people in my mom's nursing home had their meals pre-cut into bite sized pieces, some needed a much more highly modified plate because they were experiencing swallowing difficulty (dysphagia), you should ask the dietitian if if that is a possibility.
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I wonder if you can try a homemade protein shake with real ingredients. Plant based milk, banana, dollop of peanut butter, handful of spinach, and a good protein powder. There are also plant based pre-made shakes available on Amazon.
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Flavored yogurt, protein drinks - if she can tolerate them (they can have a lot of sugar), smoothies, pudding.
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My husband has trouble swallowing. He is enjoying smoothies made with frozen blueberries, milk for blending ease, full milk yoghurt, and a little honey. You could easily put a little protein supplement in with it, I believe.
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You could also try Carnation Instant Breakfast mixed with a lactose free milk. My husband could tolerate that whereas regular milk-based products upset his system, even though it has dried milk powder.
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I try to feed both moms (one with Alzheimer’s, one with vascular dementia) lots of protein. They like tuna and eggs, both are dense proteins and easy to chew. We also do lots of beans and rice. We’ve found protein helps them maintain weight and some muscle mass.
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When my suffered with signs of dysphagia, I was encouraged to put her on a pureed diet. Some might not take to it. Because she had diabetes, I gave her Glucerna as it did not seem to irritate her stomach as much as other products and a little lower in sugar.

You can try mashed or sweet potatoes. Applesauce, pudding, yogurt, and even baby food has worked for me. Good luck with whatever you try - nutritionist, dietician and all. I know how hard it is to see your loved one wither away despite all best efforts.
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Msblcb Sep 2022
I bought baby food today. I am going to try it. She has always been a picky eater and now it is much more difficult. Thanks for the advice,
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Have you looked at the Ensure label? 210 ml of salt and 28%sugar. The average person should not eat more than a teaspoon of salt a day, thats 2000ml. The sugar is over 1/4 of the drink. Lots if additives one is Carageenan. This is used to thicken products up. My daughter has IBS and cannot eat anything that this additive is in. She gets pain and diarrhea.

"What Is Carrageenan? Carrageenan is an extract from a red seaweed commonly known as Irish Moss. This edible seaweed is native to the British Isles, where it's been used in traditional cooking for hundreds of years. It's also widely used in the food industry, mostly as a thickener and gelling agent."

I looked for Aspartame but its not in the ingredients. Aspartame is found in sugar free candy, besides other foods and drinks, which my Dad ate because he was a diabetic but...it caused him to have diarrhea.
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My first suggestion would be to buy carnation Instant Breakfast. It's a high calorie drink mix you mix with whole milk and tastes good. They have a few flavor options to choose from: chocolate, vanilla and I think they have one more, but I can't remember. The second option I would try would be getting a high power blender and making fruit smoothies and adding protein powder. You can also use the blender to puree a steak dinner or anything else. The key is making sure to get the high power blender like a Blend Tech because it makes all the difference. BlendTech is very expensive but you can purchase one that's refurbished like I did and it works just as well for a much cheaper price point. I have had my refurbished BlendTech for 10yrs and I have never once had a issue and it's paid for itself with all the amazing recipes and health benefits. ENSURE and BOOST and all the OTHER DRINKS LIKE THAT ARE JUNK AND FULL OF SUGAR AND TERRIBLE ingredients. I have NO idea why doctors and hospitals even recommend them. The health benefits of making your own is so worth the investment and anything you make will also taste good. You can get free smoothie recipes online too. This is how they used to make baby food before the big supply chains.
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It's the magnesium most likely. I give my mother Muscle Milk because it doesn't have the magnesium that can cause diarrhea and all of the sugar. I mix it 50/50 with Lactaid Milk and put a drop of organic vanilla flavoring in it and she loves it.

I also buy her the little cups of Breyers ice cream.

She loves the little Entenman's cherry and apple pies and gets one with breakfast.

I also give her "cookies" which is a protein bar.

She likes egg salad sandwiches which are easy to make and have protein from the egg and fat from mayonnaise.

Hope that helps a little.
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Many people cannot tolerate soy-based products. Other ingredients, including sugar, could also be problematic. Dairy-based ingredients may also cause problems.

Avoiding soy, dairy, fructose, gluten, artificial sweeteners and histamine does not leave much you can conveniently buy and serve. Rice and oat based products are a place to start, but check commercial versions of those products for ingredients on the "intolerance" list.

If your mother is having bad side effects from what she is eating now, she is probably not absorbing much, either, and will continue to lose weight until you find more well-tolerated foods.

You may need to pay closer attention to the foods your mother can digest without difficulty and create your own supplements.
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Msblcb: Perhaps she needs to see a nutritionist.
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You may find a few of AgingCare's articles helpful

https://www.agingcare.com/topics/41/diet-nutrition/articles
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Those are mostly corn syrup, aren't they? We get Premier Protein drinks from Sam's Club or Walmart, much cheaper at SC and delivery is free with Plus. We get Liquacell Protein drink from Amazon, recommended by the kidney dr. Mom is still very thin, but we give her eggs every morning with avacado in some form (mixed with hard boiled eggs, sliced on the side, mashed on plain or buttered toast with pepper and celtic salt).

Lunch and dinner is usually mackerel (canned) or salmon (fresh filet) which is broiled, pan heated or grilled, or roasted chicken. Also steamed or canned vegetables. Tomorrow I'm baking a tray of chicken quarters and some garlic mashed potatoes, steamed broccoli and cauliflower.

Mom also eats a handful of nuts, cashews or pecans mostly, and 2-4 prunes a day (for the fiber and she gets constipated if she doesn't). She has no problem eating, but if I ate as much as her, I'd gain weight, and she doesn't. It's so hard to understand.

I'm beginning to wonder if some of her meds can cause weight loss, as her appetite is great!
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JoAnn29 Sep 2022
I just found out I can no longer tolerate eggs. In stuff does not seem to bother me but a cooked egg alone does. Something about the stomach not being able to digest the proteins anymore.
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