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She refuses to eat which is causing serious weight loss.

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Lewy's body dementia is terrible and I can so relate to your situation. My 93 year old Mom had it. Her brain was broken and no matter how much we reassured her, her mind was made up. According to her, ALL female caregivers were having affairs with my Dad! And my Dad was a kind, meek man ..LOL...Her anger, confusion and anxiety was through the roof! She was calling the kindest, most gentle caregivers, "jack ass", etc. Almost comical if it wasn't so tragic. I was in the process of working with her doctor, to find out if she could be given something for her anxiety. But the next week she passed away. Partially relieved for her, that her struggle was over, but also mourning the loss of my Mom. It's just such a difficult learning process. This website helped me more than anything else. Just knowing I wasn't alone, and others were going through similar situations. I wish you all the best.
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Imho, you should ask her physician and go from there.
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Oh I can so relate to this. My mom had Lewy and “poison”. For mom, it was a phase, lasted maybe 4-5 months when she first moved into a NH. Her weight loss was not “significant” as in more than 10% in 30 days but was around 5% range. The % loss matters as there’s protocols that kick in for how to handle if it’s “significant”. So ask abt her %.

I do think that the seasoning blends, oils, etc used in cooking since their institutional foodservice do have a different taste & texture & somehow they can sense it. Plus they don’t have the smell they are used to from their home kitchen to give them clues as to what the menu is, to help them identify stuff. Their in another solar system most of the time but by gosh they can tell that taco seasoning isn’t right. LOL.

see if dietary can do sandwiches for your mom. For my mom, if she had a sandwich, she would totally eat it all. Just something about being in control of eating seemed to make a big butt difference for her. But in my experience the weight loss is kinda inevitable. It’s pretty amazing & somewhat horrifying just how tiny they can get but still be keepin on. Their not expending much in calories, so gradual weight loss isn’t a biggie. But they do need to do fluids. If she’s drinking water & juices, that good and this is important to do.

regarding the protein drinks, this is what I was told by the DON & dietary at my moms NH, that you really want them to actually have to eat even if they get a liquid as a small supplemental; that eating as a process is “active”, they have to move food about, cut/fork, lift, open, bite, chew, swallow. Eating is a physical act and keeps their cognitive ability up and going 2-3 times a day. If they switch over to being on liquid diet, all that goes away; it’s only “passive” feeding that they will likely loose ability or interest to use a straw so then you face the issue of going enteral feeding (like Pegline, NG tube) or going onto hospice and letting nature run it’s course. There have been oodles of posts on this site about pros / cons on feeding tubes; it’s not a decision to take lightly.

If she does get a liquid supplement, ask about having her on one that is designed for low volume feeding. Most of the drinks we think of....like Boost, Ensure... are based on getting the nutrition by drinking the entire 8-12 oz. bottle. Well they arent likely to do that. There are drinks specifically designed for high protein high nutrition low volume feeding with probiotics added (so easier processed in her gut). When my mom became bedfast (after a bad fall), she had her food mechanized for meals (so easier to “cut”), got a sandwich every other day AND had a can of Abbot labs Two Cal HN added to her daily dietary. Hospice MD ordered it and it was billed within hospice benefit. Dietary did the can either at lunch or dinner depending on what their day was like or when hospice aide was there. She was on hospice 18 months & finfound that hospice and NH staff really worked well together for my moms needs. It’s on retrospect amazing just how little food they need and still be ok.
Good luck in all this. It will get easier over time.
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Would she accept food more easily if it were sealed?
Have them wrap her plates and bowl with plastic wrap.
Would she more easily accept things like Premier, Boost, Ensure? Those are sealed and not easily tampered with.
There is a product called Magic Cup it is like an ice cream but has added protein, vitamins and calories.
Might also be a time to talk to the doctor about adjusting medications if this is a newer paranoia.
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Just read your profile - so things have progressed from you helping her at home to her being in a nursing home?

Have you asked her doctor or asked the nursing home staff to ask for her to be put on a med to help control her paranoia?
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