Jump to content

EXTREMELY low weight elderly (23kg)...


  • Please log in to reply
28 replies to this topic

#1 TillyTake2

Posted 23 December 2012 - 01:47 PM

A relative of mine is very elderly (mid 90s) & has been petite all her life. She has recently gone into hospital for dehydration & it turns out she weighs only 23kg!! I calculated her bmi & it would be around 9-10.

She can walk (with a walker) & apparently all her tests show that medically she is completely fine (apart from bloodworm showing signs of malnutrition).

There is a whole heap of background that I won't go into but I'm wondering how this is even possible?! How long can your body really live at that weight? I can't see her gaining any significant weight any time soon (she's been in hospital for 2 weeks and has not gained any weight). There is no medical reason for the weight loss, she is just fussy & would prefer not to eat than to eat something she doesn't want.

#2 Mousky

Posted 23 December 2012 - 02:05 PM

Sounds like my 91 yo grandma, she has mostly lost her sense of taste, so barely eats anything.

#3 TillyTake2

Posted 23 December 2012 - 02:07 PM

Any medical type people able to offer insight? Is this a long term sustainable thing? The nurses in the hospital seemed shocked. We are trying to work out what we should do in terms of planning. Obviously plans for her will be different if it's likely a matter of weeks or months vs potentially years. The thing that gets me is that they say medically she is "fine". How can you possibly be medically fine at 23kg?!!

QUOTE (Mousky @ 23/12/2012, 03:05 PM) <{POST_SNAPBACK}>
Sounds like my 91 yo grandma, she has mostly lost her sense of taste, so barely eats anything.



I'm sorry to hear that sad.gif Is she in a nursing home or at home?

#4 snuffles

Posted 23 December 2012 - 02:08 PM

Not much you can do then I guess??

My Grandma lost a lot of weight before she died, she had Alzheimers and just stopped eating eventually.  All I can suggest is that you do what you can to make her last days/weeks as happy as possible.

sad.gif

#5 TillyTake2

Posted 23 December 2012 - 02:10 PM

I should add that mentally she is totally with it & has been living (alone) at home up until I made her go to hospital a fortnight ago. She is still of the impression she will be going home. Unfortunately the wait list for in home help is huge & she's not even had an ACAT assessment yet.

#6 porkchop's mama

Posted 23 December 2012 - 02:24 PM

As scary as those numbers sound, it's reassuring that your relative is still able to mobilise.  Without prying, does she have a history of depression or low mood that may be causing her to lose interest in food?  Her treating time are probably looking into whether her medications could be causing her to lose her appetite.  Does she have swallowing issues or poorly fitting dentures that make eating difficult or painful?

It can be difficult for people to put weight on even in hospital because the nutritional supplements prescribed are not to everyone's taste.

Without knowing the investigations performed, their results and what other illnesses your relative may have, it's difficult to prognosticate but as I mentioned earlier, if she is mobilizing and cognitively well, she doesn't sound in danger of deteriorating rapidly.

How long has your relative been at this weight?  Obviously a gradual decline would have different causes to a more rapid one.

With regard to the ACAT assessment, this would usually be done when medical and allied health teams are satisfied that she has reached her best functional capacity.  The actual assessment takes a few hours and once you have the paperwork and know what level of care she may require then it takes a while to organise service packages or placement depending on what your relative wants.  She sounds like she does have capacity to make this decision.

If there are concerns about discharge planning from the hospital's perseptive, a family meeting can be arranged where relatives can meet with the patient and the treating team (medical, OT, PT, nursing and social work) so that everyone's side of the story can be heard.

Hope this helps and isn't too vague.


#7 porkchop's mama

Posted 23 December 2012 - 02:26 PM

Forgot to mention, for some patients, ongoing rehabilitation in a dedicated unit (as opposed to the medical wards of acute hospitals) may be suggested to give them more time to reach their best function and avoid nursing home / high level care.  This would be suggested if the allied health team identify rehab goals for your relative that would be amenable to therapy.

#8 TillyTake2

Posted 23 December 2012 - 02:30 PM

She's been moved from a acute care unit to a rehab hospital but they can't give any indication on the plan.

She doesn't have a history of depression but they are trialling some antidepressants. Unfortunately she's not very compliant with medication & will just throw it away (& even though the nurses say they will supervise they don't).

She apparently has a history of abusing laxatives (although we only found this out recenty).

She has lost probably 10kg in the last few months & 10-15kg in the few years before that.

#9 Mousky

Posted 23 December 2012 - 02:36 PM

QUOTE (TillyTake2 @ 23/12/2012, 03:07 PM) <{POST_SNAPBACK}>
Any medical type people able to offer insight? Is this a long term sustainable thing? The nurses in the hospital seemed shocked. We are trying to work out what we should do in terms of planning. Obviously plans for her will be different if it's likely a matter of weeks or months vs potentially years. The thing that gets me is that they say medically she is "fine". How can you possibly be medically fine at 23kg?!!




I'm sorry to hear that sad.gif Is she in a nursing home or at home?


She is currently in hospital as she had knee surgery but otherwise she is at home by herself.  I work in very high care disability and when someone is under weight, there are things like Ensure puddings and drinks that you can order from the chemist. Aparently they are quite nice, but nan wont have them.  Other than the knee, she is quite well, very with it, so hopefully will be like the durocell bunny original.gif


#10 snuffles

Posted 23 December 2012 - 03:13 PM

It does sound much more hopeful than I thought.  Hope she keeps on!!!  original.gif


#11 Froger

Posted 23 December 2012 - 03:20 PM

I know an elderly person like this (a relative on my ex's side). She has been seriously underweight for a good two decades now. She seems to exist on cups of tea and takes great delight in cantankerously refusing all the lovingly prepared food that her close relatives, friends and neighbours make for her. She is in her mid 90s now, and continues to be in reasonably good health (although she did break her leg once) despite seemingly existing on pretty much nothing.



#12 skylark

Posted 23 December 2012 - 03:26 PM

My grandmother was a chainsmoking alcoholic and anorexic and managed to live into her mid-90s at a weight in that range. She was a couple of inches under 5 feet tall to start with, and like a tiny shrivelled skeleton. She was very proud of how thin she was. She was active and lived at home alone right until the last 6 weeks of her life.

I have no idea how any of that is even possible, it defies all kinds of logic. She used to cackle and say "My hate keeps me alive." She was an awful person.

#13 Dylan's Mummy

Posted 23 December 2012 - 03:37 PM

Regarding the puddings that a PP mentioned. When my Dad was in hospital recently, we found that he had lost a lot of weight and lost more during his hospital stay. He had these pudding/custard type meals in hospital and ended up putting on a bit of weight. He doesn't really eat much due to having cancer, being very tired and also because the type of can we makes it almost impossible to eat solid food. He liked eating the puddings and they helped him gain some weight. He wouldn't eat the other puréed they made for him (meat, veges).

The puddings are expensive so Mum researched on the internet and managed to order the same ones a lot cheaper from overseas, so have a look I to that.

#14 TillyTake2

Posted 23 December 2012 - 03:45 PM

QUOTE (skylark @ 23/12/2012, 04:26 PM) <{POST_SNAPBACK}>
My grandmother was a chainsmoking alcoholic and anorexic and managed to live into her mid-90s at a weight in that range. She was a couple of inches under 5 feet tall to start with, and like a tiny shrivelled skeleton. She was very proud of how thin she was. She was active and lived at home alone right until the last 6 weeks of her life.

I have no idea how any of that is even possible, it defies all kinds of logic. She used to cackle and say "My hate keeps me alive." She was an awful person.


Lol. I had to laugh as my grandmother is also a horrible person (as awful as that is to say). I have joked with my husband that evil preserves you.

#15 TillyTake2

Posted 23 December 2012 - 03:48 PM

We have tried the puddings (& the 2 cal drink) but she refuses.

She insists the food is disgusting (it's not, she's in a lovely private hospital & I've personally sampled some of her food). She also has complaints about the "foreign" staff etc but we won't go there. All in all she's not particularly popular on the ward!

#16 #YKG

Posted 23 December 2012 - 04:06 PM

Keep in mind that as you get older your appetite does de tease significently. While you may be starving after 2 crackers and a cup of tea many older people in their 90's will find it filling. TBH with many over 90 year olds I have experience with eat very little, weigh very little but are active and medically ok. Your body as you get older appetite does decrease and weightloss in older people is common.

Have a chat to her Dr they will be in a better position to explain the good,bad or indifferent to her current needs.

#17 TillyTake2

Posted 23 December 2012 - 04:48 PM

Yeah tube feeding etc has been ruled out & at the end of the day it is her choice to eat or not. At this point our biggest fear is that she will be sent home without the support in place (as the waiting lists are too long) as they believe she should go into a nursing home which she refuses.

If they send her home then we will be forced to go morning and night to help her (or leave her to die on her own which obviously we can't do). She lives an hour from us & has only 2 living relatives (myself & my dad). Well technically my brother too but she alienated him many years ago.

It sounds horrible but at this point I think the best thing is for her to just peacefully go off to sleep & not wake up but the fact she seems to be "healthy" & surviving at such an insane weight makes me think this is pretty unlikely.

The fact she has refused any help in the past puts us in a really hard position as she's not had any of the assessments or gone on any of the waiting lists for help.

#18 Guest_LeChatNinjah_*

Posted 23 December 2012 - 05:00 PM

If she's not interested then it's going to be really hard, but if she could force them down those Ensure and Sustagen drinks really help my mum, who battles with being underweight as well.

Good luck, it must be so difficult for family  sad.gif


#19 TillyTake2

Posted 23 December 2012 - 05:18 PM

Yeah we've tried making everything from puddings to biscuits to pies to lemon tarts, quiches etc. She will take a couple of bites & toss it or say that it lacks salt/pepper/herbs, has too much salt/pepper/herbs etc!!

Apparantly she also takes laxitives so basically even of she does eat something it just comes out. They (drs) think she's probably been doing it a long time.

I don't think she's trying to die (she's still very concerned about her clothes/makeup/appearance & makes sure we are caring for her huge gardens and pool!) so she doesn't seem to have lost the will to live.

It's just so crappy as she's so manipulative & selfish & she will just insist that we have to come every day or leave her to starve sad.gif

Is there any emergency way of getting care at home when you haven't served the 6-12 month waiting list?

#20 Fenrir

Posted 23 December 2012 - 05:24 PM

QUOTE
Keep in mind that as you get older your appetite does de tease significently. While you may be starving after 2 crackers and a cup of tea many older people in their 90's will find it filling. TBH with many over 90 year olds I have experience with eat very little, weigh very little but are active and medically ok. Your body as you get older appetite does decrease and weightloss in older people is common.

This. You also lose taste as you get older and eating becomes a chore rather than a pleasure. My MIL couldn't have weighed more than that when she died either.

The other option to get nutrients into her is Sustagen. The nursing home where  my MIL spent her last days used to supply these and they could have as little or as much as they wanted when they wanted.

Another possibility, as much as it may upset you, is that this is her way of saying she has had enough. There comes a time when life is not what it used to be for our elderly. They have aches and pains and have seen and done all that they wanted. It could be that she is just tired of life and wants to do it in her own way.

I remember how crotchety and stubborn  MIL got towards the end. Food had no taste so she didn't eat nearly enough. The staff were the wrong kind of person. They were mean and horrible to her etc etc. She was put on AD's as well but there was no improvement.

By all means push for ACAT but do not be surprised by what they may say.


#21 TillyTake2

Posted 23 December 2012 - 05:31 PM

She orders the laxatives from the chemist who home delivers. Because she is of sound mind we have no say in anything apparantly sad.gif

I was told there was a 6-12 month wait by the 3 different social workers I've spoken to & they said the only other option is a nursing home which she refuses.

The biggest "problem" is that she is deemed to be of sound mind so she has total control over all decisions.

She has signed an advanced directive (but even this only happened a week ago & she still talks about how that was a mistake). My dad will have power of attorney but that only comes into effect if/when she is incapable of making decisions.

#22 TillyTake2

Posted 23 December 2012 - 05:33 PM

QUOTE (Alpha_Chook @ 23/12/2012, 06:29 PM) <{POST_SNAPBACK}>
My guess is that they have a done a heap of blood tests and they have all come back normal...she is cognitively OK, doesn't have any complaints regarding pain so theres not a lot they can say I guess.


She has plenty of complaints regarding pain lol

She has a bad back & takes panadol & iboprophene.

She reports she is "allergic" to almost every medication under the sun so this makes things difficult.

#23 TillyTake2

Posted 23 December 2012 - 05:37 PM

I guess if we had any idea how long this could go on for we could make decisions like paying for private help etc but the problem is, we can't really do that if this could go on for a year or more.

I can't believe she can continue to live in this state but my gut says she will still be chugging on this time next year so we can't really go paying for private help for years to come.

#24 Peanut

Posted 23 December 2012 - 05:58 PM

QUOTE (Dylan's Mummy @ 23/12/2012, 03:37 PM) <{POST_SNAPBACK}>
Regarding the puddings that a PP mentioned. When my Dad was in hospital recently, we found that he had lost a lot of weight and lost more during his hospital stay. He had these pudding/custard type meals in hospital and ended up putting on a bit of weight. He doesn't really eat much due to having cancer, being very tired and also because the type of can we makes it almost impossible to eat solid food. He liked eating the puddings and they helped him gain some weight. He wouldn't eat the other puréed they made for him (meat, veges).

The puddings are expensive so Mum researched on the internet and managed to order the same ones a lot cheaper from overseas, so have a look I to that.


Gosh, this is pretty much my Dad too.  I'm so glad I stumbled over this thread because I'd never heard of the Ensure Puddings before.  My Dad has put on weight with each hospital stay but loses it almost immediately after returning home despite all the meals my Mum tries to get him to eat.

Can I ask where you were able to order them through?  Would you mind pm'ing me if its not allowed to mention it publicly?

Sorry OP, didn't mean to butt in.

Edited by Peanut, 23 December 2012 - 05:58 PM.


#25 ednaboo

Posted 24 December 2012 - 09:26 AM

QUOTE (TillyTake2 @ 23/12/2012, 03:30 PM) <{POST_SNAPBACK}>
She's been moved from a acute care unit to a rehab hospital but they can't give any indication on the plan.

She doesn't have a history of depression but they are trialling some antidepressants. Unfortunately she's not very compliant with medication & will just throw it away (& even though the nurses say they will supervise they don't).

She apparently has a history of abusing laxatives (although we only found this out recenty).

She has lost probably 10kg in the last few months & 10-15kg in the few years before that.

Is it possible she has had a life long Eating Disorder, which has deteriorated significantly with age?  If so, it will be difficult for her to change now.  Her BMI defes logic.  Most people would be at deaths door by about 11.  Are you sure you calculated it correctly?

The hospital should have access to a dietitian who can prescribe a variety of supplements such as Resource Plus, Ensure Plus, TwoCal etc.  I find Sustagen Hospital tasted the best though.

Peanut: you can buy Ensure Puddings from most pharmacies.

Edited by ednaboo, 24 December 2012 - 09:28 AM.





1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

Get your FREE Baby & Toddler Show ticket!

Get your free ticket to the Sydney Essential Baby & Toddler Show for September 25-27 - register online now.

Win Love Child Season 1 & 2 on DVD

To celebrate the release of Love Child Season 2 on DVD from July 9, Essential Baby and Universal Sony Pictures Home Entertainment are giving away Love Child Season 1 & 2 on DVD to 13 lucky winners.

10 things I wish my pre-baby self knew

I look back at my pre-baby self and laugh at how ridiculously easy I actually had it. I remember complaining about how tired I was and how little time I had.

Creative ways to store your child's art

Ideas for storing your child's artworks have moved on from sticking them to the fridge door before guiltily dumping them in the bin.

Child abuse ignored because 'it's not your children': Waleed Aly

Waleed Aly takes apart the immigration law that's designed to "protect politicians"

How a newborn niece changed star Australian basketballer's life

In August 2013 star basketball Abby Bishop was 24-years-old and in the prime of her sporting career.

Guilt is my new shadow

No one warned me that when I gave birth there would be an additional side order of guilt.

12 brilliant Ikea hacks for kids’ rooms

Check out these creative upcycling ideas that transform regular Ikea items into something special for your little ones.

Child's nightmare about 'man with a light' turned out to be real

For three days, a three-year-old boy had been saying there was "a man with a light" outside his window at night.

Toilet truths after giving birth

The thought of going to the toilet after giving birth is often feared, but there are ways to make it less painful.

Woman asks strangers for $1 million to stop her having an abortion

An anonymous woman is taking an extreme moral and ethical stand by seeking $1 million in donations to prevent her going ahead with a planned abortion.

How a woman's dying wish made another woman a mum

"I kind of think about, 'What did I do beforehand? What kept me so busy back then?' Because now I'm really busy."

The parenting do-over: what six parents did differently second time around

In playgrounds across Australia, you can hear parents lamenting, "When we have our next baby I swear I won't be doing THAT again".

A solo birth, a wasp swarm and a forest fire: mum and baby's amazing story of survival

Desperate, out of petrol and low on food, a new mother lit a fire in the hope of attracting attention.

Boy found on swing died of hypothermia and dehydration, autopsy finds

The story was chilling and heartbreaking: a three-year-old boy was found dead in a Southern Maryland park, his mother pushing him on the swing.

Child's play and laughter help battle fatigue

Feeling fatigued? Uh-huh, thought as much. Join the queue.

Dad shares entertaining 'how to hold a baby' clip

For many new dads, their own child is the first baby they have ever held. So one dad has posted an instructive YouTube video titled "How to Hold a Baby".

The Australian baby with 100,000 Facebook fans

She may be only eight months old, but Egypt has already amassed more than 100,000 fans and received a letter from royalty - Hollywood royalty that is.

Tongue tie: what you need to know

Tongue and lip tie can lead to many problems for babies - and their parents. Here are the signs of tongue tie and how it's treated.

My daughter is small but that doesn't matter

My daughter may be small, but it's my job as her parent to refocus back where it belongs - on who she is as a person

Wet wipes linked to rise in allergic reactions

The government has issued a health warning after a rise in allergic skin reactions has been linked to a preservative found in some wet wipes.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

27 funny ultrasound pictures

Ultrasounds give you a look at your growing baby ... and sometimes what appears to their womb-buddy, or your bub in an amusing position.

What all parents should know about safe babywearing

A picture of Ryan Reynolds always gets the girls talking, and a recently shared photo has done exactly that - but this time, it's for all the wrong reasons.

Baby's head shape reveals potentially fatal condition

Thinking her baby just had an unusually shaped head, a mother was shocked to discover it was instead linked to a dangerous condition.

Why IVF success rates may not be what you think

Transparency, accountability and responsibilityare essential measures to protect IVF vulnerable patients.

Mother-in-law 'from hell' inspires survival guide

The happily ever after Nicola Milan had imagined wasn't to be – and she blames her mother-in-law.

Owning a pair of nail scissors does not make me a hairdresser

It's been a whole year since sleeping in until 10am. A whole year since having a peaceful shower.

The 83 children who were tragically let down in the last decade

Over a 10-year period, 83 children died from domestic violence abuse in NSW, with three quarters of the victims aged five years or under, the NSW Ombudsman has revealed.

Is it reasonable to expect your partner to give up drinking in pregnancy?

From the moment that I fell pregnant with my son, I realised just how much my life had already started to change.

Stroke victim joins class action against makers of popular contraceptive pill

"I was terrified I would always be this way. The pill needs to come with a much higher warning."

Sexy time

Why you should get excited about scheduling sex

Unfortunately, the belief that sex should always be spontaneous is a myth. It just isn't.

When newborn photoshoots get messy

When it comes to newborn photoshoots, it is all about the timing.

Expert Q&A: Gross motor skill development in toddlers and preschoolers

Dr Katie Heathershaw answers questions about jumping, toe walking, riding a bike and being pigeon toed.

'Samuel is our firstborn, and he will never be forgotten'

Having lost their firstborn at one day old, the Carrolls were overjoyed to welcome their daughter Isobel into the world a year later.

Dad takes miraculous catch while feeding baby

One American father has taken multitasking to a new level at a Cubs-Dodgers baseball game at Wrigley Field.

Name your baby Quinoa, win a $10K gift card

Choosing a name for your little bundle of joy is always a major decision. It can be something traditional, trendy, creative … or inspired by the menu of your favourite chain restaurant.

On the 10th anniversary of my son's death

This day marks a significant day. Today marks 10 years since I lost my son Kai.

'Help - my toddler hits me!'

My toddler has started hitting when he gets frustrated, is feeling ignored, or just thinks it might be fun.

The top 6 misleading parenting terms

From 'morning sickness' to 'the terrible twos', there are many parenting terms that are misleading.

When 'good' nannies go bad

While most nannies take pride in their work, there can be some who have a hidden side.

Woman hospitalised for skinny jeans injury

Beware: skinny jeans might be bad for your health.

Gauze seeding: the bacteria-breeding birth trend

A number of women having caesarean deliveries are now taking steps to give their baby a better 'microbiome' start in life.

Jimmy Fallon writes new children's book for dads

Jimmy Fallon, host of NBC's The Tonight Show, recently wrote a children's book about every father's secret wish for their baby's first word to be "dada" - not "mama".

28 names for babies born in winter

Looking for some baby name inspiration for a bub born during the colder months? Here are 28 options from around the world to consider.

 

FREE TICKET

Get your FREE ticket to the Baby & Toddler Show

Get your free ticket to the Sydney Essential Baby & Toddler Show for September 25-27 - register online now.

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.