After her Stroke my mom does not want to eat pushes her food way.

Posted by jules17 @jules17, Mar 1, 2019

My 83 year old mom who was in good health before her stroke 6 weeks ago… Mom always had a great Appetite and a healthy diet. She has recently passed the swallowing test but refuses to eat, she pushes her food away. Anyone have any ideas on how we can try to help or want to eat?

We have tried the change of scenery different ideas… she did have a lot of problems with her tummy and the liquid meds that they had to give her through the stomach tube could that be discouraging her thinking that eating has consequences of a bad tummyache ?
Thank you
Julia

Interested in more discussions like this? Go to the Stroke & Cerebrovascular Diseases Support Group.

I'd like to ask @lakelifelady @jmjlove @rldawg @pegharlow and @bermuda to join this discussion about eating after stroke.

Jules, it's not uncommon to experience a loss of appetite after a stroke. Your mom has had a lot of changes. You mention that she pushes her food away. Is she able to talk? Does she tell you why she doesn't want it? Does she push everything away or eat a bit and then push it away?

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JULES, I know how mom feels. Stroke wiped away my appetite, too. Hunger pains were rare, so had little clue I was hungry. Maybe taste buds are off, creating a bland flavor, with even the best of foods. Mine are partly dead, or so it seems, then sometimes there is a metallic flavor (chocolate, various sweets, even spicey foods). Of course it's not the food, it's my dysfunctional taste buds. Some seem to work, but those on left side of tongue do not. Between taste buds and plain lack of appetite, I learned to eat to live. I ate little, but tried to consume healthy food.

Also, don't know if mom communicates, but I had a major problem biting inside of lips and cheek. Chewing, as well as, minor sluggishness in tongue, contributed to making eating literally bloody business, lol. I had sensation on my left side, just poor control. Don't know if mom deals with this, but just throwing those things out as contributing factors to her disinterest in food.

For months after my large cerebellar stroke each and every activity was troublesome, overwhelming, challenging, and just plain work. Even eating. If she eats little, pack her *little* with high quality calories. Keep available to her calorie rich drinks, like "boost". Her therapy may help her work up appetite, maybe plan eating for after therapy? Stroke patients are frustrated. We seem to complicate even simple activities, like eating, because strokes suck the life out of us, though usually not literally. They can extinguish a sparkling personality, not necessarily with depression. Emotionally, I sort of flatlined. Life had a bit of a surreal quality. It was all around me, so apparently life goes on….but my place in it, my participation, no longer seemed important, had little satisfaction, and required so. much. work. I lost my usual zest for life. Hard to believe, instead of depression, I dealt with my own lack of will to participte, because participation required lots of thought, clumsy attempts at family dinner, using my stupid walker, and being upright. I was so tired, I just wanted to sleep. Not work on my participation skills, lol. As I improved, the veil lifted a bit, I began to find my place, enjoy humor again, use my deficits as my daily challenges and embraced working on them. Didn't love it, or enjoy it, didn't get all sporty, lol. But I knew I would not improve unless I put the effort in. God bless.

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After my accident I lost ten pounds and was very thin. My mouth was so dry that food had no taste and Food had an unpleasant taste. I drank Ensure for some time in addition to eating as much healthy food as would go down. Plus, I had a neck brace that pushed my head up a bit so I had to use a mirror in front of my face to see where my mouth was to put food in, which would often spill on my neck collar. It was miserable but I got through it.
Maybe your mom would drink Ensure or smoothies. Be sure she takes a multivitamin in some form. There is a special toothpaste called Biotine and there are lozenges, mouth washes or sugarless gums that help with dry mouth…..that is if she is able to take those products.

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@colleenyoung

I'd like to ask @lakelifelady @jmjlove @rldawg @pegharlow and @bermuda to join this discussion about eating after stroke.

Jules, it's not uncommon to experience a loss of appetite after a stroke. Your mom has had a lot of changes. You mention that she pushes her food away. Is she able to talk? Does she tell you why she doesn't want it? Does she push everything away or eat a bit and then push it away?

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Thank you all for your comments … It has been it has been over 10 weeks since the stroke. My mom has started being able to eat a little more variety… they have started her on different foods and she has Started getting her appetite back a little bit. She stills has her feeding tube in:(.
Hopefully it will be removed soon…
I appreciate your all the answers and help thank you so much

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@jules17

Thank you all for your comments … It has been it has been over 10 weeks since the stroke. My mom has started being able to eat a little more variety… they have started her on different foods and she has Started getting her appetite back a little bit. She stills has her feeding tube in:(.
Hopefully it will be removed soon…
I appreciate your all the answers and help thank you so much

Jump to this post

Hi, @jules17 – how are things going with your mom?

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Hi everyone,

I'd like to invite you to join us today, Wednesday, May 1 at 12pm CT for a video Q&A. Drs. William (David) Freeman and Rabih Tawk will be discussing all aspects of stroke, and will answer questions during the live broadcast.
Simply click https://connect.mayoclinic.org/webinar/video-qa-about-stroke-2/ for details.
Drs. Freeman and Tawk will answer questions live. Post your questions before and during the broadcast.

Return to this page, https://connect.mayoclinic.org/webinar/video-qa-about-stroke-2/ to take part in the video Q&A live on May 1 at noon CT. It will also be archived on this page.

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I am having a similar issue with my father-in-law. He had a stroke on 9/2/22 and he is refusing to eat. He has been very combative whenever you attempt to touch anywhere near his face. He does not speak much at this time and when he does it is difficult to understand. The hospital has sent him home yesterday but he is still not eating. Prior to leaving the hospital he had a feeding tube and the hospital did a swallow test which he passed but just will not take down food on his own. My faith is strong so I’m praying this will change but my husband feels like his father has given up. The hospital says if he doesn’t start eating on his own it’ll be a few weeks if that and he’ll probably pass away. We could not find a nursing home or rehabilitation center in our state that would take him due to his combativeness. I’m trying to remain positive so I’ve been searching for any suggestions on how we could assist in getting him to eat anything when I came across this discussion. Any additional feed back would be greatly appreciated. Thank you

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@lyn1

I am having a similar issue with my father-in-law. He had a stroke on 9/2/22 and he is refusing to eat. He has been very combative whenever you attempt to touch anywhere near his face. He does not speak much at this time and when he does it is difficult to understand. The hospital has sent him home yesterday but he is still not eating. Prior to leaving the hospital he had a feeding tube and the hospital did a swallow test which he passed but just will not take down food on his own. My faith is strong so I’m praying this will change but my husband feels like his father has given up. The hospital says if he doesn’t start eating on his own it’ll be a few weeks if that and he’ll probably pass away. We could not find a nursing home or rehabilitation center in our state that would take him due to his combativeness. I’m trying to remain positive so I’ve been searching for any suggestions on how we could assist in getting him to eat anything when I came across this discussion. Any additional feed back would be greatly appreciated. Thank you

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Family get together with his favorite food. Talk about the good times of the past might get him to eat a little bit.

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Hello all, I'm new to the group.

My mom had a stroke the day after Thanksgiving 2022. Doc at the hospital said it was a pontine stroke which is fairly rare and involves the brainstem. It can lead to 'locked in syndrome' where a person is awake and aware but can't move at all. "Fortunately" (if one can truly call this fortune) my mom only got paralysis on the right side of her body and the left side of her face (this kind of thing is common with pontine stroke).

Mom was in the hospital for about a week following her trip to the emergency room. For the first couple days she was quite lucid, but this faded. The neurologist said that this was because the stroke was continuing its course and there was nothing to do but keep giving her blood thinners and wait.

Mom never improved after that. She was discharged to a skilled nursing facility in the hopes that she could be rehabilitated and gain some independence. Instead, she was either too tired or refused to comply most days, insisting on staying in bed. The most she recovered was the occasional ability to wiggle her right toes or maybe lift her right knee slightly–not enough to support her weight. She barely spoke, mostly just nodded or shook her head to questions, and occasionally a partial sentence. Most of the time she refused to eat and barely even drank water. She had to get a saline drip to rehydrate a couple times. I tried bringing her food from outside because she would just pick at the meals she was served, but still all she would do was nibble and then refuse more. I insisted that her appetite might be affected by depression, and the doc on staff added an antidepressant that is supposed to help with appetite, but it hasn't helped.

Due to mom's lack of progress, Medicare stopped paying for her stay at the facility, and she was discharged still bedbound and incontinent. We originally were going to appeal but we (my spouse and I) lost faith in the facility's ability to care for her, given that it was a facility for physical and occupational therapy, not for someone in her condition. We hoped that a change of scenery to somewhere comfortable would encourage her, and have hired a caregiver to help with keeping her clean, changing her, watching her, feeding her etc. so we can do the things we need to do during the day, and because my anxiety (about making a mistake and hurting her, about watching her slowly die) is so intense that I'm unable to do a lot of these tasks myself.

The unfortunate problem is that we will not be able to afford 24/7 care for long. I'm budgeting for 6 months at most, and if she doesn't improve enough to gain some autonomy (and she is still alive) we will have little choice but to put her somewhere that / in the care of someone who Medicare will cover. In my mind that means a nursing home where she'll go to die, hopefully with some dignity, or hospice care at home–and that's only if I can stand it.

My mental health is fraught and has been for decades. I was diagnosed (in order and over several years) with major depressive disorder, anxiety & ADHD. They are all managed passibly with meds most days, but not enough that I can take the pressure of employment, and certainly not for the level of stress triggered by the situation with my mom. I've not had a therapist for about a year and I've already had several anxiety attacks and a full-on crying and screaming breakdown. I'm trying to find a long term therapist (been without one for a year; my therapist of 10 years no longer takes my insurance) but it's hard to find one with availability, and it's also another big expense when we are already putting so much money into mom's care.

The only positive change I have noticed so far is that my mom is actually drinking a lot more water now. But she still won't eat more than a few bites at a time. I think she refuses food because she is nauseous, but we're not sure why because she isn't able to express it. I'm happy for the water she is drinking, but if she doesn't get more calories in her, there's no way I see her ever getting out of bed again. She will continue to be too weak to even consider physical therapy,

She *can* eat, let me be clear. She can chew and swallow; her dysphagia is minimal. She just can't or won't eat more than a few bites at a time and seems to have lost any sense of when she is hungry.

So anyway. That's the context of what's going on so far. I guess what would help me at this point is to hear from other caregivers in a similar situation or from stroke survivors who overcame their eating apathy.

When responding please keep these in mind:
– Mom has diabetes and hypertension. Her cholesterol was an issue previously, but with how little she eats nowadays, I'm not so sure.
– We have tried giving mom a variety of foods, including some that are her favorites, but no matter what we give her she only takes one or two bites. We've had the most luck with fresh fruit, especially bananas–she will eat half of one, and occasionally even the entire thing.
– We have tried Ensure and Glucerna. She loathes it and will immediately refuse to drink it. I would be open to other suggestions for liquid nutrition that are not these two or similar.
– I am aware that some folks make a conscious decision to want to die after a stroke, and therefore refuse food. I've asked mom more than once if she just wanted to give up, and she shook her head at me each time, but I can't rule out that she's just trying to appease me. Still, until I get a clear sign that she wants to stop trying to live, and/or she reaches a point where she is no longer responsive (she currently is able to ask the caregiver for water and does so plenty), I'm not going to give up on trying to get her appetite started again.

Thanks for reading and considering my and mom's story.

– Shay, the Anxious

REPLY
@anxiousshay

Hello all, I'm new to the group.

My mom had a stroke the day after Thanksgiving 2022. Doc at the hospital said it was a pontine stroke which is fairly rare and involves the brainstem. It can lead to 'locked in syndrome' where a person is awake and aware but can't move at all. "Fortunately" (if one can truly call this fortune) my mom only got paralysis on the right side of her body and the left side of her face (this kind of thing is common with pontine stroke).

Mom was in the hospital for about a week following her trip to the emergency room. For the first couple days she was quite lucid, but this faded. The neurologist said that this was because the stroke was continuing its course and there was nothing to do but keep giving her blood thinners and wait.

Mom never improved after that. She was discharged to a skilled nursing facility in the hopes that she could be rehabilitated and gain some independence. Instead, she was either too tired or refused to comply most days, insisting on staying in bed. The most she recovered was the occasional ability to wiggle her right toes or maybe lift her right knee slightly–not enough to support her weight. She barely spoke, mostly just nodded or shook her head to questions, and occasionally a partial sentence. Most of the time she refused to eat and barely even drank water. She had to get a saline drip to rehydrate a couple times. I tried bringing her food from outside because she would just pick at the meals she was served, but still all she would do was nibble and then refuse more. I insisted that her appetite might be affected by depression, and the doc on staff added an antidepressant that is supposed to help with appetite, but it hasn't helped.

Due to mom's lack of progress, Medicare stopped paying for her stay at the facility, and she was discharged still bedbound and incontinent. We originally were going to appeal but we (my spouse and I) lost faith in the facility's ability to care for her, given that it was a facility for physical and occupational therapy, not for someone in her condition. We hoped that a change of scenery to somewhere comfortable would encourage her, and have hired a caregiver to help with keeping her clean, changing her, watching her, feeding her etc. so we can do the things we need to do during the day, and because my anxiety (about making a mistake and hurting her, about watching her slowly die) is so intense that I'm unable to do a lot of these tasks myself.

The unfortunate problem is that we will not be able to afford 24/7 care for long. I'm budgeting for 6 months at most, and if she doesn't improve enough to gain some autonomy (and she is still alive) we will have little choice but to put her somewhere that / in the care of someone who Medicare will cover. In my mind that means a nursing home where she'll go to die, hopefully with some dignity, or hospice care at home–and that's only if I can stand it.

My mental health is fraught and has been for decades. I was diagnosed (in order and over several years) with major depressive disorder, anxiety & ADHD. They are all managed passibly with meds most days, but not enough that I can take the pressure of employment, and certainly not for the level of stress triggered by the situation with my mom. I've not had a therapist for about a year and I've already had several anxiety attacks and a full-on crying and screaming breakdown. I'm trying to find a long term therapist (been without one for a year; my therapist of 10 years no longer takes my insurance) but it's hard to find one with availability, and it's also another big expense when we are already putting so much money into mom's care.

The only positive change I have noticed so far is that my mom is actually drinking a lot more water now. But she still won't eat more than a few bites at a time. I think she refuses food because she is nauseous, but we're not sure why because she isn't able to express it. I'm happy for the water she is drinking, but if she doesn't get more calories in her, there's no way I see her ever getting out of bed again. She will continue to be too weak to even consider physical therapy,

She *can* eat, let me be clear. She can chew and swallow; her dysphagia is minimal. She just can't or won't eat more than a few bites at a time and seems to have lost any sense of when she is hungry.

So anyway. That's the context of what's going on so far. I guess what would help me at this point is to hear from other caregivers in a similar situation or from stroke survivors who overcame their eating apathy.

When responding please keep these in mind:
– Mom has diabetes and hypertension. Her cholesterol was an issue previously, but with how little she eats nowadays, I'm not so sure.
– We have tried giving mom a variety of foods, including some that are her favorites, but no matter what we give her she only takes one or two bites. We've had the most luck with fresh fruit, especially bananas–she will eat half of one, and occasionally even the entire thing.
– We have tried Ensure and Glucerna. She loathes it and will immediately refuse to drink it. I would be open to other suggestions for liquid nutrition that are not these two or similar.
– I am aware that some folks make a conscious decision to want to die after a stroke, and therefore refuse food. I've asked mom more than once if she just wanted to give up, and she shook her head at me each time, but I can't rule out that she's just trying to appease me. Still, until I get a clear sign that she wants to stop trying to live, and/or she reaches a point where she is no longer responsive (she currently is able to ask the caregiver for water and does so plenty), I'm not going to give up on trying to get her appetite started again.

Thanks for reading and considering my and mom's story.

– Shay, the Anxious

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Hello @anxiousshay and welcome to Mayo Clinic Connect. This has, no doubt, been a life-altering situation for your mother but also you and your husband. It feels like you are doing all you can to ensure your mother is being well-cared for. She is very lucky to have you!

You will notice I have moved your post into a previous discussion which you can find here:
– After her Stroke my mom does not want to eat pushes her food way.: https://connect.mayoclinic.org/discussion/after-her-stroke-my-mom-does-not-want-to-eat-pushes-her-food-way/

I did this so you may read through that discussion as well as connect with other members such as @davej who has recently joined the discussion to offer some thoughts.

It seems like focusing on her nutrition has been important, as it would be if I were in your shoes as well. Perhaps with her limited movement, her typical appetite is significantly declined in addition to the post-stroke reasons. Is she involved in any physical therapy that would both increase her strength but also, potentially, her appetite?

Focusing on healthy foods high in good fat seems like a good start. Does she like any of the following, in addition to the fruit you said she will eat: eggs, greek yogurt (I would add fresh fruit), whole milk, whole grain toast with peanut butter, coffee (with heavy whipping cream for a creamer to increase calories and healthy fat)?

Also, there are so many liquid nutrition options now. I personally like Fairlife protein shakes as they have 30 grams of protein, only 2 grams of sugar and come in chocolate, caramel, vanilla, and strawberry, I like to add them, minus the strawberry, to my coffee as well. Here is a link to learn more: https://fairlife.com/nutrition-plan/

Is there any potential medications she is on that may be also contributing to her lack of appetite?

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