Physicians and dietitians that work with the elderly know that monitoring weights are important for identifying changes in their condition that require action. As part of the aging process, changes occur in their habits, body, and behaviors that put them at risk for weight loss. For many elderly individuals, weight loss is the first clue that other medical, physical, or cognitive changes are taking place.
What are some causes for weight loss in the elderly?
Significant weight loss is more prevalent in the elderly due to the following factors:
- Cognitive changes that affect their ability to eat or desire for food
- Physical changes that affect the ability to feed themselves
- Medications that affect the appetite or cause a metallic taste in the mouth
- Underlying medical conditions that cause the body to burn food more quickly for energy
What are the warning signs for a person at high risk for weight loss?
The following should be observed when caring for elderly individuals:
- Needs help eating and drinking
- Eats less than half of the meals or snacks served
- Has mouth pain, poorly fitting dentures, no teeth and/or doesn’t wear or have dentures
- Coughs or chokes when eating
- More withdrawn from others, more depressed
- Is confused, wanders, and/or paces
- Has diabetes, COPD, cancer, Alzheimer’s Dementia, or other chronic diseases
How is weight loss treated in the elderly?
In addressing weight loss in the elderly, it is important to individualize their plan based on risk factors. For example, if your loved one is having difficulty chewing or swallowing he or she may need a texture-modified diet or assistance with feeding to help with swallowing problems. Changing the dining environment may be enough to stimulate appetite. Some may prefer a quiet environment with no or few distractions. Others may thrive in a more social, group environment where they can converse with others. Incorporating nutritional supplementation such as fortified foods, high-calorie puddings and shakes are recommended. Consulting with a physician to incorporate an antidepressant that will act as an appetite stimulant may be beneficial.
Individuals with normal intakes may suffer from unintentional weight loss, perhaps related to an underlying medical condition that is not yet diagnosed. Check with your loved ones physician for a comprehensive assessment to determine the cause.
What about someone that is obese? Is weigh loss acceptable for that person?
For individuals that have been obese all of their lives, sudden or unexpected weight loss may signal an underlying condition. A planned weight loss may be desired via dietary modifications, however an unexpected weight loss (although beneficial) may cause for some concern.
What is an appetite stimulant?
An appetite stimulant is a physician prescribed medication that results in an increased appetite, thus increase in meal consumption. Megace® and Periactin® are appetite stimulants ordered to help with weight loss. Some individuals with depression may benefit from Remeron®, which is an antidepressant that has dual effects. In a low dose, Remeron® will manage depression and stimulate appetite. Appetite stimulants will not improve the appetite unless taken as they are prescribed by the physician.
What happens if a person continues to lose weight, despite multiple attempts to deter weight loss?
When individuals refuse food or clinch their mouth shut, caregivers should never force them to eat. For some, refusing foods and fluids is a natural part of the end-of-life process, which caregivers must respect and accept. When older adults are unable to maintain their weight after attempts to deter weight loss, their loved ones may need to consider alternative means of feeding, such as a tube feeding. This is a very personal decision that the patient, family, and medical team must work together in order to meet the needs of the patient in the best possible way. Being familiar with your loved ones wishes and living will may guide your decision.