Why won't Mom eat when she is by herself?

I think JGibbs had the answer, she doesn't eat because she just isn't hungry. She eats when you are there because you take her, and because she wants to please. Also, she may feel that she should eat, may even realize it is mealtime, but lacks the ability to follow through (lack of initiation).

Cheryl, I was impressed. I might try to find a place similar to it. I would visit a few around meal time and see what they have to offer. Ask other resident's family members what they think.

I was in the Assisted Living facility often visiting my cousin. I got to know a lot of the staff and residents. They really supported each other. When I would enter, residents would approach me and tell me that my cousin had a rough day or that she had been asking about me. They were a tight bunch. Prior to going there, my cousin lived alone and was very isolated. She wouldn't even come to holiday family gatherings anymore. So, this social atmosphere really helped her.

Later, my cousin's dementia progressed and she had to be moved to a Secure Memory Care facility, but they also have a great social schedule, even for those with severe dementia, including meals in the dining room, bingo, stretching, music, movies, church services, etc.

Wow, that sounds great! That's how it was at the SNF. Then they had a separate area for assisted living, but then the people are in their own little rooms, and I don't know if they got the same encouragement to join activities or requirement to eat in the common area. And we thought that at this ILF they would have some kind of transition with other residents helping, but it wasn't like that. They just called it a welcoming committee or something. And I don't think that was ever even done. But what you describe sounds like exactly what she needs.

Since she seemed to enjoy the social interaction aspect previously, I would focus on that. It would seem to me that living alone at home, even with an aid coming in on weekdays, would be the opposite of what she enjoys.

The assisted living facilities that I observed have activities throughout the day. They come to the rooms and encourage the residents to come to the rec room for dodge ball, (It's a game they play sitting in a chair or wheelchair.) bingo, stretching, music games, concerts, movies, etc.

They also require that all residents eat in the dining room for at LEAST two meals per day. They come to room with a big smile announcing meal time and helping those with walkers and canes.

They pair the resident with 3 other residents that are on their level so you have an assigned table and seat in the dining room. You are expected to be there and join your table for dining and conversation. Coffee and tea are then served and sometimes there is musical entertainment. Afterwards the residents make their way to the sitting rooms and play cards, sit on the patio, or read in the gazebo. If there is a shy resident, the social director seeks her out, includes her a lot and gets her comfortable with the schedule and people. She might ask her to help hand out papers.

I would try to find a place like that. I would also proceed with the evaluation like Babalou described. Physical therapist are well meaning, but they are not trained to make evaluations about mental status. I had some totally miss my loved ones dementia, even when it should have been obvious. She also had eating issues and lost a lot of weight. Now she eats in the Assisted Living dining room and has a great appetite.

Thanks for your responses! The stroke seems to have caused a bit more short-term memory issues, but other than that, she's pretty good. We got very lucky. She hasn't seen a neurologist yet, but all the therapists at the SNF were very impressed with her abilities. She's healthy, on no medication, can do all of her ADLs.

The physical therapist nailed her on the first visit: "She's a people pleaser." She is so self-absorbed, but in a negative way: She doesn't feel good enough, worries about what other people think of her. It is to such a level that she is socially crippled. She won't try anything new, won't go anywhere by herself because if she doesn't do something perfectly the first time, she labels herself stupid. (I know all these things because I have these same traits and tendencies, but not nearly as bad as she does!) That's why we were amazed at how social she was in the SNF. I know we probably should have given the new place a bit longer to adjust, but we were afraid she would lose the gains she had made AFA gaining weight, and keeping her balance good. So we thought a one-on-one situation with a companion would suit her personality better.

Jeannie, I think you are right, we were actually enabling her by trying to make her happy. It just made her more nitpicky about the tiniest little thing that she didn't like. My sister and I finally did step back a bit from catering to her every whim because we couldn't take the constant complaining. Guess what? She stopped complaining!

Yes, Eyerish, I agree she does need social interaction, but she won't voluntarily seek it out. We've been holding her hand through all of this, but I think that's where the resentment is starting to set in, because she is SO needy, she won't do anything without one of us there. At the SNF, we kind of broke the ice, and then she started doing things on her own. At this ILF, it is a lot more independent. There's no set dining time where everyone eats together, so it's harder to form friendships. Most of the people there are more "with it" than mommy, so if they throw too much information at her too fast, she can't process it. (When she was constantly being stimulated and busy at the SNF, I noticed improvement in that area, too).

I think she does indeed have anxiety/depression. (Again, like mother, like daughter, lol!) My sister and I are resistant to medication for that, because it can bring a whole new set of problems with the side effects. Our best possible solution was to have the companion be with her and keep her busy and stimulated by playing games with her, taking her to bingo at the senior center, etc. It seems like at the SNF, she was always so busy doing some kind of therapy or activity she didn't have time to worry about anything, and she seemed so much more alert.

So I just was wondering why she won't eat when she's by herself, but she will with us. I know she's not doing it to purposely annoy us. Maybe it is the anxiety/depression?

I agree with the others that your mom isn't trying to get attention. It sounds like she needs social interaction. Not just to stimulate her appetite but also for her emotional well being. Left to her own devices she may not be eating because fixing something and eating it alone is drudgery. I think the key here is a social issue.

You can't be with her every minute of the day and you shouldn't try to be. You said your mom came out of her shell when she was in SNF. Is placing her in a SNF an option at this point? If it's not, how about hiring a private caregiver who's outgoing and pleasant and would make a good companion for your mom? Perhaps you could request a caregiver who's a little more mature as opposed to a 21-year old college student. A caregiver who might have more in common with your mom than a younger gal would.

By putting your dilemma out there I think you're going to get some good ideas. I hope you can implement some of them and see some results in your mom.

It sounds as though mom has not been in her IL for very long. There is generally an adjustment period for elders in a new environment of 4-6 weeks. I think I would wait that out, especially there may be a huge financial loss if she doesn't give 30 days notice. Read the paperwork to find out about that.

Has your mom been evaluated in terms of her cognitive skills? Many folks have subtle damage to their thinking processes after even a small stroke. Judgement, motivation, Language skills, sequencing may all be affected. A neuropsych evaluation will tell you more about this. It's several hours of paper and pencil testing.

As Jeanne says, she's not doing this to annoy you, but I understand that it IS annoying. Think about getting her thorough workup of her impairments, including anxiety and depression, which often go along with cognitive decline.

It sounds as though independent living is no longer a good option for your mother, either in her own home or in an independent living community.

What are her impairments? How is her memory? Who cleans her house? Does the laundry? Does her judgement seem impaired?

It really sounds like Mom needs an environment where she can be a social butterfly and that does not require much initiative from her. Someone to come by and remind her it is mealtime or that bingo will begin in 10 minutes. Perhaps a group home, or assisted living, or even a nursing home (if she has needs at that level) would do it.

I don't know why she isn't eating alone, but I'm reasonably certain it isn't to make you mad, or to get attention. In my husband's case, he would simply forget to eat. I'd make a sandwich, put some grapes on the plate, show it to him, and tell him to get it out of the fridge about noon or whenever he was hungry. Sometimes I'd even call and remind him. He'd say, "OK, as soon as this nature show is over I'll get it." But he never did! Why not? "I forgot."

Actually I don't think he was hungry the entire time he had dementia. He ate when it was time to eat, when someone was there to eat with him, and because he remembered that eating was fun. But he never asked for food or said he was hungry.

Your mother hasn't been diagnosed with dementia (although dementia is not uncommon after a stroke). But something is clearly wrong with her. Depression? Anxiety? Did she have any counselling after poppy died? Has she ever seen a therapist for her severe loneliness, and intense worry?

Mom is not well. Keep that firmly in mind in discussing her with your sister and in dealing with her. She is NOT being a naughty girl. If she IS seeking attention (which I doubt) it is because she has a great need for it now.

If you get further evaluation for your poor mom, maybe you could understand her behavior better. For now, I suggest accepting that she is not well and proceeding accordingly, without anger.

Please note, I am NOT suggesting that you eat every meal with and cater to her every whim or continue to devote 24/7 to thinking about her. That isn't healthy. But try to do the best you can to come up with other solutions without anger.