As instructed at the first appt I added more sauces and gravies to Hubby's diet. Changed his milk to whole and pushed the high fat high protein and offered a nightly ice cream treat. you can only imagine my emotional pain as I declined from partaking in the delights!
For the first 2 weeks Hubby ate well. He even had a 2 week weigh in at the time that revealed a 10 pound INCREASE! Seriously! I couldn't believe it. I honestly thought the scale was broken. Dietician recorded the date and weight and said she would see us at the 3 week appointment time.
But the foods began to have a negative impact on Hubby, as in more constipation than he experiences anyway. He began to refuse the food or limited what he would eat by half or more. I continued with sauces and gravies and the whole milk anyway but as the saying goes, You can lead a horse to water...
Appointment finally came and another weigh in was had. This time a LOSS of 5 pounds was recorded.
During the appointment Dietician didn't take into account the previous weight gain and the now weight loss. She looked at it all as a gain of 5 pounds and asked if I wanted to continue with the request for liquid supplements.
Uh, yes.
Then I told her what I had witnessed and handed her the 3 week food diary while I mentioned the weight loss within the last week as well as the extreme constipation and the issues that causes. Abdominal pain and more confusion.
Then I handed her my written plea for the supplements.
Request for Liquid
Nutritional Supplements
A request for liquid nutritional
supplements for Mr (Hubby) has been made by me, Kathy, his
wife/caregiver, due to his continual decrease in weight since Dec of
2011.
On July, 2012 he had an average loss
of 1 pound per week even though his appetite had remained good, and
proper and adequate nutrition was consumed.
Blood test on July 10, 2012 verify that
Mr (Hubby's) cholesterol, blood glucose and other levels were within
normal limits.
An appointment with the VA dietician
was made and kept 2 weeks later on August, 2012. Weight loss of 4
lbs was recorded at that time. A loss of 4 pounds in a 2 week period.
Suggestions for increasing his fat and protein were made and handouts
for educational purposes were distributed to me.
I informed the dietician that Mr (Hubby) suffered with constipation problems. He takes a stool softener daily
and dosage of Polyethylene Glycol every other day or daily as needed.
I also informed the dietician that Mr (Hubby) had limited to no daily activity so an addition of more
proteins and fat might prove to be a problem with more constipation
but we would take and use the suggestions as part of the process to
receive the approval of supplements.
A 3 week diary was maintained for
monitoring consumption.
I feel it is in the best interest of
(Hubby) to receive the nutritional supplements not only due to the loss
of weight which I know can not be restored but as his dementia
increases, the amount of food he consumes decreases. Trying to
encourage Mr (Hubby) to take solid foods that will increase his
constipation suffering will do nothing more than agitate him.
End stages of dementia usually result
in the patient being bed bound. Solid food consumption is decreased
by the patient and it is my understanding should not be heavily
encouraged as the body goes through the shutting down process, yet
hydration still needs to be encouraged for the comfort of the
patient. Liquid supplements will provide some fulfillment of hunger
and aid in hydration.
Maintaining My (Hubby)'s comfort and his
calm is the goal.
Respectfully submitted
Kathy
Dietician said it sounded good and she would have to submit it for approval and that she herself was recommending the supplements.
Yet with all of this the request was denied by the pharmacist. I don't know how the pharmacist has more pull over the dietician but apparently that's how they run things at the V.A.
Got to love the government. At least they are saving some money and boosting the economy since I will now purchase the supplements on my own :)
Yet with all of this the request was denied by the pharmacist. I don't know how the pharmacist has more pull over the dietician but apparently that's how they run things at the V.A.
Got to love the government. At least they are saving some money and boosting the economy since I will now purchase the supplements on my own :)