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For most of us with aging parents, the situation comes with a lengthy list of potential catastrophes to worry about, including terminal illness, dementia, a vital bone crushed to rubble in a fall.
And while those are all valid concerns when it comes to caring for an older relative, there is one deceptively simple but stealthy little problem that we often overlook, even though it has the potential to become deadly.
As we age, we naturally tend to eat less, in part to make up for a lack of physical activity accompanied by the slower metabolic rate that comes along with aging.
But eating less as we age can lead to something much more serious, and it is so common that professionals call it the anorexia of aging.
According to a 1994 study that appeared in the Journal of General Internal Medicine, nursing home patients who lost 10 percent of their body weight during their stay were more likely to die within six months of that weight loss, no matter what other health issues they faced.
A year later, the Journal of the American Geriatric Society found similar elevated mortality rates associated with older veterans who involuntarily lost weight after the age of retirement.
“There is a fair amount of evidence that suggests if you lose appetite as an older person, in the next six months, you will have a higher chance of dying,” said Dr. John Morley, geriatrics director at Saint Louis University Hospital, and a professor of medicine.
While there are a variety of factors associated with eating less with age, depression is the leading cause of a sluggish appetite, experts say.
Issues could be chemical, but in most cases, depression in the elderly occurs because of loss of independence, loss of a spouse, loss of the family home or being forced to live in an assisted living facility because of dangers that exist at home.
And while we can understand that depression can lead to a loss of appetite – as can some of the antidepressants used to treat the symptoms, including Zoloft and Paxil, according to pharmacist Kristin Binaso, a spokesperson for the American Pharmacists Association (Ref. 2) - drastic weight loss is not a normal part of aging.
“They’re not supposed to wither before they die,” said Dr. Margaret-Mary Wilson, an expert on geriatric medicine at Saint Louis University. (Ref. 2)
But it can be difficult to try to entice older adults to eat more.
Taste buds change, so favorite foods may no longer taste the same, and things like dental problems can make eating difficult.
Not only that, having lived long, independent lives, seniors can tend toward being a bit stubborn, and might either willfully refuse to eat or pretend to eat to appease worried loved ones, only to surreptitiously spit their dinners back into their napkin after a few perfunctory chews.
Low energy levels that make cooking meals a challenge combined with financial concerns that make buying food equally problematic can also create a mealtime war zone, not only for older adults, but also their caregivers.
Each roadblock to a healthy meal, however, only exacerbates the potential for malnutrition that is already a risk to older adults, since their stomachs not only empty slower as bodily functions slow down, but they also lose some of the senses that made food so enticing, including taste, smell and sight.
Add to the mix illnesses, medications and hormonal changes that can dull a person’s appetite or even kill it altogether and you’re looking at an even bigger challenge when it comes to helping your loved ones feel their best, no matter their age.
If someone you love is not eating enough food, the problem goes far beyond just watching them getting thinner.
In the same way kids who do not get enough food have trouble concentrating and learning at school, older adults who are not eating enough are also putting their health at risk.
According to the Mayo Clinic, malnutrition can lead to:
In addition, malnutrition can lead to further disinterest in eating or lack of appetite — which only makes the problem worse.
So what is a loving son or daughter to do when mom or dad won’t eat?
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