Loss of appetite - heart failure

[wheezyjackson]

Hi all. I'm looking for some support and advice for my mother in law... she is 84, diagnosed with heart failure following a hospital admission around 8 weeks ago, and has suffered from a variety of cardiovascular issues over the last 10 years - mini stroke, borderline diabetes, high cholesterol and BP. She is now taking 7 different meds - Lercanidipine; Omeprazole; Ramipril; Rivaroxaban; Rosuvastatin; Bisprolol; Frusemide.

Since being discharged from hospital she is very weak - can just about walk from one room to another, but is very breathless unless sitting. Occasional nausea and retching. No oedema.

She did have carers in to help her get up, shower and put her to bed, but they came at 7am, and 7pm - and she really isn't an early morning person at the best of times. So has cancelled them.

My main concern is that she has no taste for food - very dry mouth and therefore isn't eating - she has lost a lot of weight. When she does eat it's likely to be a chocolate biscuit and a coffee, or something salty. The GP has given her some meal supplements and she has one a day, but 'thriving' is not a word I would use for her. It's very sad.

Cardiac nurse who visits says she is "pleased with her"... but she is essentially bound to a chair or bed all day and hasn't left the house for 8 weeks. and she was unable to attend the cardiology follow up appointment as she is physically unable to leave the house at the moment.

Her GP is in touch with her, has reduced Frusemide dose, but hasn't got a handle on the appetite issue yet doesn't seem a priority.

any advice or leverage we can use with her GP? and is it more important that she eats something rather than something low sugar / salt?

We live 200 miles away and are feeling guilty and unable to help in a practical way.

[laura_dropstitch Heart Star]

Sorry to hear all this, it must be very difficult for you all. Overall, I would definitely be asking the doctors about all of this as it sounds like it needs to be resolved. I would have thought it's most important to eat and drink at least something, even if that is a coffee and a biscuit at the moment, but maybe try and introduce some other more healthy foods as you go? If the problem is that her mouth is dry, could you try freezing fruit smoothies into ice lollies maybe? Loss of appetite can also be a sign that there is some fluid retention in the abdomen (not always as obvious as in the feet/ankles) but I think this is more common in younger patients? Might be worth asking about it though. Sounds like you are doing a very good job of caring for her, but getting a bit of medical advice/help with this aspect should make your job a bit easier. Good luck x

[wheezyjackson in reply to laura_dropstitch]

Hi Laura. thanks for your reply. That's a good idea about fruit smoothies / lollies... will suggest she gets some in. We're trying to get help for her, but she is of a generation where 'she doesn't want to be a bother'.

thanks again X

[stevejb1810]

At the age of 84 it really doesn’t matter what she eats, she just needs to eat. I have similar issues with my mother - also 84. She has stage 3 heart failure, very low energy levels and gets out of breath very easily, blood pressure that is all over the shop and stage 3 kidney failure to add to the mix (no diabetes though ). What we try and impress on her is to eat high calorie foods - as with many older people, she doesn’t want to eat a lot, so the trick has to be to get the highest nutritional value in with small volumes. As for the make up of those calories, I really wouldn’t worry

[wheezyjackson in reply to stevejb1810]

Thanks Steve. Sorry to hear you are having similar problems, and also for the advice re. the importance of calories. I am pretty sure that much of her frailness is down to not eating anything. I am a bit in the dark about the stages of heart failure, and haven't had sight of any actual medical notes other than her meds, so not sure what the future holds and if she is likely to regain some or any of her independence or mobility. She tries to eat but once she is presented with a (small) plate of food it makes her feel nauseous so she just doesn't bother. It's so sad that all we seem to talk about is what she is eating / not eating and the focus is no longer on actually making her comfortable.