I need some help. I'm wondering if this is how David felt staring up at Goliath. Five smooth stones would come in real handy about now, but I'm unarmed. That is why I am asking for your assistance. Here's my situation:
My mother is nearing her 85th birthday. For the past 11 years she has lived in various care facilities. When her dementia became pronounced, I became her legal guardian.
Last summer a stranger loaned me a copy of The China Study. I have not eaten beef since. By the time I finished the book, I was a vegetarian. Now I consider myself a casual vegan. I feel great. At age 51 this diet gives me optimism for continued health for years to come.
Meanwhile I was visiting Mom in the nursing home daily and watching her decline. While healing from a broken arm this last year she lost the ability to walk; she is now strapped into a wheelchair. Her ability to communicate has also declined. I have seen many times when she was unable to communicate personal needs. There were times that I left the home blinking back tears.
Thinking we had nothing to lose, I decided to put Mom on a vegan diet--no easy accomplishment in a nursing home. It took about three months to gain the cooperation of the facility in implementing the new diet. Originally I was told that because the nursing home receives federal funding they were required to abide by the federally approved food pyramid. I was also advosed that no changes could be made to Mom's diet without doctor's orders. I tried for time to locate a doctor who shared my interest in nutrition, but was unable to find one. In frustration I finally asked the dietician how I would be treated if, as a vegan, I someday needed care in their facitly. She assured me that personal dietary preferences would be honored. That was the turning point. I exercised my authority as Mom's legal guardian and informed the staff that my mother was a vegan and in her behalf I requested that they honor her dietary preferences.
Mom's new diet began sometime in December. Now the dietary staff serves Mom whater vegetarian foods are on the menu each day and I bring homemade, salt-free whole food plant-based dishes from home to supplement what is served by the facility. I have concerns because the nurses are giving Mom protien and calcium supplements which I suspect are harmful, but I do not yet feel knowledgeable enough confront that issue.
Something interesting has been happening over the three months the new diet has been in effect. Mom's ability to carry on a conversation has increased dramatically. She now expresses her needs to myself and to others. Family members have noticed a difference in speaking with her on the phone. In person she appears more alert. The swelling in her legs has decrerased. Now I leave the home full of joy, optimism, and gratitude.
Today things changed. I participated telephonically in Mom's quarterly care conference. The reports sounded good to me. I was told that Mom's blood work had recently been done and everything was in the normal range. Her weight, too, was right where it belonged. The doctor, however, was concerned because she had lost ten pounds and was eating a smaller percentage of her meals. He ordered that she be returned to a 'normal' diet. This was very upsetting to me. My initial thought was that I cannot fight the doctor, the nursing home, and the FDA all by myself. I told them to go ahead and make the changes thinking that Mom would begin to decline and then I would have proof that the vegan diet was better for her.
After talking to family members and friends I rethought that response. How can I put my mother at risk when I am not convinced the change is in her best interest? Is it responsible to jeopardize her welfare now to prove a point that may benefit her in the future?
This evening I wrote a letter to the home withdrawing my consent to the dietary changes. In my letter I stated that I needed more information before making any decision and requested an opportunity to meet with the doctor. Although I feel better about this decision, I am far from comfortable. As an attorney I know how to make an argument, but I know too little about nutrition to construct a proper argument. I have no credentials in the field of health, nutrition, or geriatrics. I feel greatly outmatched.
I could use all the help I can get right now. What I would like best is an expert to consult, but I don't even know where to look.
Any ideas, informtion, or resources would be appreciated.
Another interesting day at the nursing home--scary, but intersting. Early this morning the dietician mentioned that a no-salt/no-dairy diet would be nearly impossible to implement. I had realized no-dairy might pose difficulties because our culture is so accustomed to cooking with dairy products, but I was shocked to hear that a no-salt diet posed a problem in a nursing home, a facility designed to care for elderly and ailing people, many of whom have heart conditions that call for no-sodium or reduced-sodium diets
This evening I learned something even scarier: The palliative care philosophy of the home extends to dietary considerations! I was fully in agreement with the concept of palliative care--care which promotes comfort but offers no medical interventions designed to prolong life--until I discovered that healthy eating, which prolongs life, is not favored. A nurse explained this to me. Dietary considerations are governed, not by nutrition, but by what the residents like to eat. That explains the bacon! Deserts are made with Splenda so that diebetic residents can enjoy sweets with every meal.
There's one problem with palliative nutrition: It doesn't work. If the forget-about-healthy-foods-and-just-eat-whatever-makes-you-happy approach worked, the nursing home residents where my mom lives should be the happiest people on earth. They're not. Many of the residents complain daily of aches, pains, and illness; others stoically avoid complaining by saying 'I'm doing a little better today.' The residents suffer from lack of mobility, amputations, mental disorders, failing eyesight and hearing, declining communication skills, confusion, and boredom. When these elderly people decline to the point that they can no longer feed themselves, their 'happy meals' are put through a blender and spoon-fed by an attendant.
I also learned that the diet served by the nursing home is not really prepared by the kitchen staff. The meals are bought as a package from a distributor. Meal content is governed by the FDA.
Right now I'm wishing for some palliative care FOR ME because I'm getting real uncomfortable. . . .
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I see three possibilities:
a) she doesn’t like the food as much, so she’s eating less. Can you supplement it with snacks you know she likes? Some older people use meal replacements (Ensure); I don’t know if any are vegan.
b) in the smaller portions older people eat, the food doesn’t have enough calories to keep her weight up. Can you ask the facility to enrich it (more margarine for the bread, desserts)? Can you supply cheese substitutes, nut butter (if she can digest it), etc? The doctor is right, it’s important for her to get enough calories.
c) At the age of 85, losing weight could be a sign of her declining, and it has nothing to do with the diet. Try to figure out where she is about this anyway.
takingcareofmomma - the weight loss could at least partly be explained by the fluid loss from her legs. Does she look worse than she did 3 months ago? Does her face look too thin? Is she more lethargic?
It looks like you have stumbled upon an effective treatment for Alzheimer's disease, something that has not previously been reported. Do not stop the vegan diet. Do not use margarine, since it contains trans fats and is possibly even more unhealthy than butter. Also, I believe that Ensure is made from cow milk, which is about as safe as tobacco.
Write Dr. John McDougall at www.drmcdougall.com for advice on how to deal with your mom's doctor. One would think that your doctor would like to study her improvement with a vegan diet and to see how much she could ultimately improve. It could be argued that he is economically threatened by the possibility of Alzheimers disease being controlled without doctors, and that he is trying to remove this threat. This reprehensible type of coverup is already being done with multiple sclerosis, which will also respond to a low-fat vegan diet.
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