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98-year-old needs to gain weight, doesn't eat enough: Food suggestions

Hey, my grandother has emphysema and the docs said she burns approximately 3000 calories a day just trying to breath. This is astonishing since she doesn't seem that bad and doesn't need oxygen really other than when she sleeps. Her nurse said to eat as much as she can and menioned ice cream, which is now, because that's what she heard, all she eats. She is a little sensitive about hard or chewy foods and has basically been eating yogurt, soft fruits and veggies, mashed potatoes and ice cream. she also is supposed to drink five Ensure drinks a day. She maybe drinks two.

Any suggestions on some foods that are high in calories, but low in difficulty to eat. Much appreciated.

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  1. My grandmother also needed to gain weight...we just make sure there is always an ample supply of cakes, cookies, and other soft baked confections sitting on the kitchen table so whenever she strolls through she goes to town.

    Now she needs to lose weight..lol!

    9 Replies
    1. re: FoodExpression

      She does like her sweets, but the cookies have to be the soft variety. I wish I had the problem where I was told to eat more food!

      1. re: jhopp217

        jhopp, I do not indulge myself, but your mother does sound like the reason I voted to legalize medical marijuana. She may be very uncomfortable with the concept, but you can get it in pills, which may be easier for her to, forgive me, swallow, than the idea of smoking a joint. Good luck, and I hope my kids take as good care of me as you do of your mom. She must be a great lady.

        1. re: dvsndvs

          I know little about drugs legal or illegal, but if she does opt for medical marijuana, it would necessarily have to be the pill form, no?, since with the emphysema, smoking would be out.

          When my aged father was ill, he found the pudding form of Ensure far more palatable than the liquid. Something to try.

          1. re: pinehurst

            From what I've heard it's fat soluble so it can easily be incorporated into butter and/or cooked with (i.e. brownies, cookies, high fat foods). Issues would occur with dosing (where to draw the line between functional grandma and stoned grandma).

            1. re: HunterJay

              Yes, any dish that has butter or oil in it can be made with marijuana. Pesto, stir fries, mashed root vegetables, salad dressing, all kinds of desserts, you name it. If it were my grandma I wouldn't mind if she got a little high in her quest for an appetite (to my mind, that beats the side effects of the steroids recommended downthread).

              Oh, another idea - if you make a point of overcooking pasta it'll be mushy enough to eat but still delicious!

            2. re: pinehurst

              During a hospital stay, I was told that the Ensure pudding doesn't contain nearly as many nutrients as the liquid, which is a shame, because the pudding, as you suggest, is far more palatable.

              1. re: woodleyparkhound

                I used Ensure to make my father fruit smoothies. Instead of ice, which would have watered them down, I used frozen sliced bananas. For the purported health benefits, I also used some pommegranet juice. He loved the smoothies! Even when hospitalized I had to bring them to him. The nurses would keep the extra in their own freezer for him.

                On medical marijuana, many legal distributors also sell baked goods such as brownies. Just make sure that they are CLEARLY labelled so no one else eats any by mistake. I kept my Dad's, labelled in big CAPS, in a separate freezer in the garage so the kids wouldn't see them and try to sneak any.

        2. re: FoodExpression

          whatever she wants...God bless her...smoothies...mac and cheese..ask her what she craves..

        3. Maybe some real milk shakes with protein supplement--have you ever tasted Ensure? Blech.
          Easting that much when you have emphysema is difficult--I have a 60 year old friend with same problem and he is skin and bones.

          3 Replies
          1. re: escondido123

            I have tasted Ensure and doesn't know how she does it. I think she found a flavor she likes, but still.

            I was going to suggest to my father he get some kind additive and make milkshakes. She just has no energy to finish anyything though

            1. re: jhopp217

              My father has found that putting the ensure in the freezer for a few minutes makes it much more palatable.

              I also recommend protein powder to mix into shakes. Having many small nutrient dense meals is best - a too full tummy presses up on the already taxed lungs. If she likes peanut butter it is a great item to mix into shakes.

              1. re: llinza

                You can buy a good whey protein powder at WF that can be blended in a blender with fresh or frozen fruit. Add a little milk too and perhaps some flavored syrup. I put ice in mine, but you might not want to do that for grandma. With frozen fruit, the shake will be moderately thick but can be sipped through a straw. Mr. Sueatmo was advised to drink Ensure at one point in his life, and he hated it. He began eating flavored yogurt, and he continues to enjoy eating one a day.

                If she will eat it, baked fish is easy to eat and to digest.

          2. One can of Ensure is a complete meal- vitamins, protein. The Health Professionals should have recommended it.

            Vanilla flavor is pretty generic and can be doctored up. Chill a can and blend with ice cream, syrups, etc. to make a fancy milk shake.

            2 Replies
            1. re: Cathy

              They did: five cans a day but she won't drink more than two, so I think doctoring them is a good idea.

              If she's eating mashed potatoes, load them up with as much butter and/or cream as you can. Make sure she's eating full-fat yogurt -- preferably Greek yogurt, which is more concentrated nutrition. Pretty much do the exact opposite of all the "tricks" to cut calories.

              But really, what does she like to eat? Does she like any foods with strong odors that will stimulate her appetite? And if it's legal in your state (ahem), then perhaps some way to incorporate some medical marijuana to stimulate her appetite?

              1. re: Ruth Lafler

                Thats the funny thing. She will eat anything and everyhting, but has no appetite and gets exhausted eating. I had made a point to my father to get her full fat yogurt and when he went shopping the other day he stocked up....on low fat. He's 76....hard to teach an old dog new tricks.

            2. Well, after noticing that a pint of heavy whipping cream has something like 1600 calories (50 per tablespoon), could you get her eating whipped cream on foods she currently likes? Fruit, pound cake, etc?

              1 Reply
              1. re: DCLindsey

                Good call.....I think he has some too. I'll put some in with her ice cream...probably not a pint though, haa

              2. Ice cream sounds good. If you make it at home, you can pack it full of cream and egg yolks, I've seen a recipe for 12 egg yolks! If she doesn't like it cold, egg custards.

                Mashed potatoes, too, you can pack more calories in if you make it in the softer puree style, and basically it's kind of an emulsion of butter and cream.

                My mom likes to drink Boost, maybe some variety might help her drink more.

                1. Nut butters...peanut, almond, cashew, etc. all offer great nutrients with high calories....AVOCADO also, high fat and nutritious but DO take care...too much of some of these foods are constipating...the ice cream sure is and if she eats cheese, that's constipating too. She does need greens and fiber too. I was going to suggest natural nut butter ON apple slices with their peel included but if hard, crunchy is a problem, that may not work.

                  1 Reply
                  1. re: Val

                    We got her Avocados today because she loves them. Ate two bites and promised us she'd finish it tomorrow.

                  2. My grandmother loved icecream, but hated Ensure, so we made shakes that hid the Ensure with icecream.

                    1. You should go to a health food store or vitamin shop and discuss with them. They often have weight gain powders that can be made into a supplement drink.

                        1. jhopp - my mother is almost 92, and while she's quite lucid and mentally 100% there, she's had a couple of medical and dental issues recently that have led to a number of dietary restrictions. When the dental stuff cropped up last summer she lost 20+ lbs. in less than 2 weeks and her weight dropped to under 100 lbs. The dental work has been done for a while but there are simply some foods she won't do any more because they're too hard, too tough, too chewy or otherwise too difficult for her to eat one way or another.

                          By her own admission, if I didn't cook for her she'd probably eat nothing but frozen dinners, cereal or other convenience foods. They're quick and easy and don't require much expenditure of energy. They also provide a lot of empty calories. In addition to the calorie hit, your grandmother probably would benefit from a denser hit on the nutrition as well. In addition to the dental or chewing issues, older people often have diminished appetites as well and getting sufficient calories and nutrients into them can be a challenge. Here are some of the things I've done to get my mom's weigh back up:

                          - Mac & Cheese, cook the mac a little past done, add the cheese and then bake. Pasta with marinara or meat sauce made with grd. beef.
                          - Meatloaf. I use the Cook's Illustrated recipe which is very good, but also very tender. It also freezes well.
                          - Beans. Chili, baked beans, bean soup, hummus (which my mom though was odd, but she didn't hate it.
                          - Eggs. Custard made with whole milk and half & half, grated nutmeg on top. Scrambled eggs, soft boiled eggs, souflles and quiche. You can hide a lot of stuff in quiche and get both calories and nutrients into your grandmother.
                          - Peanut Butter. My mother eats this every morning on an english muffin (Thomas' are soft enough for her to eat, tho' shje prefers them toasted)
                          - Bananas, peaches, apricots, plums, blueberries, grapes, cantaloupe, watermelon, oranges. Cut the peaches, apricots and plums up. I sprinkled a little cinnamon sugar on them.
                          - Raw vegetables aren't very easy for my mother to eat, except fresh tomatoes. I get the best ones I can find, generally heirlooms at the farmers marekt or grape tomatoes. I also discovered that if I cooked carrots, beets and brussels sprouts and green beans until very well done, i.e. beyond al dente but not mushy, my mother would eat them because there wasn't much resistence and they were easy to chew. Asparagus I can cook almost normally and she can manage it. Winter squash, baked with maple syrup and grated nuts. Spinach she could eat raw or cooked, and swiss chard cooked has been easy to eat.
                          - Sweet potatoes. One of the most nutritionally dense tubers out there. Bake them so they're super soft, add a little butter, salt and pepper and they get really sweet.
                          - Other proteins that my mother has found easy to eat are...chicken tenders, halibut, swordfish, mahi-mahi, salmon, flounder, shrimp and scallops.
                          - Potatoes. Mashed, baked, steak fries, scalloped
                          - Pot roast. If I use a chuck roast which gets very tender and if I cook onions, potatoes and carrot with it. The meat has to be falling off the bone tender. Braising makes just about anything soft. My mother can also deal with corned beef and cabbage, go figure.
                          - To encourage my mother to eat I made some of her favorite foods (like baked mac & cheese) or dishes that have been family favorites for ages (like baked beans or marinated cucumbers).
                          - As much as it pained me, I routinely over cooked vegetables and pasta. But my objective was to get as much "whole" food into her rather than processed.

                          Good luck, your grandmother is lucky you're looking out for her :-)

                          10 Replies
                          1. re: DiningDiva

                            Lovely post, DD...you took so much time to detail everything too! ♥

                            1. re: DiningDiva

                              Nothing tastes better than a baked sweet potato topped with some Gorgonzola Dolcelatte.

                              Pureed beans (quality dried beans) topped with pureed cooked veggies, seasoned with Middle Eastern or Indian spices can be delicious, colorful, and varied. Packed with nutrition, too. (I think a diet of full-fat dairy is not ideal, no matter how much weight you need to gain.)

                              1. re: DiningDiva

                                Thank you so much for taking the time to write all of this. It means a lot. YOu actually named a ton of things she is eating, but in tiny quantities. She loves mashed potatoes and I might suggest to my father some sweet potatoes also. She loves peanut butter, but we have to make sure she has very soft bread (which makes spreading it a nightmare, haha). She loves bananas and has a half of one in yogurt with some type of berry every morning...and an ego waffle. It's the rest of the day that we worry.

                                The hardest part is I'm only visiting and I live four hours away. My father is 76 himself and is pretty set in his ways. She lives with him and he's quite a good cook, but he's also very into nutrition, so he has an aversion to buying crap. I am going to go out on my own and buy her some boxed mac and cheese (which she likes), some pot pies, some beans (she loves them with hot dogs) and I'll hit a GNC if there is one around and pick up some weight gain supplements.

                                Thanks again and good luck with your own mother.

                                1. re: jhopp217

                                  It sounds like one of the major problems is how much she can eat at one time. For people who are on chem or have had bariatric surgery, the recommendation is eat a little bit every two hours. There are a couple of sites that have food recommendation and recipes. One of the ones a friend used was http://bariatriceating.com/BErecipes/

                                  Is father willing to do the every two hours routine or can you package small amounts in something like food saver bags so all she has to do is throw a half cup of delicious soup or mac and cheese into the microwave.

                                  Good luck with your grandmother. It sounds like the two of your have a tender relationship.

                                  1. re: dismith

                                    Thanks for the link, dismith! I personally need to get more to eat, and after surgery (not for weight loss), I have many of the issues that bariatric patients have.

                                    1. re: dismith

                                      Not that it's really funny, but it's become a little comical how long she takes to eat, because she never shuts up. She's always yapping when she eats, so sh starts breakfast at 9:30 and finished at 10:30. By 12:30, she'll have lunch and again isn't finished til 1:30. Then she's exhausted and takes a nap. Sometimes 2-3 hour and then she doesn't want to eat, because of dinner. So she has a scotch. By dinner time, she's tired again, and isn't that hungry. Although when she reallly likes something she finds a way. She does always have room for dessert.

                                      1. re: jhopp217

                                        This may just be my Hawai'ian spin, but I think she's "yapping" now so that she won't be bothering you later in your life. Respect kupuna always, but it's OK to laugh.

                                        1. re: jhopp217

                                          I want to say, thanks for sharing your grandmother. I'm seeing a fascinating picture form of a unique and interesting lady. I'm glad you're there for her. :)

                                          Re: the long yappy meals: although her caloric needs are high due to work of breathing, the work of eating/digestion is also tiring/exhausting, due to vasodilation around the GI tract and metabolic work to convert the food to absorbable components. She's (probably unknowingly) extending the meal to allow her body time to assimilate the food.

                                          At some point in any long-term illness, calorie need overtakes ability/desire to consume calories. Just gently making available palatable foods as tolerated, not ever pushing, and not making food a focus or struggle point are key factors.

                                      2. re: jhopp217

                                        This may sound odd, but I love sweet potatoes mashed up with a spoonful of peanut butter on top. I use natural peanut butter, and the sweet-salty-nuttiness of it all works really well for me. It's a nice change from butter on potatoes, and since she likes both, why not try it? Peanut butter also goes really well in oatmeal or pudding. Actually, any nut butter or even Nutella (if she goes for that) can be mixed into lots of soft things to up the caloric/nutrient content.
                                        Also, if she likes cake, have you considered making trifle? The layers of cake and pudding and fruit should be soft enough for her, and you could use lots of heavy cream and such.
                                        Good luck!

                                        1. re: pegathaismyname

                                          my 2yo also came up with this combination :)

                                    2. Smoothies w/ her fav fruits & melons & ice cream. Concentrated meat broths/soups w/ pureed veggies, her fav flavorings (cumin, thyme, star anise, ginger-just to start you thinking), enriched w/ dairy. Whatever floats her boat to spark her interest.

                                      Does she like cheese? Lots of variety in this area

                                      Pastas loaded with high calories/flavorful sauces - baked or stovetop- topped w/ breadcrumbs for textural interest but not tax the teeth

                                      Think frequent feeding (every 1.5-2 hours) & not necessarily large portions.

                                      2 Replies
                                      1. re: Stephanie Wong

                                        Your idea of more little meals is a good one. We are trying to get her to snack, but it has resulted in her refusing to have more than two bites during dinner. She will however have ice cream after, so all is not lost.

                                        1. re: Stephanie Wong

                                          yes, cheese! she can eat small pieces of brie on a buttery cracker and pack in teh calories.

                                        2. I don't blame her for not drinking Ensure, bleh. One way to sneak them in is to serve (preferably) the chocolate in a large glass with ice chips and cut with homogenized milk. Takes a bit longer to drink but seems to go down easier. You could even doctor it with a bit of instant espresso to make it a moccachino-y sorta deal.

                                          Another idea might be to switch to some of the higher fat yogurts since she seems to be tolerating those. We have a brand here called Olympic which offers a Greek-style yogurt called Krema at 11% butterfat, tastes amazing (especially the vanilla) and has a very attractive texture. There are others in the US that would be similar in fat content I'm sure.

                                          Good luck!

                                          1. When I was on weight gain after being diagnosed as Celiac I had a heard time with a lot of foods still. My boyfriend at the time came up with the best way to get me to drink the Ensure I was required to. He made a milk shake with Ensure, full fat ice cream, peanut butter and bananas. It was super yummy.

                                            I also ate a lot of whipped cream. On full calorie Jell-O, on fruit, on cereals. But liquid calories were easiest. Milkshakes and smoothies are easiest and don't feel like you're eating all day long.

                                            I know many here are not Starbucks fans but when I was supposed to be eating between 3 and 4 thousand calories a day. There frappuccinos were an easy way to add a ton of calories.

                                            1. The people who have suggested going to a health food store (such as GNC) and purchasing "weight gainers" are on to a good idea. While it is essential for your mother to eat real food, needing to eat 3000 cals plus can be something of chore as I'm sure you're finding out. Supplementing real food with high energy "weight gainers" is a great and yes, tasty, way to get a lot of easy calories.

                                              The one difficulty you're going to run into with "weight gainers" is that the supplement market is unregulated, and often has "interesting" off-market ingredients added to them to make them more potent, and your grandmother I'm sure is on a plethora of medication which makes her is prone to unforeseen complications. But you can avoid this. One company that has a fabulous reputation for making high-quality products for a fair price with no funny ingredients is Optimum Nutrition. Another way to avoid unwanted ingredients in your products is to purchase products that are approved for use in NCAA athletes. The vast majority of products at market are not approved for NCAA athletes, but ones that are you can be sure are clean. CytoSport makes a NCAA approved supplement called MuscleMilk Collegiate that is available online (a VERY tasty full fat product) that in one shake mixed with milk can give your grandmother 800+ calories. And you can play with the amount of calories in the drink my altering milk/water ratios, or adding bananas or peanut butter if one wants.

                                              One thing I can add is that while you may be hesitant to go this route because of fear that these drinks will taste horrible, THEY DON'T. They actually taste fabulous as they are meant for gaining weight and not losing weight, and are not all full fat (and its the good types of fat - fyi) and full flavor -- seriously.

                                              Also, nearly everyone (not everyone) is suggesting your grandmother eat a lot of food that is really bad for her. Even if she is burning her way through calories like a marathon runner, she should still eat healthy products that aren't loaded with butter and will cause health problems in their own right. Supplement products can use *good* fats that are more easily used for energy by the body, and can have health benefits. Just something to watch out for. Hope this helped.

                                              6 Replies
                                              1. re: tongue_to_tail

                                                Health problems? Unhealthy food? The woman is 98 so I would say her genetics have taken good care of her regardless of what she eats. Has anyone asked her if she's not eating enough by choice or because she can't?

                                                1. re: tongue_to_tail

                                                  As a former NCAA athlete, MuscleMilk Collegiate tastes terrible. I would rather drink 20 Ensures than MuscleMilk.

                                                  1. re: loratliff

                                                    To each their own, but I was as well, and my entire 60 member football team enjoyed the product. The only ones who objected to the taste were players whom didn't enjoy protein shakes in the first place.

                                                  2. re: tongue_to_tail

                                                    Thanks for the supplement tips. I know nothing about them, but will look for them. She actually eats pretty healthy, almost too healthy, so she can definitely throw in some serious fat and carbs where needed.

                                                    1. re: jhopp217

                                                      Good! They can definitely help her. My grandfather had energy problems and we saw him through with some help from supplements.

                                                      The steroids suggestion on here was also a good idea. They make you EAT.

                                                      1. re: tongue_to_tail

                                                        If you are going to take something to make you eat I think the medical marijuana suggestion is far better than steroids. Fewer side effects:-) Seriously.

                                                  3. Coconut butter? Just a random idea. Here's a popular brand: http://amzn.com/B000WV153I

                                                    1. bless you and your grandmother... 98... and it's so nice to hear how much you care. there's a lot of fantastic advice and suggestions already here, so im going to do my best to avoid duplication...

                                                      risotto - soft, and you can do it with lots of cheese and cream
                                                      manicotti or stuffed shells of any kind - cheese, butter, cook the shells/noodles well done
                                                      granola in yogurt - she doesn't like hard, so let the granola (calorically dense) soak in the (full-fat) yogurt to soften
                                                      eggs of any form cooked in bacon fat?
                                                      polenta with cheese and cheese - top with whatever she might like... meat ragu?
                                                      arrancini - crispy (sort of) exterior but creamy interior, just to mix it up a bit
                                                      quesadillas - don't overcrisp them... does this constitute chewy food?
                                                      souffles - cheese, pureed veg, whatever floats her boat
                                                      crustless quiche - cream, eggs (extra yolk), cheese
                                                      cheesecakes - sweet or savory
                                                      fried avocado
                                                      tapioca pudding

                                                      i wish you much appetite... isn't it a shame when we no longer have to watch what we eat, we don't want to or can't? life's cruel ironies.

                                                      2 Replies
                                                      1. re: Emme

                                                        She has a lot of what you mentioned, but Quesadillas might be a good idea. Load them with cheese, avocado, tomatoes and maybe some chicken or beef. She probably would only eat 1/4 of it, but it's something she could share with someone and that might tempt her to take half

                                                        1. re: jhopp217

                                                          It might be worth trying them on the smallest tortillas you can find, too, or go ahead and divvy it up with someone else before giving it to her. Some of the older adults I work with have a really hard time facing a large quantity of food and do better with smaller portions to start with. It's hard on families because it seems silly (and ungenerous) to give the person who needs to gain weight a smaller portion than everyone else. But in the big picture, it's better for a person who needs calories to eat a 1/2 cup portion than 1/8 of a 2 cup portion that made her lose her appetite.

                                                      2. Hi, jhopp:

                                                        A couple thoughts:

                                                        (1) Ensure tastes like hole to anyone, even 98-yr-olds who can only taste sweet foods.

                                                        (2) If she's not eating enough, her appetite is probably too low. Without appetite, older folks will push away the best, tastiest food on the planet. Luckily, there are drugs and supplements that can stimulate appetite. Ask her doctor to suggest some. Specifically, ask about anabolic steroids--this may be one of the best legitimate uses of this class of prescription compounds. Google "Winstrol" and read up before meeting with the Doc, so you don't get buffaloed. The other poster's suggestion of pakololo (weed) pills is also a good one.

                                                        (3) If you're nearby, TAKE HER OUT for a milkshake often. Simply getting out of the house can have a marvelous effect on appetite. Even better if she has good food-memory associations (e.g., "I used to LOVE the peppermint shakes at ________!) and you can cater to that.

                                                        (4) Try to determine the time of day that she's most receptive to food. After late afternoon is usually bad, and before 10AM tends to be, too. Find the "window" and drive the Chuckwagon though it.

                                                        (5) If her effective Resting Metabolic Rate is >3,000 kCal/day, you gotta up her fat intake. Fat is 9kCal/g, whereas protein and carbs are 4kCal/g each. Butter everything liberally. Shakes are made with heavy whipping cream.

                                                        Hope this helps get your tutu piloli (and momona),

                                                        4 Replies
                                                        1. re: kaleokahu

                                                          Oddly, she has a good breakfast appetite, but to be honest, we've been sitting down with her at 9:15 and she has two large tablespoons of yogurt, with half a banana and strawnerries. She has an ego waffle, buttered and coffee. The issue is that it takes her about an hour to eat this. By the time she's finished and gets up from the table, she's exhausted. When she is ready for lunch, she only eats a few bites and then usually takes a nap. When she wakes up, she's never hungry

                                                          1. re: jhopp217

                                                            A couple afterthoughts: (1) Can she eat while on oxygen? If she's not as exhausted, she may be able to shovel down more at the 9:30 feeding . (2) Have you investigated EPO injections for her (Rumor has it, it helped Lance Armstrong)? (3) Heavily cream her coffee. (4) Try giving her just the yogurt and bananna at 9:30, and a larger meal after she wakes from the nap--see if she's hungrier.

                                                            Good Luck, and may you have someone to take such good care of *you* when you're 98,

                                                            My mom had COPD, and some of the meds gave her a dry mouth. A hard candy within reach was always a good thing, and the extra calories were welcome.

                                                            1. re: jhopp217

                                                              My grandfather was on oxygen for 11 years and also lost a ton of weight. We thought a lot of it was that he couldn't smell anything, so nothing tasted right and it didn't trigger the desire to eat. My grandpa still drank his scotch and enjoyed it. :) (maybe you can get her to drink some cream based white russians? Fill her up with calories, and help her sleep!)

                                                            2. re: kaleokahu

                                                              Agree especially with #2. Also if they haven't done so recently check her bloodwork and make sure something is not off there. Food that tastes good to you can taste bad due to meds, dry mouth from mouth breathing and meds and bloodwork abnormalities. Good post kaleokahu. we have had these issues with both of my parents for different reasons over the last year. The only thing that worked to make a real difference was either fix the problem if there was one or add a medication to increase appetite. We also cook what they ask for(increasing fat where we can).

                                                            3. Guacamole

                                                              Sweet potato pie

                                                              Chess pie

                                                              Mac N Cheese made with nice thick rich Bechamel sauce.

                                                              3 Replies
                                                              1. Thank You everyone for your suggestions. I've made a list of all the things she hasn't tried and your suggestions on weight gainers. Thanks for taking the time. As someone who is always fighting weight gain, it's hard to wrap your mind around the opposite at times.

                                                                How many calories are in scotch? If she doesn't have one in her hand by 5PM, there's hell to pay!

                                                                7 Replies
                                                                1. re: jhopp217

                                                                  I wonder if you could concoct a scotch milkshake? :-) Or seriously, perhaps interest her in changing her cocktail of choice to something with lots of cream in it?

                                                                  1. re: susancinsf

                                                                    One of those ice cream brandy alexanders would certainly do it for me! Good idea, susancinsf.

                                                                  2. re: jhopp217

                                                                    Scotch in mashed sweet potatoes/yams with lots of butter is one of my favorite side dishes (year round, not just ceremonial holiday meals) -- pretty too! "We eat with our eyes first"

                                                                    1. re: Stephanie Wong

                                                                      Never heard of this one before, but I love Scotch and I love mashed potatoes so how can it be wrong? About how much do you use? Do you add it straight or cook the alcohol out at all?

                                                                      1. re: Stephanie Wong

                                                                        There are also lots of recipes out there with booze based cream sauces for pasta or what not. Here is one I have http://allrecipes.com/Recipe/Smoked-S...

                                                                        I also have recipes for scallops in pernod cream and shrimp in cognac sauce, dublin lawyer, that kind of stuff.

                                                                      2. re: jhopp217

                                                                        Ha funny, I posted my comment about my grandpa above and his scotch. Because grandpa ate so little, it was the only thing he bought in bulk :)

                                                                        1. re: jhopp217

                                                                          They truly are the cocktail generation. My mother's choice would be a margarita (on the rocks) or manhattan but we limit them to Friday, Saturday and Sunday. If I don't have one in her hand on Saturday by 5 PM, she starts "hinting" about her drink :-). And we're not talking any puny "taste" here, we're talking a full 3 oz of tequila or bourbon in her drink plus the other ingredients!! And her 94 year old sister is the same. I've actually run my margarita recipe through a nutrient analysis program and they come out at around 350 calories. You might want to think about switching out the scotch.

                                                                          I have to say since I started doing the elder care thing my own wine consumption has dropped dramatically and my preference for cocktails increased substantially.

                                                                        2. Chia seeds, from the health food store. Stir them into yogurt or ice cream (may be a hard sell lol), mix it into baked goods. I mix in 2 tablespoons or slightly more into a quart bottle of water and shake the hell out of it for a long time. then I drink thewater with the seeds. It's not for everybody, but I love it. Chia has the perfect amount of fiber to regulate the digestive system. If you can incorporate chia seeds into her diet it will help her health and colon health (can'T believe I'm going there, but it really is important)

                                                                          1 Reply
                                                                          1. re: EWSflash

                                                                            Good on those who mentioned at least making a nod toward the nutrition -- and fortunately or unfortunately,with a diet of mostly soft food, EWS, mentioning fibre IS important.

                                                                          2. Well bless your dear Grandma. We've gone through something similiar recently for different reasons and it ended up with us needing to help our family member "calorie pack" which is just what it sounds like. If Grandma's eating creamed soups, make them with heavy cream. If she eats puddings, same thing. A shake's not a shake until it consists of carnation instant breakfast mixed with ensure mixed with ice cream. And a tuna melt, cut into thin strips, is a fine lunch with tomato soup made with heavy cream. If she eats those mashed potatoes, make them with whole milk or cream; better yet scallop up a pan of those devils, thinly sliced, with heavy cream and butter and some mild cheese. Creamed soups. Pastas. Egg Mayonnaise. Creamed veg. instead of plain-steamed. And on it goes. Main thing is, whatever she's eating now, go with that and figure out a way to make it as calorie-dense as possible. There are also special protien powders available to add calories, but we had zero luck with those as the merest hint of its' taste would result in the food being refused completely.
                                                                            Also ask her PCP about the possibility of Megase, an appetite-enhancing and LEGAL in ALL STATES drug. And here, because I can hear the hounds a'bayin' in the distance, I'll just whisper that THC has been known to be beneficial when consumed, both for appetitite enhancement, pain relief, and yes even symptoms related to emphysema. But you ditten hear it here.

                                                                            1. For the last five years, of her life, my mother consumed little more than pizza, ice cream, Guinness Stout and halvah. She died at 99, in good health.

                                                                              2 Replies
                                                                              1. re: beevod

                                                                                People in 'good health' don't die unless they get hit by a bus...

                                                                                1. re: kpaxonite

                                                                                  Um, yes they do. Eventually, yes they do. That is why there is an "advanced age" box for the coroner to check.

                                                                              2. My father was in the same situation as your grandmother,....the recommendation was to consume Ensure as well. While my father was in health care facility, there was a McDonald's across the street .....he much preferred a large vanilla shake each day instead. Given your Grandmother's love for ice cream, it may be an option for her.

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                                                                                1. re: fourunder

                                                                                  actually, if she is up for it..McD's is soft and fatty, but there are so many extra ingredients in there, who knows how that would affect her

                                                                                2. Sadly, this is all too common in this age group. My first suggestion is to consult with her primary care physician to see if there's anything going on, and go from there. My other suggestion, and maybe her primary care physician can help with this too, would be to find out if there are any vitamin supplements she could/should take. Anyhow, you'll get good advice. Go for it. And best of luck.

                                                                                  1. How about frozen custard? It can be flavored in an infinite number of ways and you can make it as sweet as she likes. It is higher in calorie than full fat yogurt or ice cream and also provides a good deal of carbs and protein (not to mention fat!) If you added fruit that would contribute some vitamins as well. And it is as easy to eat as ice cream.

                                                                                    Best of luck to your Grandmother!

                                                                                    1. I think a lot of the suggestions here are excellent, and I totally understand why she can only choke down 2 cans a day of Ensure. That is nasty stuff. But I do think it's important to simply let her make her own decisions about whether and how much to eat. You can provide all the tempting things suggested here, but at 98, she has earned the right to decide not to eat or to only eat small amounts. If she's too exhausted by eating, she won't have pleasure in it, anyway.

                                                                                      So I'd just make every calorie a rich, fatty one--if it includes dairy or eggs, she'll get some protein--and let her eat as she wishes. She's obviously done a lot of things right in her life to make it so far, and she's probably also blessed with good genes. Hope you inherited some of them, because 98 is amazing!

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                                                                                      1. re: Isolda

                                                                                        Isolda, how good of you to remember this and to point it out. Mariacarmen was one of the first people who told me to feed my darling small beautiful portions of things that he loved and it turned out to be the saving grace of the whole "what to do" megillah. You are so right. She has earned the right not to be force-fed, and sometimes the extreme amount of fright and angst involved in getting a certain rda into someone's mouth negates the point of lovingly feeding your family member.

                                                                                        1. re: mamachef

                                                                                          "She has earned the right not to be force-fed"

                                                                                          Wow, who here is advocating force-feeding? I think everyone is just trying to be helpful.

                                                                                          1. re: Sailing77

                                                                                            Sailing77, as sure as I am that you're right, I'm sure anyone who reads me regularly knows what I meant as well.

                                                                                            1. re: Sailing77

                                                                                              I don't think anyone is, that I've seen. But there's a certain point for some people where the entire day is a pitched battle to get calories down their throats, and it can be tiresome even if done in the nicest, most caring way possible. Based on the comment above about demanding her scotch, it sounds like she is pretty with-it cognitively, and I agree with mamachef that she's earned the right to make her own decisions, as long as a variety of nutritious and calorie-dense foods are made available to her.

                                                                                              This isn't really all directed at your comment but I think mamachef made a really good point. There is a ton of amazing information here, but the ultimate answer is quite possibly that grandma is never going to get her 3,000 calories a day, and that's okay. Food can be an amazing bonding experience and a way to show love to someone in poor health, but it can also be a tremendous guilt inducer, especially for families.

                                                                                            2. re: mamachef

                                                                                              I am so with you on this mamachef. There are calories aplenty available, it's just hard work for her--maybe too hard.

                                                                                              1. re: mamachef

                                                                                                Absolutely true, mamachef. As long as food is made available let her eat--or not eat--as she pleases. I know it would drive me nuts having someone pushing food on me when I wasn't hungry.

                                                                                                1. re: MandalayVA

                                                                                                  I completely disagree about letting her eat --or not eat--as she pleases. If she were completely healthy I would agree with you but because she has emphysema and is elderly she needs more calories. The OPs grandmother sounds full of life - would you let her waste away or not have enough energy to enjoy her life and her family just because she isn't getting enough nutrition? When all it takes to get that extra bit of nutrition is to make the food palatable for her and to coax her?

                                                                                                  I applaud the OPs efforts. A good idea would be to lose the concepts of having to eat larger amounts at breakfast, lunch and dinner and just let her eat whenever she wants. If she feels like eating a larger amount at 11am just let her go for it and then don't worry of she doesn't eat a lunch-size meal at 'lunchtime'.

                                                                                                  1. re: Billy33

                                                                                                    Uh ... that was the point I was trying to make.

                                                                                              2. If she is already eating the ice cream...then just add:

                                                                                                -peanut butter
                                                                                                -perhaps, mix in protein powder

                                                                                                1. In addition to many others here, if she likes scrambled eggs, try making them with some whole fat mayo in there before cooking. Its actually quite tasty anyway (we sometimes had this at indulgent brunches say at xmas or what not), even though it sounds a bit ugh.

                                                                                                  I ate scrambled eggs almost every morning as I went through chemo, and I often added a little bit of lower fat mayo into the mix (because I wasn't trying to gain weight), and I found it tasted much more appealing to me, and the bonus being that it also softened the eggs.

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                                                                                                  1. re: im_nomad

                                                                                                    I found the Asian Markets have a lot of drinkable cereal beverages that my grandmother used to like....basically packets of cereal, milk, sugar in a semi-powdered form that you just mix with hot water. They are sweet, creamy and warm and a calorie laden alternative to tea. They are usually sold in the same aisle as tea. And called Cereal Beverage. Atole or champurrado are Mexican versions of the same idea. I love oat Atole with cinnamon.

                                                                                                  2. 1. Food: as another poster mentioned, you will need to fatten up everything. Protien/carbs just won't do it in small portions. This is easy with baking, anything creamy, anything cheesey. Add some bacon bits.

                                                                                                    **chocolate truffles** are nearly 100 cals each. Each bite, another 100 cals. And they get eaten between meals.

                                                                                                    risotto served with a heavy butter saffron cream sauce was a winner for all time most calories at my SO's work recently.

                                                                                                    duck fat. bacon. cream. butter or marg on everything. butter her coffee. lol
                                                                                                    - The animal fats also help "move the mail" in the same way fiber does. They also intensify taste - decreased taste sensitivity is a problem for older folks.
                                                                                                    Look into heritage type recipes. The amount of fats people used decades ago is incredible to the modern cook. A lot of tasty recipes just got discarded over the years because of the calories, sugar and fat.

                                                                                                    2. Medication: check into appetite increasing meds.

                                                                                                    3.Psychology of Eating: Make dining as fun as possible. Make the food look nice. Share with her. Counterintuative, but it works, especially with old ladies who were always taught not to be "selfish" or a "pig", to think of others, not to be rude.... Encourage her to eat, not talk, by talking yourself. The distraction from the "burden" of forcing food makes it easier.

                                                                                                    take her out if possible. Novelty, nostalgia, distractions,

                                                                                                    4 Bevvy: If she likes a drink, capitalize on that. Booze is fattening, 150 cal/oz if i remember rightly. If you can get her on something sweet or creamy it's more. Kaluha milkshakes anyone?

                                                                                                    Get her to drink juice. Buying the concentrate and using less water helps.

                                                                                                    Ensure/Boost sucks. The stuff they serve at the hospital has 150 cal per drink - around the same as full fat milk. More protein and vits, but thats not the issue as much as cal. even doctors fall for their marketing shmaltz, assuming that "meal" means calories. It tastes like bum.

                                                                                                    5. add shmatlz! (grease)

                                                                                                    1. Chewing may be a major problem. Think of custardy desserts: baked custard, tapioca pudding, chocolate pudding with Redi Whip on top, soft rice pudding with raisins, bread pudding made with cinnamon raisin bread.

                                                                                                      She will do well with food that is familiar and requires little or no chewing.

                                                                                                      1. I used to make omelets w/cream cheese stuffed inside for one lady. She loved it. She too had emphysema

                                                                                                        1. I've been mulling this over for quite some time. I've come to the conclusion that if a person has reached the ripe old age of 98, they should be free to choose what they care to eat, regardless of nutritional guidelines. How much time could you hope to gain by badgering someone about their food choices? Why turn someone's last days into a fight over food? Let them eat, or not.

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                                                                                                          1. re: pikawicca

                                                                                                            The OP posted at some point in this that regardless of the number of calories on her plate, at some point her grandmother basically just got tired after a certain amount of eating and wanted to lie back and relax. I think that is exactly what should be done.

                                                                                                          2. Go to a health food/musclehead store and pick up some weight gain powder. You can mix it with just about anything she drinks and It should really help.

                                                                                                            1. freshly breaded and fried food is always appetizing-fish and chips?zucchini sticks? fried mozz?
                                                                                                              eggs benedict with hollondaise and ham or lox? can even be served on a biscuit
                                                                                                              oh and biscuits and gravy...that has to be the all time fattening soft food
                                                                                                              pasta bolognese or lasagna
                                                                                                              enchiladas suizas with crema
                                                                                                              cheeseburger with a lot of american cheese and ketchup
                                                                                                              it doesn't sound like she is into these things, but this is what i would cook if i needed to gain weight. it's wonderful you're close to her.

                                                                                                              1. I'm not 98 but I do have problems w my teeth and I have a metabolic rate that just won't quit. I'm also the opposite of an emotional eater, if I'm stressed, tired, upset, my appetite disappears. Suffice to say I have problems meeting my caloric needs.

                                                                                                                First thing I have to say regards all this milk fat advice. I, too, had the bright idea to amp the milk fat in my diet by drinking milkshakes and daily lattes with whole cream (18% mf). I also eat 6-10% mf yogurt always (the low fat stuff is full of sugar and gelatin, might as well just have jello ;) Long story short, too much rich fat gives a girl gout and stresses the kidneys generally. Apple cider vinegar remedied that (and many other problems, definitely worth a googling ;)

                                                                                                                The crappy teeth thing is limiting. Especially when it comes to getting the fiber fruits and veggies offer. Hello Blender and McDonald's milkshake straw! Even hard fruits like apple or pear, core and cut into a few pieces and pulverise. Leafy greens/salad is impossible w broken/sore teeth but no match for your blender. Berries and bananas cover the distinct green flavour of spinach/mixed greens. Avocado makes it creamy and fattening like a shake. Cut celery into small pieces cuz of the stringiness. Beets, yams, turnip, carrots can be steamed/boiled until soft enough to juicerize. Throw in anything you like, add juice or water if it's too fibrous/thick. I leave fruit peels on, remove peels from anything that needs to be cooked to soft. Lemon added will help keep it from turning brown if you're using bananas and apples. You can basically cram 3-5 servings of fruit/veg into an 8 oz glass. I make 2L at a time and freeze half. It's not a pile of calories but it does make you feel awesome. And with the straw you can really pound it back before you feel full or tired from eating.

                                                                                                                Protein powder tastes like crap but when I can manage to choke it back I do notice I'm a lot less tired. Hemp hearts (17g protein in 5 tbsp), again w the blender and a few drops of oil and you can use the paste in the fruit juice, blend any nuts or seeds first, then add the fruit.

                                                                                                                If you're in the city, Indian food is a great source of fatty good comfort. Even the way they prepare meat makes it the softest and fattiest and tastiest food going. Its all fairly healthy, too. If meat is too tiring for her system, no worries, their vegetarian fair is just as soft and satisfying as a meaty diet. Potato chips are also a good source of snackables of the fatty variety. Takes longer to eat with broken teeth but definitely not impossible to gum ;)

                                                                                                                Chocolate has a lot of iron which might help w the tiredness (and/or lack of meat in the diet). Make sure she's getting enough vit c, to absorb the iron and avoid constipation. Blender juice will help w both.

                                                                                                                Re:medicinal marijuana. If it weren't for MM I wouldn't eat at all some days. Usually I smoke it but it can get in the way of productivity so I've started experimenting w cooking lately and it seems to be the way to go. 1/8 cup of butter w finely ground 1 gram of bud OR 3 grams of leaf, melt over double boiler on lowest heat and leave it for an hour or three. add a little vanilla and one cup of chocolate chips, add cocoa and a bit of salt if you're a dark chocolate lover. Stir it until all the chips are melted (lowest heat!!!) and then spoon onto cookie sheets or into cupcake cups. Should make about thirty chocolates. Start by eating half of one. Wait at least two hours to measure the effects. Some people notice the effects of one, others don't notice the effects of 5. Increased appetite, restful sleep, muscle relaxant, calmer mind. Always use caution when experimenting w any new medication.

                                                                                                                Cakes and homemade baking are a better source of calories, fat, protein and carbs than ice cream :)

                                                                                                                1. Lots of good advice, but of course, it's dependent on what she likes and what little energy she has to eat it. Someone mentioned meds, and that's what I'd also recommend. Talk w/ her doc about appetite-enhancing meds. Megace is commonly use, but expensive and doesn't work for many folks. Consider something like low-dose Remeron, an antidepressant with the (desired, in this case) side effect of stimulating appetite. Best wishes. Sounds like you're a loving grand-daughter who is trying all you can to keep grandma as strong and healthy as she can be, given her health problems.

                                                                                                                  1. My mom made a ton of deviled eggs for my grandfather in the months before he died - he had some dietary restrictions because of health problems, and needed to keep on some weight. You could also try things based on hard-boiled eggs, like Chinese style "tea eggs".

                                                                                                                    1. Tapioca pudding, definitely. Buy Minute Tapioca and follow the recipe on the box for Fluffy Tapioca (I double the recipe and increase the eggs to 3). Having said that, let me add that I have made this a zillion times---it was a staple in my husband's last illness--- and find that the easiest way to put it together is to set the mixing bowl with the egg whites on the counter next to the stove where the milk, tapioca, and egg yolks are coming to a boil. Have the measured sugar on the counter too. In this way you can keep stirring the custard every few minutes while you are at the same time holding the electric hand mixer in the egg whites. Beat the sugar into the egg whites so they will remain stable. Then as soon as the custard boils dump it all into the egg whites and whip like mad. The heat of the custard cooks the meringue. After it cools a bit, add the vanilla. This sounds complicated but you will get the routine down immediately and it takes only 5 minutes. The resulting pudding is delicious---the "patient" will actually eat it--- and has two other advantages for your situation: it is very nutritious and can be eaten with minimal dental activity.

                                                                                                                      Also: pudding made from a package if she likes it; bread pudding; baked custard. You can add whipped cream if she likes it---by her time of life, you don't need to be worry about cholesterol, so see if she will eat the potatoes better with gravy (from jar or can)---only beware of this if she is on restricted sodium. A baked sweet potato with brown sugar and butter may work. Jello will get liquid and calories into her. Same with popsicles. Hot cereal, grits, cornmeal mush? Elderly people often like foods from their past. Bless you for your loving care of your grandmother.

                                                                                                                      1. chocolate every day... if she likes junky candy bars like snickers or reese's pb cups or whatever would buy her fun packs of those and leave them out in a bowl for snacks and "dessert" after breakfast etc :) if she likes good chocolate i'd stock a whole cupboard and again make sure she gets at least a couple of squares every time she eats. remind her partner that chocolate is a health food--especially for her :) make sure the choc is melt-away and not difficult to chew

                                                                                                                        there is a less ass-y, organic "ensure" type drink called orgain.

                                                                                                                        does she like egg nog... or spiked egg nog.... around holiday times? if you can source egg nog off season it is a great calorie supplement drink, she can have a couple of happy egg nogs for her afternoon cocktail. hot whiskey w honey, hot buttered rum are also soothing, old-fashioned and caloric alcoholic bevs. i don't suppose she cares for white russians?