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My mom has late stage dementia and is on a pureed diet and I'm concerned about what and how she's being fed at her facility. Her food is pureed in a blender very smooth, but it is all combined (vegetables, meat, etc.). and poured into a bowl. I don't even know what she's eating since it's all blended together. She also has a couple of ensures each day. I've had to take her to the ER a couple of times (from falls) since she's been on this diet, and the hospital cafeteria serves the pureed food separately (vegetables, meat, fruit, etc.). on a divided plate. It seems like a lot of food and more varied. Does anyone else's place do this, the blending it all together into a bowl and not separately? I find it strange and she's lost a lot of weight eating pureed food.

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If she's losing weight it could be that she just does not have an appetite anymore. Also, the pureed food served in a nursing home is disgusting and if she already doesn't have much of an appetite that food certainly isn't going to encourage one.

Also, her not eating could also be a result in there being no one available to sit and take an hour or more to slowly feed her a meal. Many people hire private caregivers to go into nursing homes and memory care facilities to feed a person because it can take so long.

Try bringing her in some food that's actually appetizing. Like mashed potatoes and gravy with finely ground meat. Then give her ice cream for dessert. If you can't go yourself, hire an aide for two hours to feed her. If this works, you'll know the problem is the food and the time. Then you can make a plan for her meals.
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Reply to BurntCaregiver
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US prisons used to serve nutraloaf, which was the meal puréed together without dessert, and then baked. The courts made most prisons stop it.
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Reply to PeggySue2020
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there are a lot of factors here.
She is losing weight not just because of the pureed food but she is eating less.
As a person declines they do not require the same caloric intake that you or I do.
This is part of the End of Life process. if you or I skip a meal or don't eat enough we feel hunger, a person that has a body that is shutting down does not feel hunger like we do.
You can ask that the pureed food be served in separate sections of the plate.
Is your mom feeding herself still or is she being fed by staff?
It is possible if she is being fed that they are not spending a lot of time feeding her. If they have a lot of residents that they have to feed they may not take the time to feed her an entire meal. This might also be a reason for her weight loss.

I will strongly stress that you should not entertain the idea of a feeding tube. To do so could lead to a host of problems. Often a feeding tube will lead to more pain and discomfort as the body shuts down and can not process the food that is forced into it.
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Reply to Grandma1954
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MargaretMcKen Aug 14, 2024
I remember feeding Dora in the NH. She took quite a long time to swallow every small spoonful, nearly half an hour for a meal. I can certainly understand the staff not being able to spend that long on one person, and skimping.
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You can ask the facility to put her food into divided plate (which you may have to provide) and ask them to help her eat protein and produce (veggies and fruits) first. Carbs do have calories but not as many micronutrients that she (and everybody) needs. She should be offered Ensure High Protein - to give her extra protein - several times a day (at least 3). Ask a registered dietician to evaluate her needs and recommend a diet plan for her. You can get a referral for a dietician from her usual health care provider.
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BurntCaregiver Aug 17, 2024
@Taarna

With my last homecare client a bedbound invalid with late stage LBD, we used to serve her the high-protein Ensure drinks. We'd put them in the blender with a scoop of protein supplement powder and two scoops of ice cream. The client loved it and always finished.
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Roseformom: Pose your question to the dietary staff.
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Reply to Llamalover47
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Everything blended together does not necessarily make for a good taste at all. Sounds like a shortcut/laziness to feeding someone. My aunt used to mix all the leftover table straps and serve it to my grandfather’s pigs. Humans should not be treated like that.
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Reply to LoveLea
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BurntCaregiver Aug 17, 2024
@LoveLea

It's totally gross. In a care facility they do not ever have enough staff where an aide can take an hour or two to feed a person. So they mix it all together and give the person as much as they can in the few minutes they get to feed them and probably ten other people.
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We blended Mom's gluten free foods separately and they were served separately on her plates (red) at home.
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Reply to brandee
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I have never heard of different foods blended together in such a GOO, as cwillie calls it. Never. This must be almost beyond obnoxious tasting. I have seen it done for tube feedings, where taste isn't involved.

At some point that may be the direction you are heading if you continue to look for ways to keep your loved one alive when even the ability to accept food is gone. Speak with the dietary department and the administration.
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Reply to AlvaDeer
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ElizabethAR37 Aug 15, 2024
Yikes, I think I'd be more than ready for my Final Exit if I needed a feeding tube or could eat nothing except greige mush. Ugh!
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As much as I squabbled with the NH about my mom's diet I can't fault the kitchen for the way food was served or their attempt to make everything attractive and palatable. Nothing was ever blended into a homogeneous goo unless it was something like a soup or a stew, all foods were separated on the plate - that made it even more maddening when I observed some of those feeding the residents vigorously stir the offering before spooning it into their charges mouth 🙄

Just coming back to add - some commercial suppliers of pureed meals do have mixed-mush-in-a-can, especially the cheaper options. If the kitchen doesn't prepare their own purees this might be all the facility has available.
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Reply to cwillie
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I SO dislike a bowl-o-blend! Practical but so visually unappetising.

My son makes health smoothies. Looks amazing going in, all those healthy things layered up then WIZZ & he has a drink of brownish-red or redish-grey.

My Mother was served a plate of pureed pink-grey once in rehab. Under a pink-grey lid on a pink-grey food tray 😞 WT# "Where's my meal?" she asked.
She couldn't even seen it!

The BEST I have seen is when the food is pureed separately by colour & served in a moulded shape. IE beige chicken puree in a chicken breast shape, pureed greens in a pile of peas shape, pureed pumpkin in a wedge shape. Colourful + appetising + dignified. Bonus: If your vision is not so good, you wouldn't even see the difference.

I hope the future brings that way of presenting meals into the quality standards for all health & care settings. (I'd certainly be more tempted to eat colourful shaped food than a bowl of greige).
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Reply to Beatty
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My MIL’s NH served food partly separated. Things that would be served mixed on a normal plate (eg meat and a couple of stew veges plus gravy) were pureed together, but there were always separate parts with an individual taste (eg particular veges). MIL could pick what it was and comment about how the x had a nice taste tonight. I'm sure that it encouraged eating, even when it looked a bit like mashed nothing. I sincerely hope that your M’s fruit isn’t mixed with the savories!
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