Decline in eating and drinking

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Decline in eating and drinking

Postby Ann Croft » Sun Sep 24, 2017 6:40 pm

I care for Dad now 91 and he has been hovering at around a GFR of 24- 28 for the last 3 or 4 years. He is being treated with "conservative management" due to multiple health issues- vascular dementia, pressure sores, fractured spine, cataracts, very poor mobility and now incontinence creeping in to the mix.
What brings me back here today is a decline this week. He has taken to his bed , quite unusual for large parts of the day and is eating and drinking too little. He has had egg on toast x 2 for breakfast with about one cup of tea (after making 3 or 4 potfuls and umpteen reminders). For lunch he had a slice of fruitloaf and some home made cake with another cup of tea. He has had sips of water with medication two or three times and Dr made him drink half a glass this morning. She has put him on ABs in case he has a water works infection . He has refused everything else since lunchtime.
Is this decline in eating a typical pattern for kidney failure patients? I would have expected a little and often decline rather than breakfast , little lunch and then zilch.
Is this lack of fluid intake likely to escalalate kidney failure and at what sort of rate?
He was in hospital several months ago on Antibipotics for 5 weeks plus more ABs either side of hospital stay (UTIs, Ulcer infection and sepsis) . They said they wouldn't put Dad on a drip again just for fluids- only for ABs, they didn't really want him back in hospital (clogging up their beds) as they couldn't do much else for him.
Ann Croft
 
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Re: Decline in eating and drinking

Postby Ann Croft » Mon Sep 25, 2017 2:48 pm

Today Dad had one small cup of tea at breakfast time and has refused all fluid intake since then. He had some toast and egg with cup of tea but no lunch.
Surely no one can keep going on one small drink until 4.00 PM. Could this be kidneys closing down? Could this be End Stage???
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Re: Decline in eating and drinking

Postby wagolynn » Tue Sep 26, 2017 2:46 pm

I think it would be best to have a long talk with the medical team. Unless you are advised otherwise he needs around 1 litre of fluid to survive.

With sick kidneys, and I think aging, taste buds tend to dull their responses making most foods taste rather bland, I have resorted to using more herbs, and spices, and as salt is a no, no, I use pepper instead, five peppers is very good.

The same goes for drinks, strong cordials can be interesting. Too many eggs, I find, tend to make me constipated.

The medics can prescribe drinks that have protein, vitamins, and minerals in to ensure he is well nourished.

Best wishes to you both.
wagolynn
 
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Re: Decline in eating and drinking

Postby Ann Croft » Tue Sep 26, 2017 6:05 pm

Hi Wagolynn

Thanks for your reply- we have already had referral to dietician, tried every supplement under the sun- all been refused and now discharged again as unable to help him.

I spoke with GP today who feels that decline is due to Vasc Dementia dip causing his brain to no longer recognise the need for food and drink which in turn will have a knock on effect with kidneys rather than kidneys or UTIs being the cause of the current problems.
Today he has had one cup of tea at breakfast , one cup of tea at lunch time, a sip of tea at dinner time and just told me he doesn't want supper. A little water has been taken with medications. I doubt his fluid intake is as much as 1 litre today. The GP is arranging for blood tests to see where his GFR is now . I suspect he is very close to stage 5 , if not there already.
Ann Croft
 
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Re: Decline in eating and drinking

Postby Henriettab » Tue Sep 26, 2017 8:47 pm

link
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Re: Decline in eating and drinking

Postby wagolynn » Wed Sep 27, 2017 3:26 pm

I am afraid, it doe's not sound good.
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Re: Decline in eating and drinking

Postby Henriettab » Thu Sep 28, 2017 6:32 pm

The rollercoaster continues on- hospital were almost discharging him again today- nothing medically wrong and stats all good, dad awake , eating, drinking lunch and moaning loudly- they can't wait to get their bed back. Not spoken to Dr since conversation about fluid intake on initial admission. The loop of dementia/ckd and uti seems to go round in a circle one causing the other and so on .
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Re: Decline in eating and drinking

Postby wagolynn » Sat Sep 30, 2017 9:43 am

With low kidney function his immune system will be depressed making him vulnerable to any infection.

Low fluid intake will not help the UTI infections.

Best wishes.
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Re: Decline in eating and drinking

Postby Henriettab » Sat Sep 30, 2017 9:52 am

Just got dad back from hospital and GFR is 23 so still stage 4 .
I'm fuming with the hospital as papers say reason for admission is "general decline and unmet care needs"
The fact that neither myself (the only person he will listen to) or carers could persuade him to eat or drink properly and he ended up "unrousable" so tht OT thought he needed admission and 2 paramedics thought he needed admission the hospital think it is all my fault!!!!!!!!!!!!!!
If I wasn't in the middle of caring for Dad I would shout extremely loudly from every available platform and still may do so :twisted:
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Re: Decline in eating and drinking

Postby wagolynn » Sat Sep 30, 2017 3:05 pm

Try not to worry too much about what the hospital say, they can only go on what they see when they receive a patient.

The hospital notes need to be brief, and unfortunately, when read later can appear to have completely different meanings, just try to remember it is a brief description of the patient in front of them, rather than a comment about what has gone before.

They have no way of knowing how difficult it is at home with a patient with dementia or how much effort has gone into trying to persuade him to eat/drink.

It is not unusual for an elderly patient to be more cooperative with strangers than with family.

I also notice that, when asked, how they are, at dialysis, elderly patients tend to say they are OK when it is obviously not the case, modern nurse training does not appear to teach nurses this, nurses who were trained the old way, (on the job) learned how to, 'read' a patient.

Best wishes to you both.
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Re: Decline in eating and drinking

Postby Henriettab » Sat Sep 30, 2017 5:01 pm

Thanks :)
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