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Senior Nutrition with Seanna Marceaux, MS RDN

During Mom's earlier stages of living with Dementia, unbeknownst to our family, there were some obvious signs. At least now years later I can say they were obvious, but when I continue to reflect on how we as a society are missing the signs I understand now. Our culture driven by convenience has become conditioned to extreme sweets and salts. We go beyond the pleasure center of the brain when we feed the cravings we don't even realize we have on autopilot. Mom craved ice cream so often after craving fried porkchops, but what I can now see is a craving for normalcy, love, acceptance and many other natural human desires that went unfulfilled.

Although Mom was very passionate about philanthropy through teaching her middle school students, she struggled to adapt to the stressors that come with the environment most teachers experience. Over the years as she engaged with others or in activities less out of exhaustion from the weekly routines. By the time Mom retired from teaching, she gradually stayed home more and binged on junk food. Even though she had the financial means to eat healthy, Mom was not one to cook so simplicity in microwave meals changed to boxes of salty and sweet foods to match her cravings.

Managing stress is challenging when your body, more specifically your gut, convinces you that a Pepperoni pizza will make you feel better and even more blissful with a bowl of ice cream smothered in hard-shell chocolate. Just like we used to eat when we were younger. Remember how yummy and fun that was? Remember how happy that made you biting into the hard-shell?

That voice may sound familiar to you because it is what my body used to say just about every Friday. Growing up, our cheat days or nights off for the cook, a.k.a. Dad, was the Little Cesar's pizza night. My body remembers it very well. The night I ate eight slices of pieces washed down with two cream sodas. I don't know where I put it all back then because now it shows up in my core and thighs the next morning it seems. I believe that is where the problem began, and it's not all Little Cesar's fault either. It's not because I am aging and my body cannot handle it like it used to. Sure, aging is part of it, but the reality is the formulated program of stress = coping mechanisms or over indulgence of junk food.

As Mom aged with the mid-stages of Dementia her body experienced stress from life changes outside of the classroom. She was no longer grading papers, lesson planning, or corralling hormonal teenagers, but her body was still craving those kinds of foods she often ate on the fly for quick energy. Eventually, she acknowledged the side effects of aging but rather than do something differently nutritionally, she resided to the fact that we're all going to die someday so why not die happy. I agree with idea of what she intended to do by letting go of her youth but aging is a gift, not a curse. We can age gracefully without it turning into a make-up or local gym commercial.

I certainly see the gift months later more after she is no longer with us. She truly is in heaven feasting on all her favorites and more without a single concern of calories, weight gain, or treadmills. The stress that I experienced from her death, and adapting to life without her has caused me to focus more on healthy weight loss, avoiding dehydration, and balancing my gut. Losing an appetite for life placed me in familiar comfort stress eating patterns back from the corporate days that showed up in my last blood work. I wouldn't say I hit rock bottom but my hormones flat lined.

I convinced myself that it was because of perimenopause but it was more related to grieving because I paused on my proactive measures.

To say I was frustrated with the blood results is putting it lightly. I knew I wasn't eating enough, but instead of craving junk food I lost my appetite altogether. Snacking to get enough calories so I wouldn't fall over was not good. Barely drinking 40 ounces of water a day when I normally would drink double that on a slow day was not good. I was in a trance most days and functioning just enough. Of course, in the moments I had no clue or concern. I was just getting by one day at a time, waiting for this raw feeling to subside. It wasn't until I went over my results with my nutritionists that I snapped back to reality. My gosh! This is what Mom was doing for the last 10 years of her life.

Suddenly the flashes of what my relationship with food had been over the past four months made it clear how Mom lost her appetite for life. Over those declining years, Mom retired from all that gave her purpose and hope in life. Sometime just before retiring, Mom and Dad divorced after 37 years of marriage. With her being the independent, self-reliant proclaimed survivor Mom reached out to us for connection but did not want to seem needy and we could not fill the gaps for her emotional stability. So Mom tried to fill those gaps with food and Choco Vine Wine. I see it now because I can feel the attempts to fill my own gaps.

These are the Aha moments that reinforce my belief that Dementia is environmentally related to stress and lifestyle as I snap back to life. When Mom lost her purpose in life and tried to manage with a broken heart, the cravings took over. The foods she chose to eat did not provide her with the energy she needed and her desire to exercise outside slowly created the cognitive decline I watched over the years that made me feel helpless to make a difference. In reaction to her stress, I stressed over being enough for her to want to engage in life again.

Caregivers often do not see the subtle changes that make big differences. We see the behaviors that drive us mad and search for reasons to avoid engaging in the madness. We search for services or resources that will help us make sense out of what is happening to our loved ones. Many changes our loved ones are experiencing are related to life transitioning moments and many are reactions to poor adaption. By the time we should be seeing the early signs of Dementia, we have normalized their ups and downs to various reasons when most of it points to how our body process the food we give it.

After Mom's divorce she lived alone, but had something outside of the home that kept her involved in a form of community through her job. Once she made the decision to retire, letting go of her life long career of 32 years turned into more depression than she had learned to function with before. Rather than travel the world or take up several hobbies, she tried to cope with grieving the loss of life as she once knew it with a lonely, depressed, and cognitively challenged mind and broken-heart.

Once her days became naps with insomniac nights, Mom no longer felt there was a point to walk the dog. She slowly stopped managing her personal hygiene, oral health, and gave into a growing appetite for sweets. No physical activity other than a short walk to the kitchen eventually became a nest on the couch surrounded by food boxes and cellophane wrappers. Each time I tried to encourage different habits I quickly discovered why change would not go well for her. Without a desire to live beyond existing, without purpose beyond binging episodes of Everyone Loves Raymond, without an understanding of the need to maintain personal hygiene - changing her diet would not create much change.

I snapped out of my grieving spiral because I know the path that Mom walked for many years. She modeled what not to do or what reacting to life without a support network looks like. I have a support network and I still have to fight the darkness, push back the cravings, and encourage a desire to be adventurous. Getting out of my comfort zone takes courage and effort. Knowing that most of my battle begins with what I put into my body is helpful, but knowing specifically what my body structure needs is where my nutritionist is very important to my overall health.

The questions shared below are the subtle areas to be aware of when you care for your loved one. Whether they lived with you or you check in on them occasionally, keep these points in mind as food for thought in their nutritional habits.

1. What are they eating on a regular basis? How much variety of fruits and vegetables, if any?

Poor nutrition will contribute to low energy, muscle weakness (contributes to falls), and degrade our immune system. Bowel movements may become difficult causing issues with hemorrhoids and upset stomach that contribute to a loss in appetite without proper nutrition. Other challenges may occur from wounds not healing well creating risk of infection.

2. What are their views about eating healthy plant based foods? Do make/have meals regularly or just snack?

Food insecurities may occur when your loved one is struggling to manage diabetes, obesity, or cardio vascular disease but not have enough food in the household to manage properly. Fewer healthy nutrients will keep the body in a state of depletion that contributes to depression and cognitive decline. What this looks like is buying less variety and stocking specific food with shelf life but not eating as much to make it last longer. It may look like not having much in the pantry at all and no plant based foods because of cost. Frozen food may be purchased or provided but not cooked to save or used sparingly.

3. How often do they need to go to the store or are able to grocery shop or have groceries delivered?

Healthy nutrition not only promotes health and well-being, but will also provide an opportunity for social interaction. Older adults may fine reasons to stay home to save money on gas or time in commute, but what seems logical to them may also become a source of unintended isolation. The less they get out, even if it is to the store, the less interactions they have which worsens depression. Even when they say they are fine, put your eyes to the test and confirm what their idea of 'F.I.N.E' is because they might just be in Fear, Isolated, Neglected, or Energy-deprived.

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