Nurse I'm starving hungry

Nurse Ratched, RN · Apr 12, 2005

Is she diabetic? Grossly overweight? (A couple of extra pounds on an older person ain't a bad thing.) Has other staff given a good reason *not* to feed her as much as she wants?

barefootlady, ADN, RN · Apr 12, 2005

Your concern is to be commended. I have no advice to give except, if she eats, does not get sick afterwards, and then rests, she must be hungry and feeding her is not wrong.

studious · Apr 12, 2005

Hi everyone,

Thankyou for your validation, this lovely lady(she never misses an opportunity to fly off the handle, and packs an amazing punch for someone that size, never misses either, I adore her tenacity for life) is not overweight, in fact she is tiny in stature and very very thin. She does not have diabetes, and lies in her bed all day every day (special mattress, no pressure sores or red areas either). I just hate the fact that I know she's hungry, and people automatically see it as a sign of her dementia. Surely if I was feeding her more than she could handle she would be sick??? If it was down to her dementia, would she still not be losing weight instead of actually gaining since our team started working in that ward??????? And surely she would not be able to tell me when she has had enough to eat if her dementia was that far gone?????? I am going to refer her to the dietician, and speak with the Consultant in our unit. I have been a Staff Nurse in Care of the Elderly a long time, and have always tailored my form of care to suit the individual client. It never ceases to amaze me that in this day and age, there is still a lot of institutionalised beliefs. Sorry, I tend to get a bit gungho when it comes to caring for elderly patients, and I'm probably going on a bit. I'm going to go for now so hopefully speak with you all soon.

Nurse Ratched, RN · Apr 12, 2005

Is there any chance of a medical reason for her hunger? If she eats and eats and is still thin, I mean. Tumor of some sort? (No tapeworm, I presume .) If she's healthy, and not missing good nutritious foods by snacking (and who cares if she is - she's probably in her 80's - if she wants to eat candy 24/7 I'm kinda of the opinion she should be allowed to...) then let her eat whatever. It's probable the other staff are just finding it inconvenient. Sounds like a good thing to address in her care plan.

studious · Apr 12, 2005

No, there isn't any obvious signs of tapeworm :) or tumour, in fact her only medical history consists of a cva, she can only eat lying down on her side, due to contractures of the legs, she is in much pain if we try to sit her upright, then she won't eat. She has manged to live like this for over two years. She came to us over three years ago, a very large lady, who has always had a good appetite(when she wasn't throwing it at the nurses). She manages a pureed diet, as lumps can make her choke. I feel the same way as you, in that it may be laziness of staff, as it can take some time to feed this lady. If she were still losing weight instead of gaining it, I would be inclined to agree with the diagnosis of dementia rendering her unable to remember when she last ate, but she knows what she had for supper last evening, and knows when she has had enough(she tells you in no uncertain terms to get that stinky stuff away from her). It's a worry, but I will find a way to get the message across. Thank you for your input.

Doris

Fiona59 · Apr 12, 2005

Study up on some of her meds. There are a few that are appetite stimulants (but this early in the morning, I can't think of them...)

studious · Apr 12, 2005

Thanks, already done that, she's only on paracetamol to help with her discomfort due to contractures. She only eats as much as she needs to, then she's sated, and rests for a while, the only difference is she likes to eat up to two plates of food as opposed to mrs. x who is sated after one plate. I prefer individualised care and am just concerned that her nutritional needs are only being met when certain nurses are on duty. As previously mentioned she is in fact starting to put weight on of late. It's a very dodgy one, as I don't want to upset anyone, I just want to get my point across without coming across as bossy or argumentative with my colleagues. I'm trying to be her advocate I suppose, but unfortunately we have some very strong personalities where I work. I'm not a strong person unfortunately, especially when I have no articles or anything to back myself up, hence the reason I think I will be involving the dietician and consultant in this one. I really do appreciate everyones input in this, thank you very much. I've just realised I've contradicted myself, I posted on another thread that of course you can walk out of your shift and not think about the place or the people. What am I doing????????

pediatriclpn · Apr 17, 2005

I would definitely get the dietician involved. Good luck, and great job worrying about her, even when you leave the building!

glascow · Apr 17, 2005

I definitely agree with a dietician consult. Sounds like perhaps the nurses on the other shifts aren't taking the time involved to feed this lady. Maybe a calorie count could be started to see how much she is actually taking in. Also, the other nurses should be documenting in their notes how much (%) of each meal, snack she eats, are they doing this?

Just to rule out any medical problems, a TSH might be helpful. Good luck!

punnit_square · Apr 17, 2005

Hi there everyone,
I need some help here. We have a patient with dementia who is forever saying she is starving hungry. When I am on duty and she wants to eat I will give her as much as she would like. However, some factions believe that this is her dementia talking therefore is only entitled to a plateful of food and a pudding just like everyone else. This lady states when she has had enough, has told me not to stop feeding her as she will starve to death, and does not want to die. She also knows my name, even after a period when I was off work for several months, she knew my name straight away when I resumed duty. I have tried to look for articles on dementia and nutrition in order to back myself up. Am I wrong to assist an individual who quite obviously wants to eat? She never vomits afterwards, is on a pureed diet, knocks several lumps out of me during her meals, but always enjoys them anyway. I would dearly love anyone to give me advice, or direct me to a website that can give me articles on this subject, as it is dragging me down

When you are at the end of your years, you should have whatever you want. If the woman wants to eat nonstop, than she should. Hunger, like pain, is subjective. We are not in her body to know if she is hungry. I am sure if she says she is hungry, then she is feeling hunger pangs. It is her money paying everyone's salary.

leslie :-D · Apr 17, 2005

has she had any recent tsh levels lately?

leslie