to think my elderly dad needs to eat less?

[LouuLou]

I know this sounds harsh. 72 year old DF has already had a heart bypass and is now very immobile. He’s steadily getting bigger and bigger, and it’s reached the point where it’s affecting his care.

We can’t even weigh him anymore because we can’t get him onto scales. The carers are struggling to move him, bathe him and change him. When he fell recently, even two paramedics had difficulty getting him up and into a w
wheelchair.

I do understand that food is one of the few comforts he has left. I’m not blind to that, and I’m not trying to take away the only thing he enjoys. But at the same time, this is starting to feel unsafe and unsustainable for everyone involved, including him.

My brother does the online food shop and just buys whatever DF asks for, including things like fried chicken. I’ve tried to say maybe we should rein that in a bit, but he thinks DF should just have what he wants. The carers also tend to give him whatever he asks for.

So I feel like I’m the only one thinking long-term about his health and practical care and I end up sounding like the bad one.

AIBU to think we need to put some limits in place, even if he won’t like it?

How old is he? What's his prognosis?

I'd imagine it really depends how old he is? 65 yep cut back, 95 leave him be.

Not that I think is 65 is elderly, hopefully saved by the edit.

He doesn't have a prognosis. I was told he could last for years like this because his body is not getting worn out because he is so sedentary.

How old is he? Is long term actually a realistic worry?

I think you should have a conversation with your DF about this, express concern, and perhaps explore ways he can do things other than eat. His life sounds boring, and some interests beyond food and discussing how you mught help him might work.

If he’s so big and heavy it’s affecting care … I don’t think you’re being unreasonable at all.

While your DF has capacity, he can eat what he wants. To not spend his money on what he wants, is financial abuse. You can speak to him, but if he wants to eat himself to death, nothing can stop him.

Problem is it sounds like what he eats is one of the few things he has control over so I don’t know if taking that away will do anything to help.

He has to be motivated to make changes himself. He may think it’s not worth it for the difference it will make

If he's an adult with capacity, you cannot unilaterally restrict his food without his agreement. Is he paying the food bill? He could refuse to pay for anything he didn't ask for and doesn't want.

Adults are allowed to make choices other people might not agree with.

Does he have regular check ups or appointments? You could ask whoever he sees to discuss it with him. But they won't be able to tell you about any conversations they have with him.

Have you talked to him about his weight?

If he has capacity, then it’s his choice what he does.

Eventually, if he gets too big to move manually then he will have to consider being hoisted from bed to chair etc. How would he feel if he lost his independence and potential dignity?

Yes he is paying the food bill. He pays for the bigger clothes I need to keep buying for him also. One of the carers has already hurt her back when trying to move him but yes he has capacity. He can make any choices he wants - it is affecting other people negatively though.

I regularly go walking with a guy in his 70s who's had bypass surgery - he's very mobile, and full of vigour. Sounds like your dad has sort of given up, which is a pity. Good luck, hope he can get motivated to live a healthier life.

I have spoken to him. He insists he doesn't each much.

He is already moved by hoists. He already has no independence. He is immobile. I see the carers really struggling to move him even with the hoist.

What medications is he on?

weight gain in this kind of situation is often more about the medical condition and meds rather than eating food.

This is really hard. If your DF has capacity then absolutely your brother should be ordering what he is asking for. You could try taking g him some healthier meals, preparing lower cal snacks and taking them round, raising your concerns but ultimately if he has capacity he has the right to choose for himself

Apart from his bypass does he have other health problems, is he immobile because of his weight. The carers have to carry out a mobility, skin, hygiene, falls, lifting and handling assessment. Does he have a bariatric hospital style bed with a pressure mattress, commode, hoist, wheelchair. He needs a up to date therapy assessment. Its difficult for him if hes bored, housebound and food is all he has.. being immobile has it's own dangers so ignore whoever told you he can last for years. The risk, especially when he has a heart issue ars blood clots, pneumonia, urind infection, i skin breakdown, pressure sores.

Harsh though this sound, a bypass operation doesn't automatically mean he's in a wheelchair

Does he have any other issues?

Bypass surgery is meant to give a better quality of life, not allow you to keep eating yourself into the grave

Are the GP and Cariology Team aware of the situation?

Can a home visit be arranged by a GP to assess his mental state?

The carers need to speak to their manager and arrange a new assessment, they can also keep a food chart, he's not able to prepare food himself so it's easy to monitor it. I agree it may be his medical issue though.

Certainly talk to him. And I would talk to your brother too. Knowingly providing your father poor choices of food that are affecting his health could be considered a form of abuse. The carers too need talking to.
I understand it may be what he wants. And changing things may take time.
Some food delivery companies do nutritionally balanced meals. Freezable, no contract needed. Just select from a catalogue.
I would also, write a letter to his doctor to express your concerns. When was the last time a GP saw him even?

An unwise choice isn’t a reflection of a lack of capacity. Just leave him be.

I think the argument that he is an adult and can do what he wants only works as long as he can take care of himself. Once he starts relying on others then he can't just do what he likes anymore. I think you're right to step in OP and step back if he won't accept help.

He needs another assessment then, hoists are made for all shapes and sizes. Some are fixed onto the ceiling.

Does he have a bariatric bed?

Actually not buying him food he wants is abuse, he has capacity and funds so it’s his choice.

True but self neglect is also a concern

What a sad situation. But he knows he's very overweight, he knows he's immobile because of it, he knows it's only going to get worse. It's his choice what he eats (although noone would truly choose that life for themselves, weight is a difficult issue often created by mental/emotional issues). People can get to a point where losing weight feels impossible so they might as well enjoy their food.

'Nagging' does not help. Would he see a dietician arranged by the GP. A very positive approach focusing on how he could regain mobility and start enjoying activities he used to do might work better than doom and gloom about the future. If he's always been a couch potato though there's probably not much to motivate him unfortunately, and you may need to go back to the warnings. Having to be moved into a nursing home when care at home becomes Impossible etc.

He may not be eating a huge amount, it's the lack of activity and type of food that's the problem. A Physiotherapist can help with exercises he can do in bed. Dietician re the food. Maybe he also needs a Physiologist to help with the mental health/emotional causes. Does he really understand/believe the bypass meant continuing normal life, not 'protecting' himself by cutting his life back?