LOSING APPETITE “Sometimes people may have suffered from untreated depression all their lives from enduring traumas that were never effectively processed. When they were younger they may have had the internal resources to function effectively in life regardless; suddenly when they are older and don’t have the same inner resources they are hit hard with the depression.”

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henever an elderly person undergoes a change in behavior such as depression or refusing to eat the caregiver’s first step must be to bring them in for a medical evaluation to rule out any biological causes. Very often changes in mental status or activity level are caused by an infection (for example commonly a urinary tract infection). Since elderly people’s immune systems are not as robust as younger people’s the traditional signs of infection – fever inflammation redness pain and loss of function – often aren’t present and the only signs that can alert a caregiver to the illness are these subtle behavioral changes such as depression.  They can even be walking around with an undetected stroke or heart attack with the symptoms masked as lack of appetite indigestion and depression.

Another common medical cause for loss of appetite is an electrolyte imbalance due to dehydration.  At our clinic at Quality First Urgent Care which is equipped for a full-scale medical evaluation including lab tests and ultrasounds one of the first things we do is test for dehydration and electrolyte imbalances and correct any imbalance with on-the-spot intravenous fluids. Time and again we’ve witnessed the dramatic change that the infusion of fluids can cause.  Not just in the elderly; even young people brought into the emergency room for weakness and flu-like symptoms can perk up significantly from a simple infusion of intravenous injection fluids.

Another culprit of depression and lack of appetite may be incorrect dosages of medication. The senior may have gotten confused by a recent change in the prescribed dosage may be double dosing unintentionally or may be taking medications prescribed by different doctors that don’t mix well with each other.

Once all possible medical causes are ruled out our clinicians investigate for any psychological components. For example forgetting what foods he likes to eat or simply forgetting or refusing to eat altogether may indicate the early stages of dementia.  An important part of our evaluation process involves sending a social worker or nurse to the home where she can get a real picture of the situation. Sometimes especially if the elderly person lives alone what the child takes as a refusal to eat is in reality something quite different: the senior is too embarrassed to tell her daughter that she can’t go shopping on her own and so has no food or that she finds it difficult to turn on the stove or that she’s scared of walking through the dark house and tripping so she simply doesn’t enter the kitchen at night.

Once we get a thorough understanding of the causes for the refusal to eat we can begin to address them initiating a cascade of therapies that can literally save a person’s life.