Depression vs. appetite

A resident I will call Stan has lived here for more than two years. He is blind and does not use a cane. Some blind people prefer not to. Even without a cane, Stan is good at getting places on his own.

From what I have observed, I think depression brought him here. Stan has always spent most of his time in his room sleeping. When he first moved in, he was overweight and easily could have done without 50 to 70 pounds. His sister used to bring him fast food every weekend. I always wondered what they talked about.

Even with his sister’s visits, I wondered how Stan occupied his time. I was curious about whether he knew braille or even wanted to read or listen to audio books. I am sure that the social services director tried to get him interested in some pursuit.

Stan is relatively independent. He can walk, use the bathroom, feed himself and, with urging, take a shower. So he does not need much "hands-on" care. His weight has dropped considerably since he arrived, and he is now quite slim. His weigh loss was caused by what could be a harmful situation.

Stan does not want to take his medication. The nurses used to put his medicine in his food, but he caught on to that and would skip meals to avoid being medicated. At times, he goes several days without eating. With few fat reserves, he quickly gets dehydrated. Then he is off to the hospital to be encouraged to eat and take his medication.

An aide who works every other weekend asked where Stan was. When she was told he was in the hospital again, a pained look came over her face and she shrugged her shoulders.

“Matt,” another resident, said that when Stan was on the gurney being wheeled to the door to be transported to the hospital, he said, "Why can I just not eat?" Matt asked me what I thought about Stan’s question. I really did not know what to think.

I empathize with Stan's feelings about medication. I have taken antidepressants for 26 years and have dealt with weight gain, swelling, sleepiness, insomnia and irritability, along with other side effects. I take my medication because my doctors tell me to. Also, since I live in a nursing home, I think some medication helps me get through daily life here.

Like most of us, Stan probably does not want to live here. Unfortunately, he has not found any goal or distraction to motivate himself. I understand how difficult it must be for him, because I have been there.

Stan is by no means an old man, but he seems to be tired of life. Refusing to eat and take his medication is Stan's way of being in control.

I wonder whether there is a positive resolution to Stan's situation.

Topics: Clinical , Nutrition