The Plate Comes Back Full: How to Tell Her Eating Has Slipped Before Anyone Else Notices

Eating drops off slowly in a house where one person does all the cooking, cleaning and watching. You stop noticing that the bowl comes back with half the soup still in it, because you are already on to the next job. The problem being solved here is noticing the drop early enough to say something useful to her doctor, and the way to notice it is to write it down for a short run of days.

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What the change usually looks like

The first signs are often small. She finishes the first course and skips the second. She stops asking for food between meals. Food that you put in front of her stays where it was, and you find it later. She needs more prompting to start eating, or she eats only when you sit beside her. Some people in her position eat faster than they should, while others stop chewing well. Watch for any of these, and note when they happen.

Keep a short log

On the day sheet, add a small row for meals with three boxes: ate most, ate some, ate little. Mark each meal as you clear the plate, and add a note if she needed prompting, left food in her mouth, coughed while eating or seemed to tire partway through. Keep it for enough days that a pattern can show, and keep it in the same place each time so you can read it at a glance.

Do not change the menu for the test. Let the log show what she eats on a normal week, because that is the record her doctor can use.

What to check on the plate

Look at the texture and the portion size. Some people find a smaller portion less overwhelming. Others eat more readily when the food is easy to hold and easy to chew. Try one change at a time and note what happens in the log. Do not force her to finish, and do not argue about it at the table. A calm meal with less on the plate is often better than a full plate she turns away from.

When to call the doctor's office

Call the same day if she coughs, chokes or gags while eating, if her mouth holds food for a long time, or if she seems unable to swallow comfortably. Call the doctor's office within the week if your log shows a clear drop over several meals in a row, and bring the log with you, marked with which meals she ate less of. You will be asked specific questions, and the log answers them better than memory can. For more on keeping a clear record of what you see, see Sources and dates checked.

Look after your own plate too

If you are skipping meals while you manage hers, log that on the same sheet. A caregiver who eats standing up at the sink is also at risk of a slow drop, and that drop is easier to miss because nobody is writing it down.