Hello,

New here, excuse me if this is some super-rehashed topic.

My grandmother is bed-ridden, and has difficulty chewing, and not much of an appetite. She lost a lot of weight recently, and because of that she developed a pressure sore in the lower back region.

I researched the net, and a good way to help the person get better is to provide 1.5g protein/kg of body weight, at least 35 calories/kg of body weight and 1 ml/kcal of food. In the case of my grandmother, that's around 1800 calories, and 60-80g protein and over 2 liters of liquid. She was not getting any of those.

I bought this protein shake that's 40g protein per portion, and I mix it with full fat milk and I add a spoon of peanut butter. After adding this to her food, for just 2 days, and she got colour back in her cheeks, she's more present, and she speaks more.

The brand I use now is - Pro nutrition Milk&Egg protein powder. It doesn't have any other stuff in it (didn't want to risk her not being able to digest the stuff).

Any other recommendations?

Keep in mind I'm in Eastern Europe, so I have very few options here (no Ensure shakes, no Calogen) what I can order is off ebay.co.uk.

Thank you

Welcome, Suz! In most areas, protein powder (whey & eggs as the protein sources are preferred over soy or wheat) is available and can be added to nearly ANY food, especially mushy stuff. While milkshakes are great, lots of elderly people do not like to drink cold stuff or milk, so you can try warming a chocolate protein shake and passing it off to your gramma as hot chocolate, or spiking her coffee or tea with it. It can be added to puddings, jello, fruit juice, ice cream, yogurt, soups, mashed potatoes, etc.

Protein is arguably the most essential nutrient for elderly patients, particularly those who are bedridden. It takes protein to heal wounds and prevent future breakdowns. Her doc may order a test called "prealbumin k" which is a measure of her protein levels. As people age, this can decline and an extremely low value is a prognosticator of poor patient outcome. Do your best to keep this up so long as her kidney functions can tolerate the extra protein.

Be sure that she is turned or shifts her position every 2 hours to prevent pressure sores and future breakdowns. Extra hydration is needed to keep her skin in good health and to heal her wound.

Realize that, again, as people age and especially bedridden patients, they lose the ability to absorb nutrients. If there is any way possible, get your gramma out of the bed and into a chair so that she can keep better muscle tone and control of her sitting balance. It also helps with bowel functions, etc. People were never designed to "lay up" and being bedridden opens up a whole world of troublesome issues! You did not say why she's bedridden, but if there is no physical cause, try to keep her moving!! "Move it or lose it" is more than just a saying - it's a law of life!

Good luck, dear and MANY BLESSINGS to you for all that you do for your gramma!

Suzushii, Welcome to ECO. We ( I am in the USA, but I should just speak for myself) do take a lot for granted here about the availability of so much. It sounds like you are doing a great job of it so far.

What fresh fruits are available? They can be blended in drinks to add fiber and vary the taste while being a good source of natural sugers. With my Mom, her appetite fails when she is constipated so the fruit helps prevent that and her appetite is better. Plus, elders can lose the sense of taste (and thus their interest in food) but the taste of sweet seems to stick with them.

What are her other problems? Can she eat mashed vegetables (like potatos). You might try baby foods, either available in the store or home made recipes, using a blender, food processer or a sieve after cooking until soft. Add appropriate amounts of suger or salt, considering whether she is diabetic or has high blood pressure, etc. The protein powder can usually be blended with them as well butter or olive oil for extra calories. Variety really does keep meals more interesting.

Now about the pressure sore... I agree that diet has a lot to do with it but are you repositioning her frequently. (The rule we try to follow is a position shift every 2 hours.) Use pillows to prop behind her back for support to help her stay on one side or the other.
Part 3 of pressure sores is to keep the skin as clean as possible, use a protective barrier protectant, like the diaper rash ointment, petrolium jelly, not sure what is available. We use A&D ointment or 40% zinc oxide paste.