Clinical inquiries. Should we use appetite stimulants for malnourished elderly patients?

Good advice for a common problem this question hits home for me. I recently sat down with the husband, and main caregiver, of a woman with advanced dementia. the woman eats very little and is losing weight despite her husband’s great efforts at encouraging her to eat. under the care of another physician, she had been given megestrol acetate and there had been some improvement. Her visit to my office was an opportunity to continue an ongoing conversation with her husband about his wife’s overall decline, her advancing dementia, and the sorrow he was feeling over her failing health. Should we use appetite stimulants in malnourished elderly patients? “probably not.” that is a good place to start to avoid harm to our most frail, declining, elderly patients for whom we care. that leaves open flexibility to patient, family, and caregiver preferences, but reminds us that the most important part of caring for these patients and their families is clear, compassionate communication regarding goals and expectations.