I regard myself as a sensible person but, oh boy, have I been stupid. I’ve been interested in food for as long as I can remember. I cook. I read recipes. For a while in the 1980s I taught vegetarian cookery. I gobble books about eating and its effects. I know about nutrition and healthy eating. Yet, although I had vaguely noted that My Loved One is becoming seriously underweight (as he was in his teens and twenties) I hadn’t considered what I should be doing about it. Now that I’ve confronted it, my former lack of awareness is almost unbelievable.
Some background: I have struggled with my weight all my adult life and have long adapted my eating habits to keep calories low but plates full. This is nothing to do with “going on a diet”. It’s a permanent way of living. Thus cooking with very little fat or oil, bulking out every meal with vegetables (we became vegetarian in 1978) and always buying low fat versions of anything where there’s an option – cheese being an obvious example along with ready-mades such as pesto, curry sauces, salad dressings and so on. It also meant not buying or making cakes or puddings except on special occasions.
Well of course I didn’t cook two versions. I simply made what I regarded as a healthy meal and served it for us both. When he was well, I now realise, he was so used to this routine that he thought nothing of it and often simply had an extra course such as cheese and biscuits. He was fit, reasonably active and stayed the same weight for many years.
Then Ms Alzheimer’s arrived and his body began to disappear. All the medical professionals comment on it and express concern. They keep weighing him.
We have recently been visited twice at home by a very pleasant, congenial, practical speech therapist to whom we were referred because MLO has a persistent, worsening cough. Nasties, such as lung cancer, have been eliminated and the consensus now is that the cough – like his diminishing voice – relate to the weakening of his swallowing reflex which is an Alzheimer’s symptom. Anne, the speech therapist, wanted to observe MLO eating so that she could make practical suggestions which might ease the situation for him. Quite early in the conversation she observed that his clothes are very loose and asked about his weight.
The upshot is – not that she would have put it in these terms – is that I’ve been starving him for decades and now that he’s ill the effects are showing clearly. He’s unlikely, at this stage, to put weight on because, towards the end of life, as Shakespeare observed, “shrunk shank” is natural but in order to keep him as strong as he can be for as long as possible we must try to stop him losing any more.
Cue for a big rethink. My fridge now looks like something in a student-shared house. I have two plastic pots of grated cheese labelled with our names – mine’s low fat and his is full. There’s hummus in two versions. I have a bottle of top quality walnut oil which I drizzle over his pasta or rice at table. I put what Enid Blyton would have called “lashings of butter” on his toast. I give him best dairy ice cream, formerly an occasional treat, almost daily. I buy him those little individual steam sponge puddings you can do in the microwave. I encourage him to drink more fruit juice.
Anne also suggested that I make him food which slips down very easily on account of the swallowing problem. So now it’s very soft sandwiches with cream cheese (full fat, naturally) or gooey egg mayonnaise. And I dutifully cut the crusts off, feeling as though I’ve morphed into my pretentious maternal grandmother or an underling in the kitchen at Fortnum and Mason. It’s a pity he has never liked soup but the cut off crusts (I was brought up not to waste anything) work well as bread dippers for my daily low calorie lunchtime bowl. Biscuits are a “tough eat” too, I’m told, so I’ve been buying moist fruit cake and malt loaf for him – and although I’ve barely made a cake since my hungry sons left home I’m resolved to go back to baking provided I can resist the temptation to eat the results myself. I shall have to do as I always used to when the boys were small and make the sorts of cake I don’t much like.
It all feels very odd because it flies in the face of everything I’ve done for decades. And in a funny way it really isn’t all that healthy because he’s eating, for example, less fruit and fewer vegetables although he’s probably still consuming more than the average Brit. He’s certainly also having quite a lot of sugar, given his cake consumption, but I suppose it’s a question of balance. At this point preventing further weight loss matters more than fretting about the finer points of his diet. We have to deal with the present. There is, after all, precious little future to safeguard against.
I really ought – given the level of my engagement with food and healthy eating – to have worked all this out for myself and done something about it before now. I must be more blinkered than I thought. Too much else to think about too.
