John O'Connor

Are you in the market for an agonizingly slow, painful death? In that case, I can’t recommend small cell lung cancer strongly enough.

It sure did the trick for my mother, not that she was looking for a miserable endgame. In addition to stealing her ability to breathe, walk and otherwise live normally, it also helped scrape more than 60 pounds off a body frame that could ill-afford the loss.

It was while she was trying to stay above the 100-pound mark (unsuccessfully), that she first encountered dietary supplements. It’s fair to say they left a bad taste in her mouth in more ways than one. Her primary complaint was that the taste of these supplements compared unfavorably to, shall we say, fecal matter.

I’m reminded of her experience whenever I see supplements in nursing homes and other senior living settings. It’s not hard to see why they have become so common. Weight loss is certainly a serious problem among the elderly. But feeding residents a nutrition supplement drink instead of meals hardly ensures adequate nutrition, much less a pleasurable dining experience.

In recently released Choosing Wisely recommendations, the American Geriatrics Society noted that geriatricians should avoid “using prescription appetite stimulants or high-calorie supplements for treatment of anorexia or cachexia.”

At the organization’s mid-May meeting in Orlando, Paul Mulhausen — who led the Choosing Wisely work group — was less ambiguous. He said that the main ingredients in these drinks are water and sugar. Rather than calling them supplements, he referred to them as “liquid candy bars with vitamins.”

So what’s to be done? Many experts insist that a far better option is to find ways to help residents eat actual food. A more palatable diet can help. So can providing a more social environment during meal times. And as any aide can tell you, many residents can use a little extra eating assistance.

Unfortunately, many operators find that it’s much less of a hassle to pop open a bottle of the old liquid candy bars instead. Yes, there may be times when no other option exists. But supplements should be served as a last resort.

In fact, you might find it helpful to try a glass of the stuff yourself. I’m guessing you’ll discover that Mom’s assessment wasn’t too far off.

John O’Connor is McKnight’s Editorial Director.