There’s Nothing Like a Good Bowel Movement

There are 3 questions that I always ask my patients. They are about “E, S, B&M”: How well are you eating? How well are you sleeping? How are your bowel movements? These are questions that patients are glad I ask. They show that I care about life’s most basic needs. It’s a doctor’s more specific way of asking “how are you doing?” ESBM are important in childhood, adult life and as people get older. The answers to these questions are “life” vital signs. Just like heart rate or respiratory rate, they give me clues about […]

“Wow! She really ate well!” 4 Things Caregivers Can Do to Improve an Older Person’s Appetite

I have a dear friend who is incredibly accomplished and independent. I’ve always loved visiting with and hearing about her adventures — including sailing around the world on a sailboat when she was well into her 70s! But on a recent visit, I became concerned. Now 93, my friend was sleeping much of the day. She’d had some falls and was unable to reach her walker on the other side of the room. Most concerning, she’d lost weight. When I checked her kitchen, she had very little food. The leftovers in her fridge were clearly […]

Loss of Appetite: A Fifth Vital Sign

My mother was discharged from the hospital yesterday. She was treated for a serious urine infection. Now she won’t eat. She says she’s not hungry. I’ve checked her vital signs. They all seem ok. Should I be worried? Yes, this is something to be concerned about. In previous posts we discussed the four classic vital signs. They are heart rate, blood pressure, temperature, and respiratory rate. However, normal vital signs do not tell the whole story. Appetite is an important “fifth vital sign” in frail older adults. If this patient doesn’t eat, she will become […]