hey techie, i'm 46, i've had a tube in me for two years, going on three. i use a liqued called Two-Cal HN. it has 475 calories per 8 oz can. i get it from apria healthcare. it starts out as a liqued, then hardens. i know this by spilling some. if you get a drop or two on your jeans, ten minutes later, it's hard. i have two cans per serving.when all this cancer set in (larnyx) i dropped down to 102 pounds. almost three years later i'm 165 pounds,(soaking wet).good luck God bless you and grandma. upstatesteve