Dining and Dementia- Making the Most of Mealtimes
By Mara Botonis, Ft Meyers, Florida
Author of “When Caring Takes Courage”
Changes in appetite are a common occurrence in those with
Alzheimer’s/dementia for a variety of reasons. For example,
mealtimes can be an over stimulating experience for person’s
with Alzheimer’s/dementia, your loved one may not recognize
that the items on their plate are edible, they may have difficulty
with the senses of taste and smell that many of us rely on to
make dining more enjoyable. Your loved one may have other
physical factors negatively impacting their appetite also, such
as lack of physical exercise, adverse reactions to medications or
even potential dental problems. Making a few easy
adjustments may help you meet your loved one’s nutritional
needs more successfully and may help decrease the risk of
malnutrition and/or dehydration.
Always provide adequate supervision. Your loved one may
have difficulty swallowing, may forget to chew their bites
enough before attempting to swallow or forget to take in
enough fluid during meals. All of these can lead to an increase
risk for choking. Stay close by when your loved one is eating.
Check your loved one’s mouth for any areas that appear sore.
Make note of any dental discomfort, difficulty with dentures or
struggles with swallowing then report these to your dentist and
physician.
Contact your loved one’s primary care physician and let them
know about their decreased appetite. Be sure to have ready a
list of all current medication and any vitamin supplements that
your loved one is taking for the doctor to review.
Track intake and changes in weight and/or appetite weekly if
you suspect significant changes in weight. Communicate any
weight changes of over 5 pounds per month to your family
physician.
Don’t ask your loved one if they are hungry. They may not
remember when the last time was that they ate, that the
stomachache they are feeling is actually hunger or that their
dry mouth indicates thirst. Simply serve your loved one a small
portion of favorite foods and beverages several times
throughout the day.
Work to pack as much nutrition as possible into the foods that
your loved one is eating. Consuming smaller amounts means
that you’ll need to be thoughtful in ensuring the calories they
do consume are as nutritious as possible. Keep in mind that
they still need a balanced diet. Consult your family physician
for any caloric guidelines and goals for daily intake of fresh
fruits and vegetables, lean proteins, whole grains and low fat
dairy. Try to limit excess sugar, gluten, grains, salt and fats
which are not only showing to be unhealthful, but also may
exacerbate certain behaviors associated with
Alzheimer’s/dementia.
Use contrasting linens and dishes: Changes in depth and visual
perception are also a part of the disease process that can make
“seeing” food on the plate difficult. Minimize busy patterns
and instead opt for a solid colored plate with a contrasting
colored place mat to help food items stand out.
Finger foods: Decreases in attention span and ability to sit still
for long periods of time may prevent your loved one from
staying at the table long enough to get adequate nutritional
intake. Try serving finger sandwiches, fruit and veggie slices,
cheese and crackers, and other foods that can be consumed
away from the table, “on the go” and without having to use
silverware.
Offer fluids frequently: To decrease the risk of dehydration
offer water, juices and higher water content snacks like fruit,
popsicles and Jell-O to supplement water consumption. Clear
liquid can be difficult to see in a clear glass, so adding orange or
lemon slices can make it easier for your loved one to identify
water in their cup and make it look more appealing.
Prepare the plate: Before serving your loved one, take care to
cut up meats and larger food items and add any condiments
(spices, gravies or sauces) that your loved one enjoys.
Eliminate the need for them to perform multiple, sequential
steps to consume their meal.
Use adaptive equipment. Consider using scooped plates with
higher rims around the perimeter and sectioned plates or bowls
to make it easier to get the food out. Large-handled silverware,
“Sippy” cups with lids and foods served in edible containers
(pita’s, cones, and sandwiches) that can go with your loved one
and be consumed on the move are another helpful option for
those who can no longer use silverware.
Create a routine: Try to offer meals around the same time each
day, in the same place and join your loved one at the table.
Meal times can be more successful when they are also a social
experience and joining with your loved one in partaking of a
small meal or a snack can encourage them to eat. Your loved
one may also eat more by “mirroring” you as you offer them
visual cues or demonstrate eating yourself.
Decrease the distractions: Mealtimes can be stimulating
enough with all of the sights, sounds, smells, tastes and
textures to experience. Be mindful of noise levels and impact
of additional stimulation from other people, pets, or media
such as television or certain kinds of music. Try to create a
quiet, relaxing environment for mealtimes.
Allow twice as much time for meals and then double that. If
you know that you have an early morning doctor’s appointment
tomorrow morning, make a quiche ahead of time that you can
just reheat quickly or put together a yogurt and fruit parfait the
night before. Spend less time making the breakfast so your
loved one has more time to eat it making things less hectic for
you both. Make mealtime an enjoyable experience.
Keep abreast of new studies being conducted that are
researching the impact diet and nutrition choices have on
overall symptoms, brain health and behavior for persons living
with Alzheimer’s/dementia.
Learn more simple solutions for common caregiver challenges
in Mara’s new book, “When Caring Takes Courage: A
Compassionate, Interactive Guide for Alzheimer’s and
Dementia Caregivers” or visit her page on Facebook: Biography
Based Care.