Last week my column spoke to the value of routine and schedules as they apply when you are supporting an individual with dementia. This week I am going to share some additional information that might be of assistance as you and someone you care for travel the unforgiving journey that is dementia.
In the early stages of Alzheimer’s, your loved one might forget to eat or lose the skills needed to prepare proper meals. Call to remind him or her to eat or help with food preparation. If you make meals in advance, be sure to review how to unwrap and reheat them. You might also consider using a meal delivery service. In addition, your loved one’s sense of smell and taste might begin to diminish, which can affect interest in eating.
As Alzheimer’s progresses, your loved one might forget table manners and eat from others’ plates or out of serving bowls. Changes in the brain might cause him or her to lose impulse control and judgment and, in turn, eat anything in sight — including non-food items. During the later stages of the disease, difficulty swallowing is common.
Agitation and other signs and symptoms of Alzheimer’s can make it difficult to sit still long enough to eat a meal. Distractions at mealtime might make this even worse. To reduce distractions, turn off the TV, radio and telephone ringer. Put your cellphone on vibrate. You might also clear the table of any unnecessary items. If your loved one needs to pace, try cutting a sandwich into quarters and giving him or her a section while he or she walks.
Get visual and use white dishes to help your loved one distinguish the food from the plate. Similarly, use placemats of a contrasting color to help distinguish the plate from the table. Stick with solid colors, though. Patterned plates, bowls and linens might be confusing. To prevent slipping, apply suction cups to the bottom of plates or use placemats that have traction on both sides. Sometimes bowls are easier to use than plates. Likewise, spoons might be easier to handle than forks. The larger the spoon’s handle, the better. Try bendable straws or lidded cups for liquids.
If your loved one is overwhelmed by an entire plate of food, place one type of food at a time on the plate. You could also offer several small meals throughout the day, rather than three larger ones. Cut food into bite-sized portions. Finger foods are even easier — but avoid foods that can be tough to chew and swallow, such as nuts, popcorn and raw carrots.
Take your time and do not rush mealtimes. Remind your loved one to chew and swallow carefully, and allow him or her as much time as necessary. Encourage your loved one to follow your actions, such as holding a fork, drinking from a cup, or eating with your fingers. Seriously – we had fingers long before we had forks!
Ensuring good nutrition in Alzheimer’s can be a challenge, but it’s worthwhile. Good nutrition can help your loved one better cope — both physically and emotionally — with the challenges of Alzheimer’s and related dementias.