Alzheimer's and dementia patients often eat less, and have difficulty eating, because of problems like chewing, swallowing or digesting food.
Alzheimer's Reading Room
Alzheimer's and dementia patients sometimes lose interest in eating. This can happen for a long list of reasons including loss of taste, the ability to smell, memory loss, and thinking they already ate.
Medications can also effect appetite, and can increase constipation.
When a person has Alzheimer's disease or a related dementia, these problems can become more pronounced, and often effect mood, behavior, and physical functioning.
All of these problems are caused by changes in the brain and effect eating as the disease progresses.
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By Bob DeMarco
Alzheimer's Reading Room
As Alzheimer's or dementia progresses getting a patient to eat a nutritious meal, or to eat enough, can become a problem.
This can cause the dementia caregiver to become frustrated, confused, and even angry. It can also bring on feelings of sadness and hopelessness.
1. The First Question I Always Ask is - What Color are Your Plates?
In a study conducted at Boston University researchers found that patients eating from red plates consumed 25 percent more food than those eating from white plates.
Go here to learn more.
Before you go, let me ask you this simple question? Are you sure an Alzheimer's patient can see the food on the plate? Meaning, see it is a way that you and I do, and then eat it.
2. Make eye contact while eating.
Sit directly in front of your loved one living with dementia and make eye contact
Smile and wait for them to smile back at you.
Then start eating without talking (you start eating). Keep quiet.
Be patient, very very patient, keep making eye contact, and wait for them to follow your lead.
Be patient are the key words here. You might have to do this for a while before it starts working. Remember, you are trying to break a bad pattern and replace with a good pattern.
3. Did I Say Keep Your Mouth Shut?
Trying to convince a person living with Alzheimer's, if they are at the point of not eating, that they must eat is counterproductive to your effort.
Trying to explain why they need to eat is counter productive.
The proper mind set here is learning to be a guide. A good guide makes eye contact and smiles.
A good guide demonstrates how to eat each and every time (like it is the first time, every time). The good guide does this with a smile on their face.
Here are some additional eating tips for dementia patients.
1. Utensils. At some point your patient might have problems using forks, knives, spoons, etc. If so, consider trying finger food. Chicken strips, fish stick, hamburgers, and even shrimp fall into this category.
2. Make eye contact while eating. If possible sit directly in front of your dementia patient and make eye contact with them and smile before you start eating. Then start eating without talking. Hopefully they will follow your lead. Be patient you might have to do this for a while before it starts working. Get the smile back.
3. Arrange the food on the plate. If the patient is having trouble eating, try less food (portion size), and less items. One or two food choices. In addition, if there is one food your patient really likes, put that on the plate and another food right next to it.
In our case my mother loved mashed potatoes. So, I placed the dish in a away so the mashed potatoes where on the right (as she looked at the plate), and the cut meat (steak, chicken, pork chop, etc) where on the left. My mother ate left handed and this is why I put the mashed potato on the right.
I also cut the meat or fish in very small pieces. She had to go over the meat to get to the potatoes with her fork, so my thought was she had to see the meat.
4. Praise the food. It is best to get in the habit of eating right along with your loved one. If you are going to talk, praise the food. Not a long explanation, a simple explanation - yum, this is delicious. Good positive reinforcement can be helpful. You might praise your patient for eating also.
5. Create a Positive Atmosphere before you eat. Don't just plop the food down in front of your loved one. Create a positive atmosphere. For example, while I had Dotty sitting at the kitchen table, and while I was preparing the meal, I would start singing one of Dotty's favorite songs, like Shine on Harvest Moon. Or, I would just make up some song to get her attention and get her to interact with me. Singing always put Dotty in a good mood.
6. Shut up. Once Dotty started eating I would usually shut up. This was so she wouldn't get distracted from the food. Alzheimer's patients are easily distracted, and can get confused if you try and get them to - multitask. One task at a time.
7. Eat small all day long. I know our friends in Australia and New Zealand will get a kick out of this one. I would give Dotty six potato chips at a time. If you can get your loved one to eat a small amount, several times during the day, that might help.
8. How important is nutrition? It is important for certain. However, you have to realistic. For example, ice cream usually works very well. It is a source of liquid. You might have to resort to using Boost or Ensure to supplement meals. I did that in the latter stages. About 3-4 ounces at most, at one time. Think this way. One piece of broccoli or spinach is better than nothing. So think small all day long.
9. Ask yourself some questions. What did your Alzheimer's patient like to eat best in the past? Not what you like or think is best, what did they like? Dotty would eat linguine with white clam sauce with reckless abandon every time. She loved it. She also like pork chops, and mashed potatoes. I ate more pork chops and mashed potatoes while I was caring for Dotty than I had in the previous 30 years.
10. Eating is a problem. About 40 percent of Alzheimer's patients start losing an unhealthy amount of weight at some point. So, this is a common caregiver problem. You are not alone with this problem. Try not to get frustrated. Instead, think positive, smile when it is time to eat, and sing or play music.
11. Try to be flexible and patient. Patience means giving your loved one plenty of time to eat without chastising them or blaming them for not eating. They would eat if they could, so resist the temptation to get all stressed and negative.
12.Try this. How would you like to be treated if you were having problems eating through no fault of your own?
Alzheimer's patients move slowly, and they are usually on a different clock then we are. Get on their clock, slow down. Don't approach the problems that come along with dementia with dread. Instead, focus in on what a wonderful caregiver you can be.
13. Yes, you can be wonderful. Of this I have no doubt. One thing you will need to consider is if the person living with dementia is unable to eat -- they might find it difficult, painful, or impossible to swallow. You should discuss this issue with a qualified specialist. Specialist means a person or doctor that actually deals with this problem - all the time.
Hopefully, by guiding rather than cajoling you might get a patient to eat just enough.
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Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). Bob is a writer, speaker, and influencer in the Alzheimer's and Dementia Community worldwide.
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