For individuals with memory loss, mealtimes provide social engagement, sensory stimulation and enjoyment, and can add structure and routine to their day. However, mealtimes can also present some challenges for caregivers, especially as their loved ones' memory loss progresses. There are some ways that caregivers can improve the mealtime experience, subsequently promoting the well-being, dignity and success of their loved one with Alzheimer's disease or a related memory disorder.
1. Reduce Distractions During Mealtime
Lots of noise and activity at mealtimes can be very distracting, causing the person with memory loss to lose interest in eating their meal. Therefore, keep extraneous noise to a minimum. While it's nice to play their favorite type of music in the background, be sure it is their favorite music, not yours, and that it is not too loud or of a very fast tempo.
When assisting the person with memory loss during mealtime, only one person at a time should be talking to them. More than one voice can be distracting, and might even cause them to become more confused or agitated. In addition, keep in mind that placing too much food on a plate can be overwhelming to some, which can cause them to either play with it or ignore it. If they become easily confused, place fewer items of food on their plate or simply serve one food item at a time.
2. Observe Before You Intervene
Since the skills and abilities of a person with memory loss can change from day to day, it's very important that we assess how they are managing their dining on an ongoing basis. If an individual with memory loss can still manage their utensils, allow them as much independence as possible. For example, if you notice that they can still cut their food, don't cut it for them. This might cause them to lose that skill faster. By the same token, if you notice that they aren't eating the portions that are not cut, be sure to cut the food into bite-sized pieces. To maintain dignity, always cut food away from the table before you place the plate in front of the person. If you notice they are just picking at the food, don't automatically assume they are not hungry. It could mean that the person's brain is not making all the necessary connections to initiate the eating process. When this happens you can make a suggestion such as, "How about we place the bacon and eggs between those slices of toast?" which might make it easier for some to feed themselves.
3. Provide Verbal and Visual Cueing
Sometimes people with memory loss can be unsure or confused about the dining experience. This confusion may cause them to play with or pick at their food. To prevent this confusion and resulting behavior, be sure that you are seated at the table dining with them and offering them both visual and verbal guidance. As you raise the fork to your mouth with a pleasant tone of voice you might say, "The potatoes are delicious, you should try some, too." Your visual and verbal encouragement might prompt them to take a bite.
4. Offer Hand-Over-Hand Assistance
If you notice that a loved one can no longer manage utensils, don't immediately begin to feed that person. First try some hand-over-hand assistance by gently placing your hand over their hand which guides them to complete the activity. Care managers at Sunrise Senior Living are trained to use this adaptive technique, which often helps to initiate or "jump start" the person's ability to use the utensil independently. Even in cases when a loved one no longer has the ability to manage their utensils, which requires caregivers to feed them, you should still place their utensil or a finger food in their hand to ensure that they still have some control and independence. You might be surprised to see that they sometimes still take a few bites independently if they are just provided the opportunity!
5. Enable Them to "Walk and Eat"
For those who no longer like to sit during their meal, place finger foods in a bowl with non-spill edges or in a wide-mouthed cup, which enables them to carry their food and eat as they walk. You can also place almost any type of food between two slices of bread or in a pita pocket, or even a cone that is ordinarily used to hold ice cream. For those who don't always have the urge to drink liquids, you'll also want to be sure that you are providing them with adequate hydration by offering drinks, popsicles or gelatin throughout the day.
As you can see, there is a common thread in helping those with memory loss have an enjoyable and successful mealtime experience, which is to enable their independence as much and for as long as possible. Caregivers can achieve this through constant observation and reevaluation of their loved ones' needs, changing skill sets, health needs and menu preferences. Despite ongoing challenges, mealtimes can be yet another opportunity for caregivers and their loved ones to bond and succeed together.
To learn more about senior dining, visit a Taste of Sunrise event during the week of May 20 and savor delicacies from a rich assortment of menu choices design with senior's health, tastes and preferences in mind.
For more by Rita Altman, R.N., click here.
For more on caregiving, click here.
Follow Rita Altman, R.N. on Twitter: www.twitter.com/sunrisesrliving