THE BLOG

Living With Alzheimer's: Why Caregivers Should Pay Attention to Mealtime

03/26/2015 05:32 pm ET | Updated May 26, 2015
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Food. It's something we all enjoy. But imagine that you can no longer recognize when you're feeling hungry or thirsty. What would it be like if you had just eaten a full meal, and then within a few minutes you were looking for food again because you forgot you just ate? Beyond appetite, how would you feel if you lost the ability to control your fork or no longer knew the purpose of a dining utensil?

While a person wouldn't experience all of these things during the early stages of memory loss, dementia is a progressive disease, making it likely for these symptoms to occur at some point. That's why, as a caregiver of someone who has been diagnosed with Alzheimer's or a related form of dementia, it's so important to take the time to understand what they are experiencing and respond with empathy. Here are five main tips to help make a successful and enjoyable mealtime experience for your loved one with memory loss:

1. Accommodate Personal Preferences
Those with memory loss find comfort and security in the familiar, so get to know personal favorites and serve their preferred foods. The Alzheimer's Association recommends offering foods that were enjoyed in the past, while keeping in mind that a person with dementia may suddenly develop new food preferences or reject foods they were previously fond of.

A best practice is to always offer two choices. If the person with memory loss is no longer able to respond to verbal offers or suggestions, take the time to actually show them the selections. In addition, the scent of coffee brewing or bread baking can be a wonderful, familiar cue which may help to stimulate appetite and meal participation.

Try to maintain their familiar routines, such as making sure they are seated at their favorite place at the table, offering a newspaper as the meal is being prepared, or softly playing some favorite music in the background. If she was accustomed to having a table setting that included several pieces of flatware and does not appear to be stressed by this, continue the practice. On the other hand, be prepared to spot if too many glasses and utensils are causing confusion, which could lead to feelings of being overwhelmed or frustrated.

The same thing applies when it comes to placing too much food on the plate. You might need to start with a couple items and add more throughout the meal. To promote as much independence as possible, use adult appropriate plates with high lips or edges that make it easier to get food onto a spoon or fork.

2. Preserve Dignity
Don't make the mistake of thinking a person with dementia no longer appreciates a fine dining experience. If your loved one always used a linen tablecloth or enjoyed having some fresh flowers on the table, continue to make their mealtime more aesthetically pleasing by upholding the practice. Carnations are a nice option because they are decorative and happen to be edible (safety first!). Additionally, remember it's also your approach that helps to set the stage for a successful and enjoyable meal. Take the time to greet and make good eye contact at their eye level. If assistance is needed during the meal, sit down with them rather than stand as you help. Spend time having the meal together, as this more social environment encourages people to eat.

To preserve dignity and avoid drawing attention to the fact that he or she needs additional assistance, cut food into bite sized pieces before bringing it to the table. If food tends to spill on clothing, it's much more dignified to place a large napkin over the front of someone's shirt and an additional one on their lap versus rely on a bib. Adults with memory loss should always be treated with dignity and respect.

3. Adapt the Environment
Remaining flexible and creative allows you to discover there are many ways to establish an environment that promotes a positive mealtime experience. First, let's discuss how to accommodate your loved one's change in vision. Along with the normal sight changes that accompany aging, damage to the brain in the form of plaques and tangles, which are hallmarks of Alzheimer's, can occur in the part of the brain responsible for transmitting visual information. Specific difficulties that have been reported include object and facial recognition, figure-background contrast discrimination and color perception, among others.

As a solution, placemats and tablecloths that contrast with the color of the plate can help your loved one with dementia more easily identify their food. Likewise, keep in mind the way that the food might contrast with the color of the plate. Take, for example, white mashed potatoes. If served on a white plate, this could present a challenging situation; instead, opt to serve them on a bright plate, to provide color differentiation.

At Sunrise Senior Living, we use solid, bright yellow dining ware because it resonates with most people in the senior population and the design is very adaptable to their needs. Among the benefits of using this type of tableware, whether at your own home or in the case of Sunrise communities, in our Reminiscence (memory care) neighborhoods, are:

  • Familiarity: It resembles the dishware that many seniors used or saw while growing up and has a bold, solid color with no distracting patterns. The yellow ones contrast well with most foods, making it easier to distinguish where the food ends and the dish begins.

  • Flexibility: Mugs are multipurpose and incredibly helpful for anyone with limited mobility or motor skills. Our two-handled soup bowls are convenient for those who have difficulty using a spoon. And the fact they can only hold six ounces makes them lighter to lift.
  • Enhanced Appetite: Research suggests that using dishes with primary colors stimulates one's appetite. According to a Boston University study, individuals with dementia eating from red plates consumed 25 percent more food than those eating from white plates.
  • Now that you've carefully considered the visual elements of your table setting, ensure that mealtime is free from environmental distractions. Turn down loud background noise from the television, confirm adequate lighting and, if your loved one tends to feel cold, offer a favorite sweater to support an overall comfortable dining experience.

    4. Promote Independence
    Even when memory begins to fade, much of a person's procedural memory remains. If you think your loved one is capable, encourage him or her to plan the menu, help with food preparation or set the table. These are familiar routines, and as long as he or she still obtains satisfaction in doing chores, it's important to continue to invite their help. Such efforts support your loved one's inner need to feel a sense of purpose. So, beyond these mealtime tips, consider other activities of daily living that may support this same idea, such as folding towels or helping you as you tend to the pets or work in the garden.

    5. Make Modifications
    As dining skills tend to decline with the progression of Alzheimer's, be prepared to make further modifications that will continue to preserve dignity and promote independence.

    We can adapt almost any type of meal to "finger food" for those who have difficulty using utensils. Try placing the foods in wraps, between two slices of bread, or even into an ice cream cone. For some ideas, consider the following bite sized foods:

    • Pita pockets
    • Wraps
    • Ice cream cones
    • Hard-boiled eggs
    • Fish sticks
    • Meatloaf cubes
    • Tater tots
    • Baby corn
    • French toast strips
    • Apple slices
    • Orange sections
    • Graham crackers
    • Tuna sandwiches

    If she needs assistance with eating, first try hand-over-hand support by placing your hand over or under hers to guide her through the process. After a couple of promptings, she may begin to take over the activity.

    For those no longer able to feed themselves, you can assist her directly, but continue to encourage her to hold her spoon, bread or another food item. I've observed that sometimes this encourages a person to continue to be independent by taking at least a few bites of the meal on their own.

    By creating opportunities for the person with memory loss to be independent, you will be providing your loved one with the best possible dining experience - something you can both be happy about. Bon Appétit!