Does your loved one have issues with food, eating or mealtime? There are a number of things you can do to make mealtimes easier.

Here at DAWN, we always first consider our clients’ underlying emotional needs. Any behavioral problem can result from feeling disempowered, embarrassed, confused, or at risk, so empathetically watching your loved one or client and then addressing the emotional need prompting the behavior is always the first step. Once you’ve ruled out emotional needs, here are a few additional things you can watch for.

Failure to recognize hunger. People experiencing dementia can lose the ability to either feel hunger or to interpret and understand what to do about the feeling. Inviting a loved one or client to eat with you because you feel hungry will be more successful than asking them to eat food alone because they need to eat. We always eat with our clients. It’s unnatural and awkward to sit and eat when another person stands by. In addition, ask them to sample tidbits for you as you’re preparing food to help you decide how much salt to use or whether something is hot enough – anything you can think of. Both approaches appeal to the need for companionship and allow the person with dementia to help the caregiver, which is a welcome change from always being the needy person.

Too much on the plate. Use a brightly colored plate and don’t overload it. Carefully separate small servings of each item, so that the plate is visible between each item. I’ve often had clients refuse to eat from a loaded plate, saying they couldn’t possibly eat that much. Scarcity seems to enhance appeal.

Vision problems. Be sure to have your loved one’s eyes checked for issues such as cataracts or macular degeneration. However, sometimes even though a person’s vision is not impaired, the brain fails to interpret the information being sent by the optic nerve. We find that when someone seems unresponsive to what is in front of them, pointing to the item or moving the item will sometimes make it seeable.

Utensil problems. We should expect our loved ones and clients to eventually forget what eating utensils are and how to use them. Model use of the fork, spoon, or knife. When modeling stops being helpful, begin presenting foods in mouthful-sized pieces that can be eaten with the fingers. While eating together, chatter about what you are eating and how good it tastes.  

Too much commotion. As people progress deeper into dementia, it becomes more difficult for them to interpret sensory stimulation. This means that when there is background music or television, several people talking at once, or lots of coming and going from the table, the person with dementia will be less able to focus on eating. Try to gauge your loved one or client’s ability to handle stimuli and modify the environment to meet their current level of functioning.

Hydrate! The symptoms of dehydration can mimic dementia. Look for ways to get liquids into your loved one or client’s routine. Find something they like to drink. Poor nutrition, low blood sugar, and dehydration all make people physically uncomfortable, and physical discomfort is expressed in behaviors.

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