When is an issue, not an issue? With Dementia eating issues!
I wasn’t sure what title to give this area. My mum may have unique challenges in this area. She was an independent character, and still is. I have read a lot on forums from those finding eating an issue. And good experienced dementia carers advise this approach. I,ve had to adapt little tricks and techniques to meet these.
The key to the approach is not to make eating an issue. Not to be direct. Do not try and reason. Or use dialogue such as if she doesn’t eat, she may get ill, too thin, or even die. ( believe me some well meaning carers or desperate relatives can say this). This scares and sends her into trauma. She can’t remember why someone said she may die, just that they did. And this fear stays with her.
The more I encourage her to eat directly, the more she resists. She will push the plate away and get angry. She was a capable independent woman, all her life and now she’s been told to eat by her children or young carers, she doesn’t even know. This is how she sees it, and she digs her heels in and refuses. ( fair enough, its demeaning). However if you leave her to it, without an obvious appetite, or understanding the need to eat to stay well, she forgets and frequently doesn’t. She may nibble on a few biscuits and drink a bit, but thats it. Her weight quickly plummets.
After much trial and error, lots of mistakes ( on my part) arguments and resistance I’ve gradually found an approach, that is working. I,m not saying this always works instantly or even within 20-30 mins. Some days are easier than overs, but overtime it has increased, as the trust and sharing experience has become a pleasurable thing to do together. Lots of laughter and socialising is something she now associates with eating . A positive time not a nagging negative one.
Some dementia eating support encouragement ideas.
1: I approach it like a social visit. She’ll chat away about this & that ( anyone with dementia parents will know 😉 I’ll have a plate of snacks & food handy and couple of small spoons. Usually something sweet. Puddings, cakes, ice-cream, bisquits etc. It can take her 10 mins to feel relaxed with me. She may crumble about her day or be agitated before mellowing and enjoying my presence. So I don’t do anything re: food in this time. When she’s relaxed and happier, smiling, engaging, I will start to eat something myself. I will chat away, take a few mouthfuls and not offer her any. This can stimulate her interest in what I am doing. She will look over at bowl of food and its when this happens I know I can mention how lovely it is, and offer some to her to taste. Maybe while watching Emmerdale or Flog it, I’ll casually just pass her a spoonful of it. Sometimes she takes it first time and eats easily, other times she’ll push it away and it will take 3 or 4 attempts of offering spoon to her. But once she does have first spoonful, and likes it, its much easier to get her to eat a few more mouthfuls. But she quickly feels full .
2: When she says she’s had enough, even if only couple of spoonfuls. I Listen! I don’t try to encourage more. I’ve learnt to be patient, leave it a few minutes. She is taking longer to digest than someone younger. Easily feels full. Trying to pressure her ,the more you make it an issue , the more she feels “nagged” ” moaned at” as she puts it. I follow this process a few times over 1/2 hour or so. Chatting away, interacting, as if over dinner with her. Talking about this & that, listening. Even if you only get 6-7 mouthfuls, if very high calorie items will be ok.
3: As my mothers dementia progresses I found strong flavours & soft consistency ( Haagen das, who wouldn’t like). Things she can easily spoon herself stimulates her interest. Softened well, so I can hand her the pot and she manages alone. Cheesecake is also a great one for this. Well liquidated soups in beakers. Fortified with coconut cream or cream, and meat stock. Custards, yogurts, and mousses. I have tried puree food, but she struggles with digestion issues around this.
4: Drinks: I use see-through plastic beaker, much like hospital ones when she’s alone. However in company I try and present a lightweight cup, and only half full, as she feels self-conscious.The beaker helps so much for her to see and feel liquid. And avoids spillage.
5: Heat. If I present a drink and my mum feels the warmth of cup, it encourages her. She often says she loves her creamy hot chocolates when I hand her warm cup, and tries to smell it. However when the cup has cooled she loses interest. So reheating or making fresh cup helps her drink a lot more. Sensory, heat, smells etc and help enormously. If I place a warm bowl of food in her hands she can smell , again can help. Soup in a plastic see-through beaker, she can feel warmth and see color of. If I give her water she says nothing there. She can’t see the water in the cup and loses interest.
6: Constant snacks placed within range. I have narrowed these down to things that can be left out for longtime. Snacks that do not go stale or dry easily. High calorie and snacks she likes. Finding things to fit all requirements wasn’t easy. And can get boring for her, especially if mainly eating these, so try and mix it up a bit. But it does work. If she nibbles on couple of biscuits a day its an extra 200-300 calories.
7: Distractions: Make sure there is not too much stimulation or distractions around while eating. A familiar calm environment is better if they have trouble focusing for long . Lots of people and movement, can draw their attention away from the meal. Its worth trying different areas to see if it makes a difference to results.