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Focus on Geriatric and Adult Services

Treating the Dementia Patient at Meal Time, Part 1

Published October 25, 2012 9:18 AM by Jennifer Kay-Williams
 Many patients with dementia are described by family and caregivers as having decreased appetites or as having lost interest in meals. Many of these same patients will continue to eat sweets, snacks, or consume beverages, but will not sit for long enough to eat a meal, or will not eat with utensils. I observe all of my patients while eating, and dementia patients in particular, whether or not they have a diagnosis of or referral for dysphagia. Here are some of the broad areas of concern I see or hear about, and some ways that the SLP can address a patient's ability to participate in meals:

A patient does not pick up utensils.

  • Serve finger foods, such as sandwiches, chicken nuggets, large "chunky" vegetables, etc..
  • Cue the patient with hand-over-hand techniques, or by placing food on the utensil and handing it to her.
  • Offer soups with meals, if the patient continues to pick up cups. Try using cups with handles.
  • Don't make it a "big deal" if the patient eats some non-finger foods with his hands! Forget about table manners.

In the News

Home-Based Assessment Tool for Dementia

Georgia Tech researchers created a tool that allows adults to screen themselves for early signs of dementia.

The patient uses utensils, but "makes a mess."

Sometimes caregivers and family will describe this as "playing with food."

  • Give the patient a clothing protector (please don't call it a bib!) or a smock to wear. A large shirt that can get messy is fine to protect clothes as well.
  • Make sure that plates, bowls, and cups aren't sliding around on a tray or tipping over. Dycem or a damp dish towel can prevent slipping plates and bowls.
  • Keep lids on cups and use straws if the patient has no swallowing problems that contraindicate this.
  • Use large handled utensils to help the patient hold them.
  • Limit the number of dishes and utensils that are in front of the patient at one time, so there is less distraction and also less risk of accidental spills.
  • Use hand-over-hand cues as needed.

Because this is a lengthy subject, and one dear to my heart as a professional, I will continue this topic over two or three posts. Stay tuned!

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