Treating the Dementia Patient at Meal Time, Part 2
Here is another installment in dining strategies for people with dementia. I think the educated and motivated clinician can provide caregivers with many options to use in order to promote the patient's ability to dine as independently as possible, while maintaining and healthy nutritional status.
The patient eats too quickly or is always hungry.
- Keep healthy snacks available
- Give small amounts at one time and monitor in order to prevent the patient from eating too quickly or taking large bites.
- Cut food into small bites.
- Give smaller, more frequent meals.
- Offer water frequently.
- Monitor for weight gain.
- Encourage the patient to take part in activities or exercise.
Some general suggestions:
- Keep deserts out of sight for as long as you can!
- Encourage the patient to take a daily walk or have some other form of exercise.
- Give the patient familiar foods that he is used to eating.
- Ask familiar caregivers and staff to feed certain patients who need it.
- Give the patient the healthiest or most nutritious foods first.
- Don't worry if the patient is messy or eats with her fingers.
- Avoid "busy" patterned tablecloths, napkins, and placemats.
- Keep table decorations to a minimum, or remove them before the meal.
- Give the person her "main meal" (the one with the most calories) when she is most alert or cooperative.
- Allow the patient to eat favorite foods as often as he would like, when at all possible.
- Leave the patient for a few minutes if he seems to be becoming annoyed or irritated with cueing or assistance.
- Avoid pureed foods for as long as you can, unless lack of dentition or swallowing impairments indicate otherwise.
- Avoid rushing the patient, asking "Are you done?" frequently. Look for body language or other signs that the person is finished. Don't let staff take the tray away just because "it is time" or "lunch is over!"
In my final post on this subject, I'll discuss some ways for caregivers and families of patients with dementia to manage the physical act of chewing and swallowing.