Treating the Dementia Patient at Meal Time, Part 3
Dining strategies for people with dementia is a complicated topic, and no one strategy works for all. With a little patience, education, and creativity, many of the common challenges can be addressed in order to increase a patient's ability to participate in meals and consume an adequate amount of foods and liquids.
Here are some additional behaviors and challenges, and suggestions for addressing them:
The patient pays little or no attention to meals. This is often what frustrates families and caregivers the most! How often do you enter the dining room hear caregivers admonishing a patient with "You've got to eat! You haven't eaten anything! Finish your meal!"
- Keep meals and snacks on a regular schedule.
- Try finger foods.
- Use brightly colored dishware, such as red, to contrast with the food.
- Keep the dining environment calm and pleasant.
- Ask caregivers, families, and staff to talk to the patient during meals, NOT with each other.
- Make sure the patient is positioned comfortable and appropriately in a chair. Avoid meals in bed.
- Present on food and utensil at a time. Sometimes foods must be put in separate bowls or small dishes.
- Monitor the temperature of foods and liquids; don't let them get too cold, but keep milk and other cold beverages from getting warm.
- Tell the patient what meal they are having, and what is being served. Don't ask them to eat anything that they say they don't like, even if they have liked it in the past.
- Rotate dishes so the foods are directly in front of the patient; patients often don't notice foods and liquids that are out of their direct line of sight.
- Seat the patient in a consistent area.
- Allow the patient to leave and come back if she becomes very agitated. save some of the meal for later, or offer more frequent snacks.
The patient becomes very emotional, agitated, or even aggressive. Catastrophic reactions to transitions and stimulating environments are a hallmark of some stages of dementia, and can occur when the patient is taken to a dining room, or when a person with dementia dines out with family.
- Always tell the patient where you are going.
- Allow them to refuse to eat in a restaurant or dining room. Forcing them into a situation will only exacerbate the behaviors.
- Choose a calm environment in which to dine, and control the noise level and amount of activity in dining rooms.
- Limit the number of visitors and "helpers" during a meal.
- Avoid too many cues or directions. Some patients will need you to talk to them as little as possible.
- Keep dining locations and seating arrangements consistent.
- Never, ever scold or lecture the patient during an outburst, or allow others to do so. Take the patient back to a room or another area and allow her to settle down, and then bring a meal to her.
- Seat them with patient's who will not distract, aggravate, or otherwise distress them. Do not sit a person who is easily agitated next to a patient who repetitively questions, or worse, talks loudly or yells.
Next week's post will continue with some final suggestions. What has worked for you?