left picture: Normal brain right picture: Alzheimer brain INVITATION TO EAT :
By : Yakob Scholer, Nursing Consultant, Home Nursing Providers
Alzheimer Dementia Patient are often overtaxed with eating and drinking. This is how we can help them.
Family members and nursing personnel of persons suffering from Alzheimer Dementia (dementia) know the problems related to food and drinks consumption by these patients. Often, the person may sit in front of a plate of food yet does not make any move or effort to start eating. At times, the person may even have forgotten what he was doing at the table in the first place.
For a normal and healthy person, eating and drinking are not only acts of sustenance but also pleasure. For a person with dementia on the other hand, these two basic acts are at times deemed a major problem with serious consequences. As a result, statistics have shown that more than 90% of dementia patients suffer continued weight loss. Drastic and continued weight loss can also lead to other severe health problems for dementia patients. Therefore, relatives and caregivers are often faced with multiple dilemmas, from coping with the dementia, ensuring proper diet and nutrition for the patients to managing other physical health problems associated with dementia.
Nevertheless, coping with dementia patients need not be a chore or a difficult ordeal. By learning to understand their needs at a deeper level, caregivers and family members can create a stress-free environment that can contribute to better dietary health and supervision of dementia patients.
For example, patients with dementia cannot recognise the feeling of hunger and thirst. Therefore, they will hardly ask for food and drinks on their own accord. This is because, at the on-set of dementia, the patient’s sense of smell and taste will start to diminish, resulting in their inability to recognise the smell and taste of food that is a prerequisite to desire food in an ordinary person. It is therefore important to stimulate the patient’s other senses such as sound, sight and touch through the preparation and serving of food in order to invoke their interest to eat and drink. This could be done from bringing to their attention the mere sounds of cooking and the utensils used, to encouraging the patient to observe as his meal is being prepared. Watching his meal prepared will help to remind the patient that the time for food intake is imminent. In addition, the way in which a table is set for a meal will also influence dementia patients to eat. For example, it is helpful to have transparent glasses and coloured plates to emphasise the colour of the food and beverages, thereby not only enticing the patient but also triggering his memory to eat and drink.
For a patient with dementia, his favourite dishes will remain a favourite even when he may no longer be able to express his wishes for them. Repetitive serving of the patient’s favourite dishes will not only ensure that his dietary needs are met through food consumption but also provide the patient with a sense of security.
Many dementia patients have also lost their motor skills to use fork and spoons. Therefore food for dementia patients should be prepared to ensure easy handling by hand or cutlery and utensils. The caretaker should also eat with the patient so that the patient can observe the caretaker and be stimulated to follow his movements in handling food and cutlery. In doing this, it is important for caretakers and family members to remember that pressure on the patient to eat and drink should be avoided, as it will reinforce his incompetence and make him lose interest in trying.
Families are at times embarrassed when the patient does not adhere to proper "table manners" and may use his hands to eat in a way deemed inappropriate. It should be remembered however
that it is OK to allow the patient to eat the way he feels most comfortable. In fact, patients should be encouraged to do so as this will improve his appetite and self-esteem.
Another great way to remind and entice patients to eat is to place titbits and drinks at various strategic places around the house, particularly in areas frequented by the patient. This will remind the patient to eat although proper supervision and control is needed to ensure that the patient is eating healthy and not just consuming junk food that could cause further damage to his health.
For other patients, regular weight control or management is usually taken to mean that patients should be prevented from becoming overweight. It is the complete opposite however, with dementia patients. Regular weight control is needed to ensure that the patient’s weight does not dip to dangerous levels. This is because, in addition to losing his appetite and not remembering how to ask for food when he is hungry, dementia patients will burn a lot of calories and use up a lot of energy from his restlessness and constantly moving around. Should the patient lose more than 10% of his original weight in one year, the feeding of energy rich nutrients and supplement is strongly recommended. This can be in the form of energy drinks or integration of health supplements into regular food. Caregivers and family members may seek the counsel of the patient’s physician or nurse. Alternatively we at Home Nursing Providers Sdn Bhd (HNP) can also provide such advice and guidance.
Special attention must also be given by family members to the problem of as dementia patients have the tendency to suffer from aspiration, a condition in which the food goes through the oesophagus into the bronchial system and lung instead of the stomach. In this case a visit to a neurologist is strongly recommended as he will be able to determine the correct diagnosis and proper management of such a condition.
Nevertheless, should this happen, the family and caregiver should be prepared to adjust the patient’s diet plan accordingly. For example, patients should avoid food where solids and liquid are served or prepared together. Instead, it is recommended to mix rice or potatoes with minced meat and vegetables so as to ensure proper swallowing and provide variety in taste and nutritional value. Sometimes it is also helpful to use gelatine (or its equivalent) to bind the liquid and yet keep the food soft. This may be used with fruits juices, thereby creating a fruit jelly that is not only healthy and appetising but also easy and safe for the patient to swallow.
Dementia patients are often very restless and may have the constant urge to move and use their hands. If they wish to assist in clearing the table after a meal, they should be allowed and encouraged to do so. However family members and caregivers can ensure their safety and avoid further mess and stress in the house by only allowing them to handle plastic plates
and none breakable utensils. This will help the patient feel useful and improve his otherwise depleted self-esteem.
It is important to understand that Alzheimer Dementia is a unique condition that requires not only physical support, but also the patience, emotional support and psychological encouragement by family members. Unlike most other medical conditions, there is no ultimate cure for Alzheimer Dementia although it is a highly manageable disease. To do so, it is important for family members to first accept the condition and proceed to gaining more knowledge and understanding of the problem. The constant support and assistance by family members will enable patients with dementia to live healthy and fulfilling lives.
For further Information and guidance in mobile nursing/MOBILE DOCTOR you may consult:
HOME NURSING PROVIDERS SDN. BHD (HNP) at : 06 03 7877 7202
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