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Meal
Time
The
brain is extraordinarily complex. It is made up of several
distinct parts, each with its own function. While these
parts are separate, they must work together to complete
the simplest task. As Alzheimer's disease affects each
area of the brain, certain functions or abilities can
be lost. One link in the chain of events may be missing
and the person will need help or a coping mechanism to
complete the task. It is important for caregivers to
remember that changes in a person's behaviour may be
related to the disease process.
The
ritual of eating
Eating
plays an important role in our lives. It is often a social
event, a time shared with family and friends. It can
provide structure to the day. Each household has its
day-to-day eating habits and patterns, the "table
manners" which family members come to expect and
enjoy. Alzheimer's disease affects these patterns because
the skills needed for eating are lost and awareness of
social etiquette is forgotten. It then becomes important
for the caregiver to ensure that the person with Alzheimer's disease is getting enough to eat and drink.
Where
to begin
Usually
we do not assess our eating habits and routines, which
have developed over a lifetime. The following suggestions
may be helpful to reduce problems and make meal time
more pleasant.
Consider
the person
- Is
the person's mouth free from sores? Do dentures fit
properly or are teeth worn down or missing?
- Are
there medications or other conditions (such as heart
condition, diabetes, constipation or depression) that
may lead to loss of appetite?
- Can
the person visually distinguish food, plates, etc.?
- Can
the person recognize food as something to eat?
- Does
the person know how to use table items, such as utensils,
condiments?
- Is
the person agitated or restless?
- Is
there confusion about meal times or whether a meal
has been eaten?
- Is
food less appealing because the person's sense of taste
and smell has lessened?
Consider
the setting
- Is
there too much noise, too many people or other distractions?
- Is
the table too cluttered?
- Is
the lighting adequate?
- Is
there a need to rush? Are other people impatient?
What
to try
Whether
a specific reason for the problem is determined or not,
there are strategies that can be tried to make eating
easier and more pleasant.
The
table
- Provide
a calm and unhurried atmosphere, minimizing distractions,
loud noises and abrupt movements.
- Simplify
the table and the setting. Omit unnecessary utensils
and condiments. Give only one food item at a time.
Reduce sharp knives or fragile china.
- Provide
a sharp colour contrast between table or place mat
and the plate, but avoid strong patterns as they cause
confusion.
- Choose
cutlery and dishes that are easy to hold.
- Ensure
plates are stable -- with mats or even a wet cloth
underneath to prevent slipping.
The
food
- Provide
finger foods: foods that have the same taste and nutritional
content as a regular menu, but are in a form that can
be picked up and eaten easily. This provides nourishment
when it is difficult to use utensils.
- Provide
nutritious foods that can be taken from a cup or a
mug: the ability to hold a mug and to drink is often
retained until late in the disease. Milkshakes or liquid
food supplements can sometimes take the place of a
full-course meal.
- Offer
frequent small meals or snacks rather than three large
meals in a day.
- Provide
food that is colourful and easily distinguishable on
the plate.
- Provide
the person's favourite food. Food that tastes and smells
good may also serve as reminders of happier times.
- Cut
food into manageable bite-sized pieces. If there is
a concern about choking or swallowing, consult your
physician.
- Check
the temperature of the food to ensure it is not too
hot or too cold.
- Cue
the person with words or actions. The person might
be able to mimic your motions for eating.
Day
to day
Elegant
dining may not always fit the realities of Alzheimer's disease. By adapting some of our eating rituals, a person
with the disease can be encouraged to eat, often with
independence and pleasure. However, what works one day
may not work on another. It is important to remember
that you are doing the best you can.
In
addition
We
are learning more about Alzheimer's disease and its care
everyday -- much of it from caregivers like yourself
who find solutions to problems and share them with others.
You can call your local
Alzheimer Society to find resources in your community.
You can also exchange ideas by visiting the Forums.
There is information. There is help. You are not alone.
Resources:
- The
Alzheimer Journey, Module 4, Understanding Alzheimer Disease: The link between brain and behaviour,
video and workbook series, the Alzheimer Society of
Canada, 2002.
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