It’s the time of year when families gather – usually around a table filled with food, and surrounded by seasonal songs and decorations. Although this is something that many enjoy and look forward to, it may create confusion and anxiety to someone who is suffering with dementia. If you’re caring for a loved one with dementia, or plan on visiting a loved one at a care home, you might be wondering how to make their holiday mealtime experience as enjoyable as possible, in the midst of all the seasonal tumult.
Sharing meals with family can provide structure to the day, but when caring for someone with dementia, meal times can often become stressful events. Not only does the carer have to keep tabs on whether the person is eating a well balanced diet and is staying hydrated, but that their meal time experience is also associated with good feelings. If the person with dementia is stressed, anxious, or experiencing negative emotions in any way, it may hinder their intake of food, or trigger a disdain for sitting down to eat altogether.
So how do we support someone with dementia during mealtimes – especially holiday meals? It all starts with investigating the persons habits and routines from their pre-dementia lives. When you understand the eating habits someone has had for decades, you can decipher why they might be doing something like refusing to eat. Try asking questions to help you decide what the best approach would be to support an individual with their mealtime experience.
Questions to Consider:
**Lists are sourced from Alzheimers.ca & wales.gov.**
About the person:
- Is the person’s mouth ok? (sores, dry mouth, denture fit, tooth ache etc)
- Medication list – could some cause loss of appetite?
- Medical conditions – could some cause loss of appetite?
- Restless or anxious – perhaps sitting still is causing some anxiety and making them less hungry
- Eye sight – can the person see what they’re eating? Can they see their fork or drinking glass?
- Smell & Taste – perhaps their sense of smell and taste have changed due to a condition/medication/dementia
- Food – is this food that the person recognises?
- Physical limits – does the person have a physical barrier in regards to using the items on the table (fork, condiments, napkin)
- Confusion – maybe they think they’ve already eaten
About the setting
- Is there too much noise?
- Are there too many people?
- Is something distracting you?
- Is the table too cluttered?
- Is the lighting bright enough? Is the lighting too bright?
- Do you feel rushed or anxious by external sources?
How to Address Decreased Eating for Someone With Dementia
When you see the questions above, you can see how easy it is for mealtime to become stressful for someone with dementia. As a result a person may lose weight due to the loss of appetite or general difficulty eating. So how can you help in this case? Firstly, ask your GP to refer you to a dietitian. Secondly, take a look at the tips below to help with mealtimes for someone with dementia.
Tips to Improve Mealtimes For People With Dementia
The setting & table
- Get rid of distractions – turn off the T.V. or radio. Provide a calm and unhurried atmosphere.
- Make sure the lighting is adequate.
- Serve meals at a time when the person is calmer and more alert.
- Eat together to keep meal times a social event.
- Keep the table simple – serve one food at a time, one utensil.
- No sharp knives.
- Colour contrast is good between plate, utensil, and table, but avoid patterns.
- Easy to hold cutlery and dishes.
- Stable plates – use non-slip mats to keep dishes in place.
The food itself plays a big role
- Is possible let them help in food prep.
- Healthy finger foods – like bite size snacks that can be picked up with fingers, but still provide good nutritional value.
- Nutritious foods that can be taken from a cup or a mug: Healthy shakes or liquid food might be able to take the place of a full meal *speak to your GP*
- Frequent snacking/small meals instead of 3 large meals.
- Colourful food that is easy to see on the plate.
- Favourite foods before dementia will probably continue to be favourite foods after. Eating them might also bring joy and serve as a reminder of good times.
- Difficulty chewing? Grind or mash foods and choose soft foods like eggs and cheese.
- If there is a concern about choking or difficulty swallowing, consult a physician. Take a look at our blog about dysphagia for some more information about this.
- Update your first aid knowledge on how to deal with choking.
- Food temp – not too hot or too cold.
Giving instructions
- Cues: words or actions – they might mimic your actions.
- Simple instructions – 1 step instructions, or break up bigger tasks into small steps.
- Speak with a calm, soothing tone, with slow and steady instruction. No rushing.
- Hands on guidance if necessary to initiate eating.
- Narrate what food you are giving to the person.
- Spilled food? No problem. Avoid commenting on it since it might cause some shame. Read our blog about dignity bibs (not actually bibs in the usual sense). Aprons could also work well if the person is used to wearing one in the past.
- Encourage the person to feed themselves even if they’re not neat.
- Not interested at the moment? Take a break, do an activity. Then lead back to the meal later.
One day at a time
As a carer for someone with dementia, it can be hard to tackle the issue of difficult eating. Just remember that the person is not trying to be difficult and it’s not personal. By setting up routines, eating rituals, and a safe familiar environment, someone with dementia can be encouraged to eat and enjoy their meal time as well. Even though the same approaches may vary day by day, just remember that you are doing the best that you can and that’s absolutely enough.
So how do I Approach a Holiday Dinner for Someone with Dementia?
Ultimately, if you as the carer know that an event will likely be too intense for someone with dementia, we would suggest you sit the event out. Perhaps organise smaller, more personal dinners to catch up with family and friends in a location that is familiar and controlled for the person with dementia. At your home, or at the care home you can control the music and decorations, or the way the table is set. When you visit a family member’s or friend’s home, even if the person with dementia has been there in the past, the overwhelming sense of a disrupted routine, new sounds and distractions, and many voices, can lead to anxiety and a negative eating experience.
