How Alzheimer's Affects Eating Behaviors
Several problems relating to memory and sensory abilities can occur. For example, your loved one might lose the ability to sense when she is hungry or full, refuse food even on an empty stomach, or ask for another meal just after eating.Alzheimer's can also affect taste and smell, so food may not be as appetizing to your loved one anymore. Eating utensils might be confusing, and your relative might not know what to do with food that is placed in front of him. He might put too much food in his mouth at once, eat too quickly, attempt to swallow without chewing, or try to eat inedible items.
Individuals with Alzheimer's are more likely to suffer from malnutrition and dehydration, both of which can worsen confusion and behavior as well as lead to other serious medical problems.
Creating an Optimal Eating Environment
In general, your loved one will have a better experience if meals are served in a quiet, calm atmosphere. As with all Alzheimer's care, mealtimes should follow a consistent routine. Table settings should be simple with all unnecessary items removed. Make sure that the room is a comfortable temperature, since those with Alzheimer's tend to be more sensitive to rooms that are too hot or cold.Be flexible if your relative changes her food preferences. She might suddenly decide that she no longer likes a food item, or that she must have a particular food or beverage several times a day. Being flexible will improve appetite and decrease difficult behaviors like aggression and sleep disturbance.
When a Calm Environment Isn't Enough
Sometimes, even a calm eating environment won't prevent all mealtime problems. In these situations, the way you respond to your loved one is of paramount importance.
- Agitation
Don't argue with your relative while he is agitated. Alzheimer's has robbed his ability to use reason or logic, which makes arguing pointless. Instead, use a calm, consistent approach, and try to reassure your loved one that you're there to help. If all else fails, distract him to a pleasant activity, such as a favorite radio show or photo album, until he's ready to try eating again. - Aggression
If your family member tends to become aggressive or combative, use unbreakable dishes and glasses. Try to determine the source of the aggression. Is the room too hot or cold? Is it too noisy or chaotic? Could a medical condition, such as a urinary tract infection, be causing the aggression? As hard as it may be, try to respond with a low, calm voice, reassuring touches, and a cheerful, friendly attitude. - Wandering
People with Alzheimer's can be prone to pacing and wandering. Those who pace might not be able to tolerate a sit-down meal. Rather than try to convince your loved one to stay at the table, it's best to adapt to the behavior. Calorie-dense foods, such as peanut butter or dried fruits, can meet nutritional needs even if your relative eats at the table for only short periods. Finger foods can also be provided while pacing.
Practical Alzheimer's Care Tips
To help your loved one eat more successfully, cut food into bite-size pieces that can easily be chewed, and use plates or bowls with protective (non-spill) edges. Set bowls and plates on non-skid surfaces.If your relative seems confused about how to begin, demonstrate how to use a utensil, or take her hand in your hand and help her with the first bite -- often, she will then continue on her own. If you need to provide directions, only give one at a time, and make sure that each step has been completed before moving on to the next one.
It's All About Respect
Most importantly, respect what your family member is communicating to you during mealtimes, either verbally or through his or her behaviors. Individuals with Alzheimer's deserve flexibility and patience and should be monitored on an ongoing basis. This way, you can continue to adapt your Alzheimer's care approach to your family member's current behaviors, preferences, and abilities.
Sources:
Eating. Alzheimer's Association. November 2005. http://www.alz.org/national/documents/topicsheet_eating.pdf
Mace, N.L., & Rabins, P.V. 2006 The 36-hour day: A family guide to caring for persons with Alzheimer's disease, related dementing illnesses, and memory loss in later life. New York: Warner Books.
Tonarelli, L. “Helping with eating: Research-based guidelines.” Alzheimer's Care Guide 2005 13(5): 4-7.
