Demenetia and Mealtimes: Little Changes make a Big Difference

Nutrition Matters Newsletter November 2018

Each person experiences dementia differently and there is no one approach that works for everyone or even per occasion. Residents can experience a loss of connection with recognising food, with how to eat, declining swallowing abilities, taste changes, stress and unsettled behavior, impacting on their nutrition and quality of life.

We all recognise that there are constraints within homes, however there is always more that could be done to provide individualized and person-centred mealtimes for those with dementia.

People with Dementia do not have a ‘best time of the day’ for eating.

Don’t always rely on the exact timing of meals, residents should be allowed to eat any time throughout the day as desired. Better yet, your home could try removing set meal times all together, particularly if you have a designated Memory Support/Dementia unit. You could offer grazing plates throughout the day in the units. ‘Household’ model of care provides this type of freedom which has started to show much improvement in quality of life and health status for residents.  Enabling staff to dine with residents has been shown to have positive results in encouraging eating and supports a more home like environment.

Freedom is the new diet

It doesn’t always have to be a large main meal. Finger foods can be useful for those who wander a lot and can be offered regularly through the day. For example, small pieces of cheese, mini savoury muffins, pikelets with cream cheese spread, small sponge rolls, cakes and slices can be offered.

What if the resident just wants to eat sweets? Offer extra serves of this through the day. It is better that they are eating something than continually leaving the main meal and missing opportunities to eat what they enjoy. Again, we need to look at providing more freedom for our residents, thereby reducing their stress.

Minimalise to Maximilise

Offering a fine dining experience in a small intimate group can encourage residents with early stages of dementia to eat and provide positive social interaction. However, in advancing dementia, a cluttered table is distracting, and a minimalist approach is better. Residents may pull at tablecloths or be distracted by placemats with patterns or scenes. Go for contrast between crockery and table/placemat colour, so that plate position is clearly distinguishable. It is not uncommon for people with dementia to mix foods inappropriately, so offer one course of food or fluid at a time.

Large dining areas are often chaotic and noisy at mealtimes, causing stress for a person with dementia. Having a smaller dining room can feel safer, secure and more ‘home-like’. Think about the types of dining rooms your resident used to eat in.

Know your resident’s strengths

Know the level of independence and abilities of your residents. This should be updated regularly in their care plans, preferably monthly as part of their ROD. Keeping watch of this means we can provide the best amount of assistance that helps them but at the same time enabling their independence. Some residents may struggle to acknowledge a meal has been placed in front of them, so some initial prompting is required so they can eat the rest of the meal with autonomy. Some residents may struggle to use cutlery, so using assistive cutlery can help them eat their meals.

Sometimes despite all of our efforts it is not always possible to coax a person with dementia to eat or drink. As end of life approaches, residents may decline food and fluids regularly and continuing to feed can cause distress to the dying person. This is a natural process as end of life nears. If you are unsure as to what interventions to implement, consult with your dietitian and doctor for further advice.

For further information, please contact Leading Nutrition on 1300 721 722 or on the contact form below.