Dining with Alzheimer's Disease: Encouraging Independence at Mealtime

By[1]  Beth Scholer, CC, CDM, CFPP

Caring for an elder with Alzheimer’s disease presents many challenges to daily living; mealtime being one of hardest. Elders in early stages of the disease want to remain self-sufficient, but changes to their cognitive function and physical abilities can affect their capacity to do so.  

A Complex Condition

Those with Alzheimer's or dementia sometimes forget the normal routines of eating like how to use spoons and forks, open packages or the motion of moving food to the mouth.  Caregivers can offer cues on eating while keeping the elder’s dignity in mind.  Focus on matching the elder’s physical and cognitive abilities with the appropriate level of personal control.

Try these practical tips to encourage eating independently:

✓   Sit at the table and demonstrate an action by saying “watch me”.  Show how to
     take a bite or sip from a cup.

✓   Encourage them by saying “try the soup” and then point to the soup.

✓   Use a neck scarf or lap bib to keep clothes cleaner.  Independence is more
     important than neatness.

Alzheimer’s affects an elder’s eyesight, narrowing their line of vision and ability to see contrast.

✓   Use brightly colored placemats or plates to bring attention to the dining space
      and food. 

✓   if an elder stops eating while food remains untouched, try turning the plate to
      put the other food in their line of vision.

 

Be Patient at Mealtimes

Many caregivers try to feed an elder while they are still capable of feeding themselves. This causes frustration and disruptive behaviors.  It’s critical that a caregiver be patient and allow an elder enough time to eat on their own.  The caregiver should be close to watch the size of bites and for any signs of choking.  Intervene only if safety is a concern.

Allow enough time for an elder to eat independently. Stay close to monitor size of bites, speed of eating and for any signs of choking. Only intervene if safety is a concern.

Try Adaptive Equipment

Adaptive equipment are specially designed utensils to increase independent eating.  Look for cups with the nose cut out, plates and bowls with sloped sides and large handled spoons and forks for easy gripping.  Red colored utensils also help to stimulate the appetite and increase the contrast between food and plate.

Serve Finger Foods

If spoons and forks become too difficult, prepare bite-sized finger foods.   Try roll-up sandwiches with meat, cheese and vegetables, small pieces of fruit and cooked vegetable – raw is a choking hazard. For protein, serve small pieces of chicken, fish sticks or cheese cubes.  Avoid anything with bones like a chicken drumstick.

Use Trial and Error

Alzheimer’s disease is complicated;  try different solutions until you find one that works.  Keep in mind as the disease progresses interventions that once worked may not work anymore.  Find what is best for the elder at this specific point in their disease.

 

Sources:

Snow, Teepa. MS, OTR/L, FAOTA. Major Considerations when Dining with Dementia. 18 Aug.
     2016. Personal Communication.

 

Chef Beth Scholer, CC, CDM, CFPP, is a food scientist, culinary instructor, author and founder of Caregivers Kitchen. She is passionate about empowering caregivers to make positive nutritional changes and mealtime meaningful for those in their care.   She can be reached at chefbeth@caregiverskitchen.net.

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