Why Having Your Parent With Dementia Be Independent With Eating And Drinking Is Good For Them?

Eating and drinking are universal activities, but they take on a different dimension when considering those with dementia. Today, we'll discuss how we can adapt basic self-care tasks to turn them into meaningful activities, focusing primarily on eating and drinking.

The Essence of Eating & Drinking

At its core, the act of eating and drinking helps maintain involvement in basic self-care tasks. It provides:

Cognitive stimulation

Maintained abilities

Opportunities for socialization

Enhancement of range of motion, strength, and coordination

Setting the Stage for Meal Times

To create a conducive environment for those with dementia:

Use familiar dining items and utensils suitable for the meal

Set up the environment with all needed items beforehand

Option for quiet, focused settings, free from background noises like TV or other distractions

Eating and Drinking Through Dementia's Phases

1. Early Stage:

Understanding and Independence: Patients can usually understand routines, making them capable of initiating their own meals.

Minor Hiccups: There might be issues with quality or minor struggles like opening unfamiliar items or containers.

Preferences: A resistance to diet changes might appear.

Social Aspects: They can converse between meal courses but might be more focused during meals.

Quick Tips: Cue the person in unfamiliar situations, eat without conversation distractions, and be ready to assist with tricky food containers.

2. Middle Stage:

Cues and Assistance: Regular verbal or tactile cues become necessary to bring them to meals. They might require assistance in using utensils.

Attention to Detail: They may overlook details, such as spilled food, and may become self-absorbed, hindering social engagement.

Safety Measures: Ensuring they don't burn themselves or eat too fast is crucial.

Quick Tips: Make mealtimes multi-sensory, use contrasting plates for better food visibility, and offer one food item at a time. Keep an eye on their rate of consumption.

3. Later Stage:

The Enjoyment Factor: Though they might not understand the feeding activity, they can still relish eating.

Hands-On Approach: They'd likely require direct assistance, from being brought to the table to being hand-fed.

Simplicity: Simple foods, especially finger foods, can be a blessing. Also, maintaining food accessibility throughout the day can help in consistent consumption.

Quick Tips: Constant supervision is essential. Offering food during their best meal times, ensuring they aren't losing weight, and providing frequent, smaller meals can be beneficial.

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As dementia progresses, the simple act of eating and drinking evolves, requiring adaptive strategies to ensure the individual's well-being. Through understanding, patience, and proactive care, we can make mealtimes a nurturing, meaningful experience for our loved ones with dementia.

Let me know in the comments below if you have questions about dementia that you need answered.

If you would like more information on how to help a parent living with dementia, join our next free workshop here.

Read More: Talking About Caregiver Burnout With Michelle Gordon

Check the other post here.

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Why Having Your Parent With Dementia Be Independent With Eating And Drinking Is Good For Them

[0:01] So today we're going to talk about eating and drinking as we continue our journey through exploring using basic self-care tasks as a meaningful activity.

So what we look at during eating and drinking is we also want to make sure that we are maintaining involvement in people's basic self-care tasks during eating and drinking.

We want to provide them with cognitive stimulation and maintain their abilities as well during eating and drinking, especially socialization skills.

Why Having Your Parent With Dementia Be Independent With Eating And Drinking Is Good For Them

Maintaining Range of Motion and Coordination during Meals

[0:37] Eating and drinking also offers us an opportunity to maintain range of motion, strength, and coordination during the activity itself.

[0:47] We also maintain our self-esteem of our loved one by providing them with independence during their self-care tasks and especially using socialization during meals.

We want to remember to use safe and familiar dining items and utensils that are appropriate for the task at hand.

And remember to set up the environment prior to the meal in order to make sure that they have everything that they need during the time that they are eating.

Setting up the Environment and Providing Supervision during Meals

[1:21] And perform these activities one-on-one or in an appropriate dining location at a table or in a small group setting.

Remember to provide supervision for people with dementia using unfamiliar or sharp items.

And close supervision is recommended to prevent choking or swallowing and observing people with swallowing difficulties.

And also remember to avoid excessive background noise, talking TV or Alexa during meals.

Ensuring Adequate Food Intake

[1:54] Our purpose during this time is to try to make sure that a person is actually eating enough.

Early Stage of Dementia: Understanding routines and social standards

[2:02] During the early stage of dementia, we can expect our loved one to still understand the routine related to meal times.

It can be expected that they can initiate coming to their meals at the routine times of day, and we can also expect them to comply with the social standards with some cuing.

They may also be expected to help set up and clean up highly visible spills or dropped food items.

So they'll probably see that there's a lack of quality.

They also will likely start to have trouble opening difficult or unfamiliar items or containers.

[2:47] They may become resistant to changes in their diet or their menus.

And they may recognize well-learned special diets and be able to tolerate those pretty well.

They will also be able to converse between meal courses, but not necessarily during the meal time.

So they become very focused on what they are doing.

They can sometimes still, at an early stage of dementia, alter their rate of eating upon request.

So keep that in mind if you're in a restaurant, that they might be able to eat a little bit faster.

But sometimes that is a difficult thing for them to do.

And excuse me, typically, as at most of these stages of dementia, everything is done at a complete, or completed at a slower rate.

[3:38] So some quick tips for early stages of dementia with eating and drinking.

Cue the person in unfamiliar situations like restaurants.

You may need to eat without conversations during the meals, and they may need help opening items.

And just remember, the more there's distraction in the background, the less the person is likely to actually eat and complete their meals.

Middle Stage of Dementia: Need for verbal cues and attention to table manners

[4:06] So, eating and drinking at a middle stage of dementia. These people typically require verbal cues or tactile cues to come to the table.

It's very unusual to expect them to come at the routine time of a meal.

You will have to likely go and get them.

They can still use a spoon or a fork in a customary manner, but may not necessarily use a knife. So for example, they will try to cut the food with the side of a spoon or a fork.

They may be able to attend to a whole dining experience, but they might need cues to continue to eat or drink, so they'll get distracted. Or they may need cues to actually remember to use their spoon or fork.

They will use food and utensils that are placed within arm's reach and typically in front of them.

And they will require cues to go on to the next step. They will sometimes wait briefly for the next course or presentation of food items.

They will probably start to eat strongly preferred foods only and may not understand the need for a balanced diet or dietary restrictions.

So they will be wanting to eat only ice cream or cookies or things like that and not understand that they need a balanced diet.

[5:31] They will also have trouble in waiting if their food's too hot and is at risk for burning themselves.

They will be able to sometimes conform to table manners if they are cued.

[5:45] And will likely not attend to things like food spilling or crumbs on the table.

[5:53] They will typically become self-absorbed and not be able to engage socially during the meal.

They will typically start to interrupt one another, people at the table, and they may eat too fast or not chew well enough or start to have trouble swallowing safely.

So some ideas for quick tips for people at a middle stage or moderate stage is to make mealtimes come alive and use multisensory experiences.

These people tend to use or tend to do well when you contrast the plate with the table.

And for some reason, red is a good choice for food for plates.

The research has actually shown people will eat more if you put their food on a red plate.

Try to use large-handled utensils like spoons or forks.

Try to remove things off of the table that are not necessary.

And offer one food item at a time.

Try not to give them too many things at the same time on one plate.

This is also the time when people will start to eat less.

And it's because partially they're not hungry anymore, but partially also because they start to have a hard time focusing on these activities for an extended period of time.

Later Stage of Dementia: Assistance with feeding and constant cueing

[7:20] So eating and drinking at the later stages of dementia. The person does not understand the feeding activity, but they may still enjoy eating.

They will likely need help to come to the table at routine times.

Typically, you will have to take their hand and bring them to the table.

You will need to provide constant cueing or hand over hand initiation to start eating and to keep them feeding. Sometimes you can sit next to the person and tap their hand and say, take a bite, take a bite.

You will need to place the food items in their hands or right in front of them.

You might have to actually put the spoon or the fork in their hand.

And sometimes if you start the feeding activity by scooping it up for them and repetitively doing that for a few repetitions, they may be able to feed themselves for a short period of time.

They will tend to stop eating and walk away from eating after a very short period of time.

Typically, if you allow them to walk away but present food frequently throughout the day or bring them back every few minutes to maintain their hydration and their nutrition, that can help.

Don't expect them to sit there for 20 minutes or 30 minutes while you're eating.

Try to offer one item at a time and try to prevent the person from getting overstimulated.

[8:50] If you put a drink or a cup in front of them, they may still spontaneously drink.

But try to prevent them from spilling by only filling You cup to a quarter full, or give them something like a sippy cup with a lid.

They will try to sometimes still put finger foods in their mouth, but they'll also put other inedible things in their mouth, so you have to watch that throughout the day. People at a late stage will still likely prefer some foods over others, and will eat those and refuse other foods, and they have no awareness of food temperature or any social standards, so they need supervision for that.

They will typically eat too fast, or eat too slow, or not chew well enough, and start to have difficulty swallowing.

They may need assistance with feeding if they're not eating enough every single day.

So some quick tips at this level is to offer the person with finger foods as needed, things like bananas or cookies or other things they can just hold in their hand. Offer foods that they can eat while they're walking if they need to.

[10:10] Keep foods available all throughout the day and offer it to them at various times. And remember that they are going to have a best meal of the day and try to offer the most food at their best meal time. So some people will eat best at breakfast, some people will eat their best meals at dinner. It's your job to know which one your loved one will eat the most at and provide their best meals of the day at that time and just try to get some grazing or snacking in between.

As long as the person is not losing weight, you should be fine. Just try to maintain their best level of weight as possible.

When people start to lose about 10 percent of their weight, it starts to become a problem. So these are some strategies to try to engage people in eating and drinking at all phases of their journey with dementia.

Subscribe To Dementia Caregiving For Families Podcast

If you feel like dementia caregiving is hard and unpredictable and you are struggling to help a spouse or a parent living with dementia, join our next free workshop.

Join our Facebook Group at: 

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About the author

“Think Different” Dementia’s owner, Lizette Cloete, OTR/L graduated as an Occupational Therapist from the University of Pretoria in South Africa in 1992. Lizette has almost 30 years of experience as an Occupational Therapist in a variety of settings, the latest being in the home health environment. She enjoys teaching on the topic of dementia, most recently presenting at a national conference on the topic “Dementia Made Simple”.

Disclaimer: These blogs, videos and any work done by Lizette Cloete OT, as a Member of Think Different Dementia, LLC, is given only as educational content and consulting work. This does not create an Occupational Therapist-Patient Relationship. The educational content and consulting work performed should not be considered medical treatment as an Occupational Therapist. The consulting work does not take the place of medical work normally performed by a licensed Occupational Therapist. Please consult a licensed Occupational Therapist for medical advice.

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