At Livewell, we look holistically and individually at every resident’s eating needs, weight and nutrition. Take a look at the solutions we’ve found to common challenges associated with persons with dementias’ eating needs.
General Weight Management
- We have monthly weight and menu meetings during which we discuss every resident’s weight changes after their monthly weigh.
- In our Livewell kitchens, we have a list of all the residents’ eating preferences and dietary requirements.
Residents’ Weight Management
Due to a loss of inhibitions and the fact those with dementia at times forget that they have eaten, this often leads to weight gain. When this happens at Livewell we incorporate the following changes into their diet:
- Fewer carbohydrates
- Less refined sugars in their diets. We would rather give the resident fruit for dessert or sugar-free jelly and add citrus peel and xylitol to their Bulgarian yoghurt at breakfast
- Side salads and fresh fruit when the resident asks for another meal (when they have just eaten)
- During summer we serve fresh fruit with the afternoon tea
Persons with dementia lose weight easily, especially when they are inactive and their dementia is advanced. At Livewell we incorporate the following:
- Fortify soups and eggs with cream
- Find out what the person’s favourite snack is/used to be and keep it close
- Nutritional shakes: At times we add extra fruit and yoghurt and serve the nutritional shake in a milkshake glass with a pretty straw; this encourages the resident to enjoy the shake
‘Picky Eaters’
We see that persons with dementia are more likely to become picky eaters; this may be due to changes in sensory sensitivity as they become older and the disease progresses, loss of independence with regards to using eating utensils, visual perceptual changes, appetite changes and mood changes. When this occurs at Livewell we make the following variations, which are usually dependent on the problem identified:
Snack Plates: We have found that when our residents lose their ability to use utensils independently and don’t want to be fed, they usually accept finger foods, this is a wonderful sensory experience for the person with dementia and residents tend to enjoy their meals more and eat bigger quantities than when compared to being fed by a care provider.
Usually we place the following on their snack plate: cheese blocks, chicken pieces, tenderised steak, baby carrots, cucumber, grapes, sweet melon, small tomatoes, cut up whole-wheat bread and crackers.
Menu choices: Giving choices to persons with dementia if often controversial, but we have experienced much success;
We have created a menu with three choices per meal time and asked the person with dementia what they would like to eat before meal times. This has helped the person to have a feeling of choice and control over their choices. This is only recommended for those with the earlier stages of dementia.
Smaller meals on smaller plates, more often:
We have a few residents who become overwhelmed by a full plate of food; some of them end up sending the food back! We then use smaller plates and encourage the person to a have a few of these per day, usually 4-5 small plates per day.
Sauces and sensory profiles:
It is vital that family members of the person with dementia are contacted to find out what foods they used to enjoy. Questions which should be asked include whether they used to enjoy spicy foods or not, as this can assist a facility to find out what the person enjoyed and one could incorporate the information into their eating routine.
Seating:
Observe the environment around the person with dementia at the dinner table. It may be that the resident sitting next to the person who is refusing food is chewing very loudly or is speaking too much. The person with dementia may not be able to verbally express what is bothering them at the table.
Sensory Needs Identified
Once we have investigated why the person with dementia is not eating well and notice that it is due to sensory reasons we try the following:
- Investigate further by testing different textures. Here we will observe the resident eating different foods and see what they are sensitive to. We usually find that it is the grainy and stringy textures that residents don’t respond well to.
- Strained soup, as it contains no pieces which the residents can be sensitive to
- It may be that the person has toothache and this is why they are avoiding certain foods; foods that are more difficult to chew and are at extreme temperatures may be avoided at this point.
It is vital that all situations and persons are dealt with individually. There are many options and solutions for eating challenges associated with dementia. Usually there is an underlying cause and observing the person while eating will help to identify any issues and assist the staff to address them.