Nutrition Column – Improving Mealtime for Those with Alzheimer’s

Putting salt instead of sugar in the coffee, forgetting to add water to the soup, leaving the burner on, forgetting to eat or forgetting you’ve already eaten are common to those with Alzheimer’s disease. Particularly troubling aspects of Alzheimer’s are confusion and forgetfulness about food, which often mark the end of a person’s independence and the beginning of a downward spiral that includes malnutrition, weight loss and inability to fight infection.

At a time when proper nutrition is more important than ever, people with Alzheimer’s often have trouble getting good nutrition on their own. And as the disease progresses, it takes more than just a good cook to keep your loved one well fed. An ever-growing supply of compassion and ingenuity will be needed to keep him or her well nourished. Here are some tips for caregivers to help decrease the frustration surrounding mealtime and to improve the food intake of those you serve who are developing Alzheimer’s.

• Establish a routine. Serve meals in the same place and at approximately the same time every day. Have the person sit in the same chair at every meal.
• Create a quiet, calm atmosphere. Turn off the television or radio. Try to avoid making or taking telephone calls while the person is eating. Limit the number of people in the room during mealtime. Place the chair of the person with Alzheimer’s so it faces a wall instead of a window or traffic area to help minimize distractions while eating.
• Keep the table setting simple. Avoid flowers, centerpieces, condiments and food items other than those on the plate. Avoid patterned dishes and placemats or tablecloths that are visually confusing. Use contrasting solid colors to help the person more easily recognize dishes and food. For example, oatmeal in a white bowl may not be easily recognizable to the person with Alzheimer’s.
• Avoid presenting too many items at one time, which may confuse and frustrate the person with Alzheimer’s. Instead of serving a full plate of food with many different choices to make on what to eat first, it may work better to place each food item on a small plate or in a small bowl and give them to the person one at a time.
• Stimulate the senses. Allow the person you are caring for to touch or smell the food if they seem to have trouble recognizing it. Describe the foods being served. Explain what time of day it is and what meal is being eaten. It also helps to frequently serve the person’s favorite foods.
• Use the most appropriate utensils. Spoons are often handled better than any other utensil. Bowls are often easier to eat from than plates. Sippy cups or cups with two handles may be helpful. Avoid the use of plastic utensils which can break and harm the person. Use finger foods when the person has difficulty handling utensils.
• Share meals with the person with Alzheimer’s. As a caregiver, take time to feed yourself. Your presence at mealtime can be reassuring and can encourage him or her to imitate eating behaviors. Encourage self-feeding, but provide assistance when needed. Provide verbal cues such as, "Pick up your fork." Give simple directions that include just one or two steps. Constant reminders to continue eating also may be necessary.