This week is nutrition and hydration week which sees many health and social care providers placing a focus on energy, activity and engagement on nutrition and hydration. This promotes the implementation of the ’10 key characteristics of good nutrition and hydration care’ set by NHS England and they have created a great video describing these.
People with dementia often experience problems with eating and drinking and this can cause a challenge for maintaining nutrition and hydration. A person may experience weight loss and other problems including fatigue, higher risk of infection and less muscle strength. Some of the challenges that people with dementia experience are:
- lack of appetite
- difficulties cooking (planning, preparation, motivation, recall etc)
- problems with recognising the feeling of hunger or being able to communicate hunger
- difficulties managing cutlery
- tiring during a meal
- losing concentration during mealtimes
- taste changes
- difficulties with chewing and swallowing
- apathy (lack of interest, enthusiasm, or concern)
Our one-day course ‘Caring about Mealtimes & Swallowing’ deals specifically with these difficulties and offers strategies to help you to support the person you care for.
It is important to realise that sometimes eating three square meals a day doesn’t have to be ‘the rule’. Often people with dementia find it easier to eat little and often and to snack between meals.
One of the main difficulties that people on our courses tell us about is the person with dementia simply forgetting to chew and swallow. This often becomes worse when people aren’t given those pre meal cues that we all usually have, such as discussing a menu, planning what to have for tea, looking and thinking about the food. Without these pre meal cues, a person is less likely to produce extra saliva and this saliva is really important to us being able to eat and drink. It doesn’t just tell us we are hungry, saliva has special enzymes in it to break down chewy foods and to help us to swallow. It also activates the centres in the brain involved in swallowing to tell us what to do in eating, drinking and swallowing.
When caring for others we sometimes inadvertently take away their independence, but by involving a person in meal preparation you can help to restore that and this can also have a significant impact on improving appetite. With involvement in cooking and meal preparation producing such positive outcomes, every opportunity to encourage it should be seized. There are many ways you can involve the person you care for and many of the barriers to cooking with a person with dementia are perceived, not actual. We should strive to involve the person in every aspect of planning and preparing a meal, from creating a shopping list, selecting the produce off the shelves, to the final serving of the meal. This will often mean thinking creatively, it may not always be about preparing a main meal but it may be providing the opportunity to prepare the vegetables – washing potatoes, peeling carrots or shelling peas. Maybe laying the table. It may be looking at pictures of food, or simply smelling the spices before they are added or being able to see what’s happening in the kitchen and so on. It requires us to focus on abilities, not frailties. If we do this the impact can be fantastic.
Preparing what you eat can also improve levels of wellness and impacts on quality of life, not just from a nutritional perspective. It really is a great social opportunity for people.
If the person you care for struggles to use cups or cutlery there are adapted aids to make mealtimes easier and give the person you care for more independence. Talk to your local occupational therapy department for advice about the specific needs of the person you care for.
If you are helping to support a partner, friend or family member living with dementia, our charity is here for you. As well as a range of one-day courses on specialised topics, we run three-day residential courses which provide a supportive environment for you to ask questions, learn about dementia, build your resilience and gain strategies for maintaining your wellbeing while caring for others. All of our courses are designed and delivered by healthcare professionals who have experience of supporting people with dementia and their families. To book your free place please visit our website, email us at firstname.lastname@example.org or call us on 020 3096 7895.