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Encouraging Eating: Advice for
At-Home Dementia Caregivers


(Page 3 of 7)

Assess the Situation

Assessing the mealtime situation can help caregivers identify and resolve problems and understand what is happening from the care recipient’s perspective. “The caregiver should take time to sit back and watch—really observe—what is going on when the person attempts to eat,” Coppola suggests. “As you’re observing, think about what is happening with all of the senses. Ask yourself which part of the task might be difficult and what the person is feeling. Is the person enjoying the meal, and if not, why not?”

When observing the situation, family members and other caregivers can assess:

  • the visual aspects of the environment—for example, whether there is poor room lighting, too much glare or too many shadows in the room or on the table, unneeded items or too many food choices on the table, distracting patterns in the place setting, or too little color contrast between the food and the dishes;

  • the sounds and noise in the environment—whether there are distractions coming from people talking, the television or radio, the refrigerator humming loudly, or dogs barking in the background;

  • how the food smells, tastes, and feels;

  • how well the person manages the mechanics of eating, from grasping utensils to identifying and picking up food to chewing and swallowing;

  • the emotional climate in the room and how the person interacts with and responds to others in the room.

For everyone, nutritional needs shift as a person’s activity level changes. Therefore, it is important for the caregiver to note whether the person is eating and drinking enough or, in the earlier stages of the disease, eating too much. The caregiver should monitor the person’s weight and eating habits to assess the care recipient’s nutritional intake and any nutrition-related issues. Caregivers should pay particular attention to:

  • how much and what kinds of foods and fluids the person consumes over the course of each day,

  • what times the person tends to be hungry,

  • weight changes,

  • appetite changes,

  • problems with chewing or swallowing,

  • how physically active the person is daily.

This information can be shared with the physician to determine whether the person is eating and drinking the right amount, relative to his or her activity level. The physician may recommend keeping a daily food and hydration diary. The information can help identify new physical or medical problems that may not be related to dementia, but cause weight changes. “Assess the situation before moving to the next step,” Coppola says. “It’s important to know how much the person is really eating and how active he or she is before worrying or making changes.”

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