8 Person-Centered Approaches to Eating Assistance in Late-Stage Dementia
Among the many challenges dementia caregivers face, assisting with eating is a difficult and sensitive aspect. It demands a soft touch. A person-centered approach, if you will. We’ll always advocate for person-focused care, regardless of your loved one’s condition – but ESPECIALLY when it comes to eating assistance in late-stage dementia.
They won’t eat. If your loved one has transitioned into end stages of Alzheimer’s or another type of dementia, you’re definitely getting familiar with this. You’re concerned for their weight loss. Are they in danger of entering the “failure to thrive” category? Which begs the next logical question: How much time is left?
In this exploration, we dive into the complicated world of late-stage dementia. We discuss not just the challenges, but, more importantly, the empathetic strategies that honor the individual’s dignity and well-being when addressing dementia-related eating difficulties.
Understanding the Challenges: Why Eating Becomes Difficult
Dementia is a thief – and it’s so much more than memory loss. It steals functions and abilities until there’s nothing left.
You know this. So why do I say it? Because like so many of those regressions, consequences like not being able to eat well aren’t just the result of “forgetting to eat.” Sure, in earlier stages of dementia, a loved one may lose track of time and more frequently forget meal times. In latter stages, eating independently becomes difficult because of:
- Cognitive decline
- Motor skill deterioration
- Sensory changes
- Emotional states
- Confusion & disorientation
- Physical ailments
All of which cause a range of difficulties all their own, from recognizing food to coordinating the physical movements required for eating. Person-centered care requires understanding that these challenges are not intentional refusals, but manifestations of the profound cognitive changes occurring.
Through this understanding, you can build a better life-care plan delivering solutions that work to keep your loved one living with end-stage dementia happy and healthy – living a life worth living.
Person-Centered Solutions to Eating Assistance in Late-Stage Dementia
Of course, there are precautions that must be taken – like switching to nectar-thick or honey-thick liquids to ease swallowing. But these are solutions that can make the dementia-care environment more hospitable to your loved one.
1. Create Comfortable Surroundings
Ensure the dining area is calm, well-lit and free from distractions. The nature of dementia is confusing. Your loved one may not know how to process a busy dining room or even a TV in the background in their own bedroom.
Minimize noise and disturbances, allowing the individual to focus on the act of eating. Familiarity is key, so incorporate personal items or mementos that evoke positive memories.
2. Offer Familiar & Favorite Foods
Late-stage dementia might alter taste perceptions, making once-loved foods unappealing. Experiment with a variety of textures and flavors to identify those that resonate. If they favor a certain food that would now be a choking risk, it can always be chopped or pureed.
And as I always say, involve the person in meal-planning discussions earlier in the life-care planning process to learn and document their preferences.
3. Adapt Utensils & Tableware
Motor skills decline significantly late in the dementia journey. Conventional eating utensils will be challenging to use.
Explore adaptive utensils designed for ease of use. Consider plates with high edges to aid scooping, and weighted utensils that provide sensory feedback, enhancing control and coordination.
4. Encourage Independence with Assistance
Empower the individual to feed themselves as long as possible. Eventually, this will be impossible and they will require feeding. But before that day, offer assistance based on their cues. It might involve guiding their hand to the utensil or offering verbal prompts.
Celebrate small victories and acknowledge their efforts.
5. Maintain a Routine
Establishing a consistent eating routine can provide a sense of predictability, reducing anxiety and confusion. Even if your loved one can no longer read a clock, their intuitive senses that operate alongside their circadian rhythm may chime in to indicate, “Hey, it’s lunchtime.” Now, that won’t always contribute to their apparent appetite, but managing daily tasks in such an order typically does more to help than not.
Serve meals at the same time each day and maintain rituals associated with dining. This familiarity can evoke comfort in the face of cognitive challenges.
6. Hydration is Crucial
Dehydration is a common concern for people in end-stage dementia. If they’re not eating, they’re likely not drinking.
Ensure your loved one receives an adequate intake of fluids. Experiment with different types of cups or straws that facilitate sipping. Infuse water with subtle flavors, like a hint of citrus, to make it more enticing.
7. Monitor for Discomfort or Pain
Pain and discomfort in end-stage dementia often goes undetected due to communication barriers. That, too, can hinder the eating process.
Watch for signs of discomfort, such as grimacing or agitation. Collaborate closely with healthcare professionals to address any underlying pain issues.
8. Embrace Flexibility
Understand that each day might present different challenges. We mentioned the importance of routine, but always be open to flexibility in your approach. Some days it’ll work; some days meals will consist of only a few sips of a fortified protein shake.
(And there’s absolutely no use in force-feeding a person who can’t help any of this.)
Daily feeding routines must adapt to the individual’s mood, preferences and physical capabilities – which may change day to day and even hour to hour. A person-centered approach is about responding to the unique needs of the individual in that moment.
A Nourishing Approach for Loved Ones with Dementia
A person-centered approach to eating assistance in late-stage dementia is about fostering an environment that respects the individual’s autonomy, preferences and inherent dignity. It’s an ongoing journey of discovery, adapting strategies to align with the ever-changing landscape of Alzheimer’s and other types of dementia.
As devoted care partners, our role is not just to nourish the body but, more profoundly, to nurture the spirit, ensuring that every meal is a moment of connection and comfort amidst the challenges of late-stage dementia care.
I understand the difficulties from multiple perspectives, as a Board-certified Patient Advocate and the life partner/care partner to my Brian on his journey with Alzheimer’s disease and vascular dementia. Let me help you navigate these realities!
