Mealtimes provide important opportunities to socially engage and continue meaningful roles. If cooking was a prominent part of a person’s role in the past, finding ways to continue their participation is really important.
Research into mealtimes found that families can promote involvement by thinking about how a person with dementia can participate and have a role in mealtimes, and by providing supervision and assistance as needed. The research found that:
- mealtimes can be a good opportunity for people living with dementia to make decisions
- help should be provided (such as following a recipe) without taking over
- letters, emails or familiar objects at the table can be useful conversation aids
- seating near a window can prompt conversations about outside (such as birds in the garden)
- specific foods can trigger memories, which can spark conversation
- slowing down the pace of the conversation and recapping conversations help interaction
- rehearsing names prior to family mealtime visits can help
At Newcastle University, researchers created an ‘Ambient Kitchen’ which was a proto-type kitchen fitted with sensors integrated into the floor, benches, cupboards and utensils. The aim was to investigate how people living with dementia can continue to take part in food preparation. Projectors were placed within the workbenches to allow the display of cues, prompts and information (e.g. recipe steps), so that a person could more easily follow procedures for making a cup of tea, or a simple meal.
Issues for people living with advanced dementia
For people with more advanced dementia, they may become dehydrated because they are unable to communicate that they are thirsty, hungry or full. This can lead to headaches, increased confusion, urinary tract infections and constipation. As dementia advances, a person living with dementia may engage in behaviours that make mealtimes challenging. The Edinburgh Feeding and Dementia Scale outlines some of the challenging behaviours we may face:
- Leaving mouth open
- Refusing to swallow
- Turning head away
- Refusing to open mouth
- Refusing to eat
What can we do to improve mealtimes?
The following strategies can help:
reduce distractions (turn off television, use a contrasting plate and table)
eating in a chair rather than bed will promote good posture,
if possible make mealtimes a social activity
use verbal cueing and prompting (e.g. take a bite, swallow), to demonstrate the motions so person can copy
use hand over hand to guide a person
keep the focus of the conversation on the meal
We can make things a little easier by making compromises too - by using external meal providers, or semi-prepared foods., or asking family members to take a turn organising meals or bringing ʻpotluckʼ contributions. This can help to reduce carer stress.
What has helped you at mealtimes?