Eating and assessment
An assessment should be carried out to consider whether there are any barriers or impairments that are affecting eating. A full assessment would include consideration of dental health for instance, false teeth not fitting, loose teeth or tooth sensitivity.
An assessment may be carried out by a specialist such as a speech and language therapist or an occupational therapist. However, assessments can also be carried out by nurses, healthcare assistants and non-professional carers. There are freely available tools to guide this assessment, for example:
• The Edinburgh Feeding Evaluation in Dementia Scale, which helps with identifying the level of assistance a person with dementia needs.
• The Dementia Mealtime Assessment Tool (DMAT), which helps with selecting interventions, and generates a person-centred care plan. This is in the form of a printable form, and is also available online and as an app, both of which identify interventions based on responses.
From a social and cultural perspective we might want to consider if the food the person likes is available and if it is available at the time they would normally eat. We should also consider the environment in which meals are served. Again an assessment of this behaviour should be considered as it is important to be aware if this behaviour occurs at certain times of the day and if this is related to the cause.
An important point to bare in mind is typified by the concluding remarks of a Japanese study: ‘most Alzheimer’s residents continue to spend their days alone, doing nothing, with little social interaction; and what we call “null effect” is probably concealing much more sadness and loneliness than we would care to admit’ (Schreiner et al. 2005: 134).
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