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Orchard at Tucker Unveils 4 Tier Nutrition Therapy Program!

Nutrition Therapy at Each Level of Dementia Care

mousse-desserts-square.dlWhat is a common challenge for those with Dementia?

Challenges at mealtime are extremely common for those with dementia. These mealtime challenges will change as dementia progresses. There are distinct and separate challenges that are associated with early, middle and late stage dementia.

What are the common mealtime challenges for those in the Early Stage of Dementia?

  • Forgetfulness
  • Loss of concentration
  • Changes in food preferences
  • Reporting that foods taste bland (foods previously enjoyed)
  • No longer enjoying favorite restaurants
  • Unable to hold attention through a meal
  • Distracted by the environment at mealtime

What are the common mealtime challenges for those in the Moderate Stage of Dementia?

  • Confusion and unawareness of surroundings, place and time
  • Appetite increase and weight gain
  • Decreased appetite and weight loss
  • Failure to understand proper use of utensils
  • Refusal to sit during meal times- pacing, wandering
  • Increased difficulty with word finding and decision making
  • Unable to recognize food temperatures
  • Unable to see food as food (may think food is poisoned)
  • Unable to recognize food items once liked
  • Hiding of food

What are the common mealtime challenges for those in the Severe Stage of Dementia?

  • Preference for liquids over solids, due to appetite change or lack of swallowing ability
  • Aggressive or combative behaviors during a mealSmoothies
  • Clenches jaw, or closed fist when attempting to feed or be fed
  • Refusal to eat due to unknown reasons (variety reasons could be at play)
  • Inability to self feed, not being used to being fed
  • Swallowing impairments ranging from mild to severe
  • Weight loss despite regular caloric intake (can also be due to increase activity due to increased anxiety)

What are some important tips for a creating a dining environment for those with Dementia?

  • Tableware contrast ( avoid white plates on white linens)
  • Too many utensils
  • Avoid high gloss floors
  • Natural light is best
  • Avoid a distracting dining environment with too many items on the table
  • Make sure the table and chair is sturdy, and of the right height
  • Simplified dining room is best
  • All food served at once is usually best (although there are some exceptions)
  • Offer finger foods (avoid finger food that are too intricate or rare)

What if the above tips do not work?

If the above tips do not help with the challenges presented at mealtime, your team needs to take further steps to make sure that nutritional needs are met and your resident with Dementia is getting adequate caloric intake and the necessary nutrition.

The first thing your team needs to do is to do a full assessment of each person’s unique situation and determine the specific deficiencies caused by the mealtime challenges.  During the assessment your team must set goals and prioritize the deficiencies, identify resources needed based on the severity of a person’s challenges. Your team needs to also identify possible behavioral and nutrition interventions such as a change of dining environment. Finally your team should specify the time and frequency of the intervention.

What’s Next?

Please check back soon for Part II of this article

 

Anxiety is Another Road Block to Dementia Care at Home

Common Psychological Conditions

Apathy, depression and anxiety are common conditions experienced by people with dementia. They are known as psychological conditions because they can affect a person’s emotional and mental health.

What is Anxiety?

Anxiety is a normal feeling that everyone experiences now and again. In
some people, however, these feelings can be very strong and persistent.
This can interfere with a person’s everyday life. Anxiety is the main symptom of several conditions, such as
anxiety disorder, panic disorder, phobias and obsessive
compulsive disorder.

Who gets Anxiety or One of the Related Disorders?

About one in 10 people will experience an anxiety disorder at some point in
their lives and many people will have more than one form. Anxiety is substantially more
common in people with dementia than those without.

Why do those with Dementia get Anxiety?

In the early stages of dementia, anxiety may be linked directly to a person’s
worries about their memory and about the future. Changes to the brain, caused by the
dementia, may also lead to anxiety. Anxiety in people living alone has been linked to unmet needs,
including a lack of daytime activities and a lack of company. As dementia
progresses, people become more disorientated and confused, more forgetful and worse
at thinking things through and planning. This constant struggle to make sense of the
world around them can therefore be an underlying cause of anxiety.

How to Manage Anxiety?

People with Dementia and Anxiety benefit from being listened to and reassured. Living in an environment where someone is always available if needed to reassure a person and to make them feel safe is crucial to minimizing feelings of anxiety. Other ways of helping include creating the right environment, so that their living environment is calmer and safer, and they have an improved structure to everyday life. Social Engagement is very important in soothing anxiety. Providing the right activities and encouragement for those with dementia and anxiety has been shown to be very effective. Productive activities include exercise and activities which have meaning for the person.

anxiety