Did you know that malnutrition is one of the most important
conditions that negatively affect the health of older adults? This is
especially true with those who have dementia. In a study of nutritional status of patients affected by Alzheimer's disease living at home and the nutritional status of their
caregivers, malnutrition was prevalent among both patients and their caregivers. Corrective
measures included a nutrition education program and other intervention policies
to restore nutritional status.
A hospice volunteer in
Detroit, MI nursing homes for many years, I often sat during mealtimes at a table
with several residents who had dementia. Due to ongoing staff shortages, I
supervised everyone at the table in addition to the hospice resident assigned
to me. Because I was also a school principal familiar with multi-tasking, I did not
mind assisting in this manner. It became clear to me early on that some
residents would eat minimally or not at all without my additional support. This
is an example of a typical mealtime scenario:
“Petra, your food is
just sitting there getting cold. You have a whole tray of delicious things to
eat. You should eat some and see how good it is. You’re a good eater. Eat your
food.”
“Food? What food? I
don’t have none.”
“Watch me
point to your food. You have coffee, juice, milk, mashed potatoes, fish,
broccoli, bread, and fruit. That’s your name spelled P-e-t-r-a.”
“That’s not my name. My
name is Petra. That’s somebody else’s name. That’s not my name. I know my
name.”
“You should eat before it gets cold. Go ahead and eat.
Give it a try.”
“Eat? Eat what?”
From previous experience, I knew that Petra and I could
go on roaming forever around this same circle. Luckily, she was sitting next to
me that day. I gave her a taste of the fish, something I knew she liked.
Because I was aware that she was capable of feeding herself, I placed her fork
in her hand and started her off eating. I did this in steps by steering her
hand and giving her directions on putting food into her mouth, chewing, and
swallowing. Residents with dementia needed tasks broken into simple steps.
Usually,
she ate for a while by herself, even with her hands, after somebody started her
off. In fact, some nursing homes serve regular meals in the form of finger
foods to further assist residents with dementia. But without any help from me getting her started and restarted, she would sit and look at the food she said was not
there. While this was going on, I also assisted my assigned hospice patient who usually ate well on her own, and I
continually corrected and praised everyone else at the table. Like my students at school, someone would often say, "Look how I'm a good eater, too!" when I praised another resident. Everyone loves a word bouquet!
Featuring
eating and drinking, this video is an excerpt from the program "Advanced
Care in Late Stage Dementia" with dementia expert Teepa Snow.
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog
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