Saturday 7 September 2013

Dementia - eating and drinking

Many of us know how hard it can be, trying to persuade someone living with dementia to eat and drink sufficiently. It’s been quite a few months now since Mum came out of hospital after a serious UTI, but during those months, I’ve experimented with a wide variety of foods, from ready-meals to full blown home-cooked dishes.

The results have been quite conclusive, and ready-meals hardly feature at all. I’ve tried finger foods, but Mum is easily distracted, and tends not to eat as much as she should.

Knives and forks are out, as food ends up all over the place, and not in her mouth. Her co-ordination with any form of eating utensil is clumsy to say the least.

Persuading someone with dementia to drink is also a problem. The solution here is simple - foods with a high liquid content. Cereals, with plenty of milk, for breakfast, and soups or other high liquid content foods for lunch. I tend to opt for the higher fibre soups containing beans or lentils, although I also use Baxter’s Mediterranean tomato soup, which has a high tomato and vegetable content. Food with a higher fibre content, aids digestion, and helps to avoid constipation.

Heinz now produce a five bean version of baked beans, in their Snap Pots range, and these have proved very successful alongside soups. Beans, as we know, are high in protein and fibre, and the Heinz Snap Pots Five Beanz contain Kidney beans, Haricot, Pinto, Borlotti and Cannellini beans.

OK, so we’ve sorted breakfast and lunch, but what about dinner? After many months of experimenting, I’ve started to compile a list of home-cooked dishes that Mum will eat, with no problem. I have to add at this point, that due to co-ordination issues, I generally spoon feed.

Nasi Goreng

I have produced a concise list (more will be added later) of dishes that Mum will eat, with little or no encouragement. Wherever possible, I try to avoid the use of prescription food supplements such as Fortisip or Calogen. The dishes are varied, and quite cosmopolitan, offering a variety of ingredients and flavours. Thus far, the list consists of the following:

1. Cottage Pie – this is the one and only ready-meal to feature as, to be honest, it’s easier and cheaper in this form - served with a variety of fresh vegetables, primarily broccoli, spinach, cabbage or Brussels sprouts, and gravy.
2. Bangers (sausages) and mash, again with a variety of vegetables, and onion gravy.
3. Chilli con Carne with rice, and plenty of red kidney beans.
4. Spaghetti Bolognese, with added tomatoes and basil.
5. Bauernfruhstuck – Farmer’s Breakfast, a sort of German bubble and squeak, made up of diced potato, bacon or ham, onions, eggs and parsley.
6. Nasi Goreng – an Indonesian fried rice, containing meat (usually chicken, although, I often use bacon lardons), prawns, leeks and rice, using Sambal Oelek (Indonesian and Malay chilli sauce, although Thai Red Chilli sauce can be used as a substitute), topped with a fried egg.
7. Cheese and mushroom omelette.

Of course each individual has a personal taste and preference, but variety, as the saying goes “is the spice of life” (excuse the pun). Finding meals that are acceptable and enjoyable, as well as being nutritious is, of course, paramount.

By using meals that have a higher than average liquid content, helps overcome some of the drinking issues faced by care givers of those living with dementia. Without them realising, they are taking on more liquids, helping to counter their unwillingness to drink sufficient fluids.

Drinking is of course still to be encouraged, in order to avoid a variety of problems, including dehydration and potential UTIs. Again, it’s a matter of finding what they will and will not drink. Mum will often drink tea, but not always in sufficient quantities, she is, however, quite partial to apple juice and grape juice, so that helps. Ice cream (of the diabetic type if needed) and yoghurt are also useful for introducing extra fluids. Of the flavoured varieties of yoghurt, I generally favour the Raspberry flavour, as this tends to be higher in fibre than other flavours.

Getting someone living with dementia to eat properly can be difficult. Taking both nutrition and variety into consideration, and then experimenting can help both the caree and the caregiver. Mealtimes become less fraught and more enjoyable for both.

If you have other suggestions to offer, please feel free to share them here.

3 comments:

  1. This is indeed one of my own concerns. Currently, Dad is going through a period of depression - 'food does not taste the same as it did 50-80 years ago' - ie, before I was born.

    Most days his appetite is good for food, but poor with fluids. He will have fruit/cereal/bread & spread with tablets and half a mug herbal coffee substitute for brekkie most mornings.

    Lunch consists of a cup-a-soup (NOT red ones, as these make him cough, 'apparently') served an hour before a main meal with dessert. (I often combine fresh veg with a vegetarian ready-meal, and as with your Mom, cottage pie, sausages, cheese omelets, are all good. He also likes Indian snack foods, the Linda MCcartney vegetarian range, and sandwiches. Dessert is often dates, prunes, dairy-free yogurt, choc pud, fruit and oat-cream...)

    Dinner tends to be a main or snack meal (if he eats a sandwich or omelet on a trip out for lunch, a main meal, if not either a snack or main.) Then, he is set free on some plastic tubs of goodies. I try to combine tastes he likes with foods that are healthy - so dried cranberries, choc-ginger, small lumps cheese with snacks/crackers, yogurt or choc coated fruits, etc - currently he is partial to cheese n onion twists!

    I try to get him to drink a morning, afternoon, and evening drink along with these meals - and most days he will oblige - though he often falls asleep and complains that there is a line of drinks on his table! He accepts decaf tea, cordials, non-alc beer/wine, but some days NOTHING appeals other than 'old flavors' such as coffee/alcoholic beverages.

    He has a flask of tea overnight, along with a tub of cookies and I bring in a cup of tea at 5-50am each morning to 'start' the day. He always has water at hand, as well...

    At the moment, we are experimenting with new drinks - as he has started to sleep more and leaves them sitting around. New tastes appeal temporarily, but do not often receive favor for long. I find it a constant battle of balancing the old but forbidden with the new and tasty. Part of our problem is a hankering for tastes of the past... some days, nothing BUT those familiar to him flavors will suffice - but he is no longer able to drink alcohol and I cannot cook foods that no longer exist!

    ReplyDelete
  2. Hello,
    When my father had Alzheimer's, there was a point when he stopped eating. My mother realized he couldn't swallow regular food and fed him baby food. There was nothing else on the market that was a prepared pureed meal. It was emotionally degrading and not nutritionally sound for an adult. But at least he ate it. Soft foods often are the only food they can comfortably eat. My father is my inspiration to help people find alternatives when they can no longer swallow, digest or chew regular food.
    Thanks, Karen

    ReplyDelete
    Replies
    1. Thanks Karen. Using a food processor, it is possible to "puree" home cooked foods, so that the person living with dementia is able to eat it. Where possible, I'd recommend this route, otherwise it's down the route of food supplements, such as Fortisip, which, due to a high sugar content, are not ideal, especially where the caree suffers from diabetes, which is quite common. Better to use pureed food, and vitamin supplements, especially B complex, than go down the "easy" route. Baby food, is not nutritious for an adult, and frankly tastes disgusting - no offence, I tried it with Mum once, and she hated it, so did I!

      Delete