By Alice D. Domar, Ph. D.

 Mealtime means more than just eating food. Ideally, mealtime is a time for relaxation and lively conversation among your family, your loved one, and you. Yet, when someone you love is suffering from cognitive impairment—whether Alzheimer’s disease or another form of dementia—meal time can become a demanding, stressful experience for everyone, particularly you.

Here are some tips on how you can handle meals with both resolve and compassion, so your loved one has the most nourishing and nurturing experience possible and so you won’t dread it.

Stick to a Routine

Creating a routine provides your loved one with a daily measure of predictability and comfort.  And, when you know your loved one is at ease, you may well feel relieved and feel your stress level decreasing—at least for a little while. Here are a few suggestions for establishing a mealtime routine:

• Try as best as you can to serve meals at about the same time every day
• Seat family members in the same place at the table
• Designate a family member (you if necessary) to sit beside your loved one to assist him/her, when needed.   
• If possible, ask another family member to handle clean-up, so you’re free to leave the table with your loved one  

If your loved one is unable to eat meals at the family table—due to either ability or desire—his/her room may be a more familiar and preferable location for dining.  If so, you can establish a mealtime routine that also affords him/her the same comfort and well-being as eating with the family. 

Keep It Simple

Make mealtime as easy and stress-free as possible by simplifying the ways you prepare and serve food to your loved one. You should:    

• Describe the foods being served   
• Cut food into-bite sized pieces before serving
• Serve food to your loved one rather than have him/her do the serving
• Offer finger foods, and those that are easy to eat with a fork—if your loved one can still manage using utensils
• Avoid hard or sticky foods; moisten foods as needed    
• Serve one course at a time
• Set out only those utensils needed—don’t set out “multiple” forks, spoons or knives
• Use lidded cups or glasses with bendable straws to making drinking easier and reduce spills
• Select brightly colored dishes that “show off” food
• Remove decorative centerpieces—these may distract or confuse your loved one while eating

Prepare Favorite Foods

You should also ask your loved one about his/her food preferences or ask relatives which ones they recall, and serve them often. These favorite foods can help make mealtime more enjoyable for both of you. 

Food preferences, however, can change and certain foods can suddenly become unpalatable. Just be sure your loved one’s daily nutritional requirements are being satisfied. Check with his/her physician or dietitian when you have any questions about meeting daily requirements for a healthy balanced diet, as well as potential negative interactions with medications.

If your loved one’s activity level decreases, his/her caloric needs will drop, too.  In this case, you may see an appropriate reduction in appetite. If you encourage your loved one to eat the same amounts as when he/she was more active, weight gain may result. This may be unhealthy and make caretaking more challenging. 

Remember that you shouldn’t focus solely on preparing foods that your loved one prefers. Giving up foods you enjoy is likely to make you feel deprived and resentful. 

Step Away from the Family’s Table

The time may come when your loved one can no longer maintain the family’s mealtime routine. It may be necessary to feed your loved one in bed or at a table in his/her room.

At this point, it may be best to serve meals one-on-one rather than have others present who may distract your loved one from eating.  Here are some steps you can take to prepare him/her and yourself for mealtime:  

• Be sure your loved one is in a comfortable position—propped up in bed or seated at a table 
• Tuck a napkin under his/her chin or gently cover his/her chest with a towel
• If bedridden, move coverings away to protect them from food spills
• Always wash your hands before preparing a meal and/or feeding your loved one
• When your assistance is needed, feed your loved one slowly—most often from the tip of a spoon
• Watch your loved one to be sure the food is swallowed after each bite
• Offer a moistened towel or napkin for washing hands after the meal

Also, if at any time your loved one seems to be overly tired, you may want to stop the meal and try again at a later time when he/she is more rested. 

Care for Yourself

As your loved one’s caregiver, it’s easy to be focused on his or her care and neglect your own.  Whenever possible, take turns with another family member or ask a friend to serve a meal to your loved one, so you can have a brief respite before resuming caregiving duties. Local resources, such as Meals on Wheels, also can provide meal services when needed.

Resources

Alzheimer’s Association           

Alzheimer’s Society–United Kingdom

4Therapy.com Network

Meals on Wheels