I remember going to the old neighborhood to visit mom. It was the home that I grew up in until I left for college. It was her first and only home with dad. She’d lived there for more than 65 years. With dad gone nearly three years, mom had been living on her own. Looking back, I realized she was in mid-stage Alzheimer’s. She was thin and pale. We had no idea what to do. Her doctor recommended a caregiver in-home, or moving her to long-term health care.
He said she was severely malnourished.
My family and I were so stymied. This was a woman who always cooked three meals a day for a family of six. During our two-week visit, we realized she wasn’t cooking anymore. She wasn’t going on her daily walks. She wasn’t socializing and stayed inside, except for the occasional furniture rearranging outside on the patio. We bought groceries for her. Not once, in the two weeks we were there, did she even think to visit the fridge for something to eat or drink. The familiar water bottle at her bedside quenched her thirst, and old crackers in her favorite snack basket on her dresser were her sustenance.
When the stages of dementia progress, nutrition is a serious risk factor. Weight loss and dehydration become fierce battles to fight. So we learned how to face this with confidence.
Make sure favorite beverages such as nutritional juices, water, or tea are provided all day.
To make sure nutrition needs are being met, the first step is to understand how the need for food changes. The ‘hunger’ signal and ‘thirst’ signal diminishes in persons with Alzheimer’s. Often, physical cues, verbal cues, and reminders to eat and drink are necessary.
The second step is knowing the individual’s medical requirements to provide the right foods. Once we had this, in addition to three nutritional meals a day, we knew to have her favorite beverages available all day: nutritional juices, water, tea, and mom’s favorite, coffee with cream (no sugar). We were told to celebrate mom’s favorites such as mocha milk shakes!
Present food in such a way that it’s easy to eat and appetizing.
The third step is understanding how to present food to make it easy to eat. We learned whatever the individual enjoys, within medical dietary requirements, provide: finger foods such as cut fruit pieces with dips or cut vegetables and cheeses with favorite condiments or dips. We learned that small sandwiches are best (cut in fours). Mom loved sliders, so it was an easy transition for her. We had no idea, as a person transitions through the stages of the disease, their ability to recognize food also diminishes. Individuals may no longer know what to do with that favorite hamburger in their hands, or what to do with the straw once they taste their favorite milkshake.
Keep main meals simple, one course at a time.
Lastly, we were told to keep the main meals simple. Provide favorites. Just do it one serving or course at a time. We were told too much on a plate is confusing. For example, we served mom salad at lunch with her favorite ranch dressing. When she was finished we gave her meatloaf and a small scoop of mashed potatoes. When she finished, we knew she’d love her favorite cooked carrots. The portions were small and she ate every bite. When she finished her lunch, we offered her favorite dessert, carrot cake. What we found most interesting is that mom needed to be encouraged to eat! She needed to have her food put on her fork. Once on her fork, we needed to let her know her food was ready to eat! It was strange. The woman who cared for all of us needed us to do the same for her.
So, what’s most important about meeting nutritional needs for persons with Alzheimer’s disease?
- Know the medical diet so you have a nutritional guide.
- Make sure favorite beverages such as nutritional juices, water, or tea are provided all day.
- Provide nutritional meals and present food in such a way that it’s easy to eat and appetizing.
- Keep main meals simple, offer favorites, and do one course at a time.
To give you the full story, mom stayed at home for another three months with a caregiver. Mom’s caregiver took her out a couple times a week to the park and the store. Mom was gaining much needed weight, her color improved, and she smiled more. Once we found an excellent memory care community for Mom, she moved.
We sold our beloved family home and kept the memories where they belonged: with our family.