One of the most important things we do to sustain life is eating. Food gives us life, contributes to good health, satisfies our hunger, and stimulates our senses as we gather around with family and friends.
When you look back over time, some of your happiest memories will be centred around sharing food: preparing holiday dinners, celebrating birthdays, a dinner out with a good friend. Which makes it that much harder when the loved one you are caring for starts making the process difficult. It may start with a diminished appetite yet can quickly become frustrating as mealtimes become a battle.
When people suffer from certain diseases – Alzheimer’s or other types of dementia, for instance – many things begin to change that can impact their appetite. Appetites decrease overall as a normal part of ageing. Some may find foods don’t taste or smell as good as they once did, making them less appealing than before. Some have difficulty chewing or swallowing. Medicines can also affect appetites, making one feel fuller than they really are. And with a disease like dementia that impacts the brain, it can also impact any part of the body that controls the seeing, thinking or moving process. If seeing the food, preparing it to one liking, or even scooping it up becomes a problem, it takes the pleasure out of eating.
As a caregiver, it’s important to not judge the situation but rather understand the meaning behind what’s happening. Eating related challenges can result from:
- Cognitive issues – remembering when to eat, how to eat, or how to express one’s desires can make it less appealing
- Behavioural issues – depression and having difficulty sitting can make mealtimes a challenge
- Physical problems – tremors, vision impairment, gum disease, swallowing problems
- Environmental issues – poor lighting, uncomfortable room temperature, loud noises
- Menu issues – too many foods at one time, foods that don’t meet an individual’s personal taste, wrong textures, poor presentation
- Chronic diseases – different diseases present unique challenges, such as intestinal issues or decreased appetite
- Medication issues – different combinations of drugs can interact with food
Rather than focusing on getting your loved one to eat, a caregiver focuses on what is happening instead. In some cases, it’s easy to pick out what the problem is almost immediately. Suppose the person is having trouble getting the food onto the fork and move the fork up to his mouth. In that case, you can focus on finding a solution that will make that process easier. When observing the situation, look for:
- The visual aspects of the environment
- The noise and how it impacts your loved one
- The choice of food, how it smells, how it is displayed, how well your loved one enjoys it
- How well a person handles the mechanics of eating
- How emotional your loved one is throughout the process
Take notice of the things that work well during a meal and things that cause problems. Instead of focusing on the food, make subtle changes to see reactions. Turn off the television for a meal. Use different sizes of plates, cups and utensils. Change lighting conditions.
As you find things that work, use them more. When you find things that agitate, test to see if you’ve found the true source of the problem. Remember, this isn’t a personal attack on your cooking or a personal choice to simply stop eating. There is usually a reason behind the problem.
You can also make mealtimes fun again. If it’s been a long time since you’ve made mealtime into an event, consider having over a friend or family member to enjoy a meal with you. If you are able, you can meet in a favourite restaurant for a change of pace. As a caregiver, it’s easy to get caught up in the moment, making mealtime another checkmark in a long list of to do’s. Yet when you step back and look at it as an opportunity rather than merely a way to get the next set of medications into the system, things can change quickly.
Mealtime is a process, an activity. It’s not the outcome that matters. Give your loved one things to do as a part of that process. Setting the table. Chopping vegetables. Mixing the sauce. All of it can make a person feel like they’ve contributed, which may make them more likely to enjoy eating it as well.
No matter how weak we get or how dependent we become on the person caring for us, independence is still something we all strive for. Because no one can control how much or the way we eat, it’s often the one area where people exert their last bit of independence. Instead of making it a battle, make it a time of enjoyment instead. A time to share and reflect on the day. A time for enjoying each other’s company.
With just a little change, you may start noticing the difference.