In-Home Care Supports Good Nutrition for People With Alzheimer's
Professional in-home caregivers help tempt the appetite of clients who are living with dementia.
In November 2016, a study about the dementia rate published by University of Michigan researchers drew a great deal of attention. According to Dr. Kenneth Langa and his team, the percentage of American seniors who develop Alzheimer's disease and other dementia is declining.
This was uplifting to hear, but some news sources misinterpreted the data, claiming that soon there will be fewer people living with dementia. Demographers remind them that even if the percentage will be smaller, with our rapidly aging population, the actual number of people with memory and thinking problems will be substantially higher than at present. The Alzheimer's Association predicts that by the year 2050, more than 13 million seniors will have Alzheimer's disease, up from 5.4 million today. And with today's smaller families and greater geographical distance between family members, an ever-shrinking pool of caregivers will struggle to care for these seniors.
Experts tell us that seniors with Alzheimer's disease tend to do best if they can stay in familiar surroundings, where they can maintain their long-time routine. Today, more families are hiring professional in-home care to allow their loved one to remain at home longer—whether that is in the elder's own home, the home of an adult child, or in a senior living community where the senior moved before developing memory loss. Dementia care provided in the home includes supervision and personal care such as bathing, dressing, grooming and incontinence care. It's important to hire a caregiver who has been trained in the special needs of seniors with dementia.
This includes nutritional needs. March is National Nutrition Month, a good time to consider the ways that in-home caregivers help clients with dementia continue to eat a healthy diet. While dementia doesn't change a senior's dietary needs, it does pose challenges to consuming those nutrients. Memory and thinking problems make it harder to prepare and eat a healthy diet. The appetite decreases as taste and smell diminish—or, a person might eat too much, forgetting what they have recently eaten. In-home caregivers help clients overcome these physical and functional challenges in several ways:
Planning and shopping for nutritious meals and snacks that meet the client's requirements as determined by the healthcare provider. Caregivers can go to the grocery store, or the caregiver and client can make an outing of it. Helping to select ingredients creates a sense of independence and enhances appetite.
Preparing meals. The caregiver can prepare meals for the client. Or perhaps the client enjoys cooking, but it's not safe for them to use the stove, or they can't remember all the steps of making a meal. The caregiver can help them do what they can, while providing watchful supervision and assistance. Here again, participating in the preparation is an appetite booster.
Providing mealtime companionship and helping clients eat. A recent study from the University of East Anglia in the UK found that socializing is a top factor in promoting good nutrition and adequate hydration for people with dementia. Most of us eat more if we're not eating alone. Having the caregiver as a dining companion provides warmth and a positive mood. And dementia care experts offer this tip: Watching another person eat reminds a person with dementia to do the same. Caregivers also can provide feeding assistance if necessary.
Addressing safety concerns and reporting problems. Some foods are harder to eat as the disease progresses. The caregiver can be alert for and report problems the client might be having with chewing and swallowing; it might be time to make some changes to the meal plan. Being able to eat independently enhances a client's sense of dignity, and small accommodations make a big difference. To help avoid choking and make eating easier, the caregiver can serve food already cut into bite-sized pieces. Coffee should be brought to the table already cooled to a safe temperature. People with dementia take longer to finish a meal; although a family member is most likely watching the clock to leave for work, a professional caregiver has the time to sit patiently until the meal is done. (To find a wealth of practical tips, see this "Food, Eating and Alzheimer's" tip sheet from the Alzheimer's Association.)
Reminding the client to drink enough fluids. With age, our sense of thirst diminishes, and dementia makes it even harder to realize that we need to drink. People with dementia can easily develop dehydration, dry mouth and constipation. Caregivers provide regular reminders for the client to drink water and other fluids.
Avoiding foodborne illness. Professional in-home caregivers provide housekeeping services, and in the kitchen, this is particularly important. The caregiver can be sure that foods aren't past their expiration date, perishables are kept cold, the kitchen is clean and sanitary, and that items the client might mistake for food, such as medications and cleaning products, are kept out of reach.
Providing medication reminders. People with dementia may take a number of medications, along with drugs they take to control other health conditions. Some of these medications can affect their appetite. The caregiver can remind the client to take medications and report a loss of appetite that might warrant a review of these medications.
Encouraging physical activity. Exercise is one of the top appetite builders. The caregiver can go for a walk with the client, or set up an exercise video at home. Perhaps a trip to an Alzheimer's café or other dementia-friendly activity would be just the mood booster to pique the appetite.
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