Sunday, May 15, 2011

Mealtimes with dementia clients

Dad tolerated the bib well
More research. This time by Holly Reimer, a registered dietician, and PhD candidate at uGuelph.
One of the routines involves showing residents the two meal choices. Sample plates, covered in plastic. This is part of the routine of larger institutions, as the staff can determine which meal a resident wants through body language, eye contact and more subtle gestures.

Staff need a toolbox of strategies, the author writes, in order to deal with challenging residents who refuse to eat:

Flexibility, rotating table service, individualized mealtime care, more staff education and training, recruitment of family members and volunteers at mealtimes.
sometimes his hands shook so much
he couldn't hold his mug

This is a great set of tools. Unfortunately, more staff and staff training are two of the issues that those of us involved in advocating for seniors in long-term care are finding difficult. LTC are very different from facility to facility. Most are for-profit, most are strained enough, meeting the individual needs of clients.

Also, tricking and cajoling residents into eating seems bizarre. If they had the staff, if would be better to allow the residents to eat when they wished. This makes more sense with higher staffing ratios, but this isn't going to happen. What would really be great is fresh fruit, buffet meals, the ability to make sandwiches, but we know this isn't going to happen in large institutions.
In LTC where I have volunteered, they serve food prepared by a method called 'retherm'. It is precooked, and kitchen staff only need heat the food. It is horrible, for the most part. I know. I went in every day to feed my father dinner in the last months of his life.

Dietitian researching quality mealtime for residents with dementia
Preliminary findings suggest greater flexibility, 
more education needed
TORONTO - Having enough helpers and the flexibility to individualize care are amongst the keys to providing person-centred mealtime care for long-term care residents with Alzheimer's disease or dementia. Full Story

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