Our role as therapists is to help all residents perform at their best and to ease the burden on caregivers and family members. One patient population that can be particularly challenging is patients with a dementia diagnosis. Speech-language pathologists play a key role in improving their nutritional intake.
A common problem observed by speech-language pathologists in skilled nursing facilities is residents leaving the dining room before finishing their meal. Here are a few intervention ideas to ensure patients with dementia or Alzheimer’s diagnoses are eating sufficiently for proper nutrition.
Survey the room. Do you observe anything that could be perceived as excess stimulation? For some residents the dining room space simply contains too much stimulation. Often the sounds of caregivers or sounds from the kitchen can be overwhelming. Try playing soothing music, or inquire if the resident may eat in a quieter environment or room. Therapists can also limit visual distractions on the table. Use only utensils and the meal; anything else is a distraction. Also, serve only one or two foods at a time.
If the resident must be on the go, offer finger foods that allow them to wander while still getting needed nutrition. Many older residents used to go to work with a lunch pail. Try packing a lunch for the resident and letting them eat where they choose.
When you have a patient with Alzheimer’s who requires a modified diet, in which they can’t “eat on the go” and they still have trouble staying in the dining room, let them move. They may be able to stand at the dining table and eat a few bites, but then need a break to walk around the room. Eventually, you can redirect them to the table again for more intake, and repeat. This way you are not fighting the behavior or urge to wander, and you accomplish the goal of safe intake while decreasing client anxiety.
On top of all these problems, time is often the hardest concept for nursing and caregivers. The resident needs time to safely eat and drink. Sometimes they may require more than an hour to eat a small meal. In addition, they may not remember when, or if, they ate. If you have a resident who continues to ask about eating a meal, consider serving several smaller meals over a period of time.
While each resident is unique and may respond to many other environmental or meal time modifications, these suggestions are generally well-accepted interventions for patients with dementia or Alzheimer’s diagnoses.
Regional Clinical Manager Jolene Denn, SLP is an expert on dementia and has presented a CEU course on the subject to RehabVisions therapists.
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