Monday, January 11, 2010

Alzheimer's Disease and Eating Diffuculties

Mom, until recently was able to inject quite a bit of humor in her conversation. A few months ago she looked across the table at the woman who sits across from her and said "she is so thin she looks like an xray". The irony of this comment comes from someone who weighs 92 pounds.

Eating difficulties and weigh loss are relatively common in Alzheimer's Disease. The damage in the brain affects the perception of food and hunger. In other words nothing smells or looks good. Hunger like pain may not be percieved for what it is. As the disease progresses the ability to remember what food is for is lost. Another eating problem which occurs in the disease is the inability to hold eating utensils, such a fork or spoon.

Chewing and swallowing problems also arise as muscle diffucuties in the throat and tongue arise. This slows the eating process and increases choking. It makes the meal process more problematic and less pleasureable. Eating becomes a chore for all involved, especially for the person.

Interventions which help with eating and prevent weight loss
1. Cue the person by eating with them to "rolemodel" the process
2. Make foods into finger foods so the person can help themselves as long as possible which perserves dignity and independence. This can be done by make most things into a "sandwich", including peas and mashed potatoes.
3. Remove distractions at meal time including music and TV. Even these are distractors to the brain which has diffuculty sorting out what is going on in the enviroment.
4. Take enough time for the eating process. Meals may take 30-40 minutes of eating time, but we must keep the food warm .
5. Add calories whenever possible. This can be in the form of butter on everything!! Lots of it! Also adding peanut butter on crackers or celery or high fat ice cream to Carnation Instant breakfast or Ensure.
6. Remember calories are king.

Meals are VERY important. Without this focus it leads to "failure to thrive" weight loss and a premature downward slide and loss of quality of life.
May God be with you and may She hold you in the palm of her hand.