ניהול תזונה עם דמנציה ואלצהיימר

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Introduction

Many things can change in a person’s life when they are diagnosed and progress through dementia and Alzheimer’s. Mealtimes can become more significant as it provides an opportunity to have some control and make choices in addition to helping with orientation to time and place. Mealtime structure has positive benefits to nutritional and mental status and facilitates opportunities for social interaction.

People with dementia and Alzheimer’s may, over time, experience:

Nutritional Factors

Good nutrition is an important part of providing care for someone with Alzheimer’sor dementia and it is essential to help them to access a healthy and varied diet. It is very common for people withAlzheimer’sor dementia to change their food and drink preferences although this varies from person to person.
Poor nutritional intake can lead to:
  • Reduced cognitive function;
  • Less energy;
  • Reduced muscle mass and strength;
  • Reduced mobility;
  • Increased susceptibility to infection.
 

Reasons for Dietary Intake Deteriorating



Managing the Food Environment


Managing the food environment can make eating easier for people affected by dementia and Alzheimer’s. Aim to make mealtimes less stressful and more enjoyable in order to support nutritional intake and health. Stay relaxed, calm and available to provide support at mealtimes. It is important to allow the person to still feel helpful and involved in the preparation of food —  for example, laying the table or helping with dishes— for as long as possible to help them stayed tuned into the eating environment,reminding them that it is time to eat.


Setting the Eating Scene


Calm and Quiet Environment

Setting up Table
Those suffering from Alzheimer’s or dementia may eventually need some assistance when eating but always remember that self-feeding, however messy, is always the best option.
Keep the table simple. Avoid distractions such assalt and pepper pots, sauce bottles, flowers, candles, or decorative tablecloths. Use primary coloured plates, especially red and blue, as these offer contrast to the food and can help increase dietary intake by up to 30%. Use lipped or high-sided bowls, plates, and adapted cutlery if necessary to make eating easier. A plain, solid-coloured place mat can help the person recognise where to sit and eat.

Solutions to Common Problems


This section will detail some possible solutions to common problems experienced by those affected by dementia or Alzheimer’s and how carerscan deal with them. Reminding g& Encouraging the Person to Eat

Overeating & Wanting to Eat too much

It is more common to worry about weight loss rather than weight gain in a person suffering from dementia or Alzheimer’s, however, weight gain can happen if the person insists that they have not eaten when they have already. This is usually a temporary phase. However, there are some things to look out for if weight gain becomes a concern:

Changes in Preferred Food

It is very common that people change their favourite foods as they experience alterations in how flavour, texture and smell are recognised. They might start to enjoy spicy foods and highly flavoured foods that they did not enjoy in the past.For this reason,you might be surprised to find that people with dementia or Alzheimer’s develop a taste for food combinations that perhaps you would not try yourself!
This is a good opportunity to introduce new foods that they may not have liked before, particularly healthy and nutritious foods that, if adopted into the everyday diet, could make up for some nutritional deficiencies and diminished appetite. Keep an updated list of new foods that the person now enjoys. Increasing flavour in food does not have to be complicated, adding herbs, spices, or lemon juice can make a big difference. Try not to add extra salt, particularly if the person has high blood pressure or the vascular form of dementia. If you are offering things like pickles, relishes, vinegar, mustard, salad dressings, or tomato ketchup to increase flavour, ensure that you choose low salt varieties and low calorie ones if you are worried about weight gain.
Bear in mind that not everyone starts to like new foods and some people find it easier to remember and enjoy the foods of their childhood more.

Only Eating Sweet Foods

Important!
It is common, especially at the end stages of dementia or Alzheimer’s, for the person to only accept very sweet foods, which can have a negative impact on nutritional balance. It is important to seek the support of a clinical dietician in order to maximise the nutrient density of the person’s diet at this point.
If the care recipient will only eat sweet foods, there are a number of ways to try and get as much nutrition in as possible.
  • Do not resort to low nutrient dense foods like biscuits or cakes;
  • Encourage the consumption of milk-based desserts, e.g. crème caramel, thick and creamy yoghurts, custards, rice pudding, semolina, or mousses;
  • Fruit based desserts are also good options, e.g. stewed or tinned fruit. Add a bit of honey or golden syrup to make them sweeter;
  • Some vegetables are quite sweet-tasting, e.g. peppers, carrots, sweet corn, or sweet potatoes. You can also consider adding a little bit of honey or golden syrup to other vegetables too.
 

Dealing With a Very Active Person Who Finds it Hard to Sit Down to Eat

People experience symptoms of dementia or Alzheimer’s disease differently and while some are very capable for sitting for periods of time without becoming distracted, others can become highly agitated and therefore pace or move around a lot. These active individuals are at risk of both losing weight and finding it difficult to eat enough to meet their increased energy expenditure. To counteract this, a number of measures can be introduced:
Finger foods
Finger foods are a good option for a number of reasons. They are a good way to work calories in throughout the day while not being as daunting as a large meal, particularly for those who are reluctant to eat. They are also easy to eat and do not require cutlery, which can allow for greater independence and lend towards more of a willingness to eat. Finally, they can be eaten on the go for those who are easily distracted at mealtimes or agitated. If using finger foods, do not just offer lots of party foods. These are often of low nutritional value. Instead, offer bite-size portions of regular foods. The following are some examples:

Hydration

People with dementia or Alzheimer’s can be prone to dehydration due to loss of the sensation of thirst or forgetting to drink. Most people need 6 to 8 glasses or mugs of fluid each day. This helps with concentration, keeping the kidneys healthy and avoiding constipation. The following are some tips to help encourage care recipients affected by dementia or Alzheimer’s to keep hydrated:

Important Points

There are two important instances when it is very important to seek professional help and guidance: