Help Needed With Feeding..... - Alzheimer's Disease & Dementia Message Board

Lessons2005 · 05-23-2008, 11:49 PM

Hi Everybody,

This explanation could get kind of lengthy. I have some very dear friends (they are like second parents to me) who have a father in a skilled care facility with Dementia. We are all fairly new at dealing with this and as I am very close to the family I thought I would try to find some experienced advice online for them.
Here's the story, Papaw (that's what everyone calls him) has dementia. He has had some other medical issues that have led up to this point but to make a long story short he is basicly confined to his room because he has a Wound Vac on his leg. The nursing home where he is at will bring his food, set it in front of him and leave!!

He can not feed himself, even when he is fed there are only certain people he will eat for and even then he eats very little. The last time I visited, we walked in his room and there he sat looking at some cold roast beef that he wouldn't have been able to chew even if he could feed himself. They are trying to get the nursing home to understand that he needs protein shakes, puddings etc. but that's a another story. Anyway, between me and another person he ate a little bit of ice cream, but I noticed after every bite he would say something to the effect of "now you take a bite", so I told the family afterwords that they need to eat something with him and then maybe he would eat better. They hadn't thought of that and they are going to be trying that as a new approach. Here's my question: Do any of you have any other suggestions/tactics we could use to try and get him to eat more? He is losing so much weight and it really has us worried.

Thanks so much.

Martha H · 05-24-2008, 05:34 AM

At the nursing home where my Mom was, they had standing orders to serve her only pureed solids and thickened liquids. The reason for that is a difficulty in swallowing which sooner or later affects all Dementia patients - if they live long enough. The swallowing reflex doesn't work properly and there is no way they can swallow solid foods without some of it getting into the breathing tubes and causing choking or even pneumonia.

For a while she was able to eat the pureed foods, but when she didn't seem to know any more what to do with the food tray, even though she was at a table with other patients who were all eating, a nurse's aid fed her by the teaspoonful. Yet, after 2 or 3 swallows, she was done.

In her case, the doctor explained that her whole body was in the process of shutting down. Her body more or less rejected food, and was not even processing the food she did eat. This was a sign that the end was near. Mom lived almost a year after the eating problem began, lost a lot of weight, and died weighing 75 pounds just this past December. It was not a lack of trying on the part of family and staff - she just could not process food any more. She was 99 and had had Dementia for at least 8 years.

I don't know how old your loved ne is or what stage of Dementia he is in, but in stage 6 this slowing down begins and cannot be reversed.

love,

Martha

mudcatgrant · 05-24-2008, 09:14 AM

Same here...Mom is stage 6 or, most likely, stage 7. She is becoming "pickier" about what she'll eat. I noticed last night that the chicken was harder for her to chew. She will still eat sweets and shakes, so at least we're getting some calories into her. She has lost 10# in the last year.

I know the Lord has her in his arms! I'm trying to stop thinking what can I do and put it in his hands....

Lessons2005 · 05-24-2008, 09:26 AM

Thanks for the info. I'm really not sure what stage he is in. It's kind of odd because he is almost totally dependent (can't feed himself, confined to a wheelchair etc.) but yet he can be very aware of what is going on. It's almost like he can't feed himself because he gets too distracted though, not because of ability. And he's in a wheelchair because of a leg issue he had that's not even related to dementia. At the visit I previously talked about it been literally months since I had seen him and yet he knew me. Sometimes he can be very aware and others, he's not there at all, so it's really hard for me to judge.

gemini1961 · 05-25-2008, 06:43 AM

HI there Lessons !!

I think you have to ask a few more questions from the Facility to get some answers from there or here.

First and foremost, is he at the *final* stage? and continuing:

Is he no longer processing food? (that is, they can eat, or not eat, it doesn't make any difference to their survival at this stage) the Registered Nurse or his Doctor MUST be able to answer this, it's a simple yes or no.
Are they offering *soft* or *vitamised* foods? (minced & pureed)
Has he been assessed by a speech pathologist for swallowing difficulties?
Do they have Palliative Care trained staff?
Have all medications bar: pain relief been removed? (this means he's probably at end stage)
And most importantly: Do they have enough staff to actually FEED residents who can no longer feed themselves?

That's the biggie. Many places are strapped for time, let alone staff, and sadly, near enough IS good enough (we know it isn't, but you can only do so much in so much time with the expectations of the heirarchy who have no idea what working 'on the floor' is really like)

Get your notepad out, ask questions. Get answers.

Goodluck.