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Advice by Alicia: Addressing Challenging Mealtime Behavior

Monday, March 04, 2019

Alicia Seaver is the Vice President of Memory Care Operations for EPOCH Senior Living and a Certified Memory Impairment Specialist. Every month, she addresses a specific issue related to memory and memory care. If you’re interested in hearing about a particular topic, please send a suggestion to [email protected].

Q: What can I do to get my loved one with dementia to stop acting out at mealtimes? Any tips on how to make this easier for both of us? 

A: Dementia comes with many challenges, doesn’t it? While I hesitate to say mealtime behavior is the most frustrating one caretakers deal with, it’s definitely in the top 10. Unlike a lot of other tasks, eating isn’t something you can just stop doing, because, well, everyone has to eat! But in between all the running around, behavioral issues, tasks and everything else, dealing with challenging behavior at mealtimes can often feel like the straw that broke the camel’s back.

Take heart, caregivers. There are ways to work around some of the most common mealtime challenges. It can take some patience and a little work, but by understanding why your loved one is acting the way he is and taking steps to address the issue, you’ll be able to make mealtimes more enjoyable, relaxing and rewarding.

Problem #1: Your loved one is refusing to eat what you’re serving.

If your loved one turns up their nose at what you’re serving, or worse, spits it back onto the plate (or across the table), it’s hard not to get frustrated. Instead of becoming angry, try and figure out what is actually bothering the person – chances are, it’s not a comment on your cooking. They may not like the food, sure – but the food could also be too hot, or they could be feeling rushed, or they could be confused as to what to do with the food. Really, it could be anything, from frustration at the difficulty they’re having to sensory overload. Look for non-verbal cues from your loved one and don’t pressure them to eat or drink. If needed, wait until they’re calm again before offering something else. Do your best not to rush them and help them maintain as much independence as possible, such as allowing them to feed themselves even if they get a little messy.

Problem #2: Your loved one’s tastes and preferences have suddenly done a 180.

All of a sudden, your vegetable-loving mother will only eat meat. Or your dad refuses to eat his favorite food, cheese. This could be because their preferences have changed, or they’ve remembered a time when they did/didn’t eat that particular food, or they’ve seen you eating the food and want the same, even if they don’t know what it is. Try to use your understanding of the person to find out what’s going on and why they might be preferring something new. It’s always good to find out if your loved one is having dietary issues – for example, suddenly not being able to tolerate dairy products – that could be causing the switch. Of course, if the new eating habits aren’t causing harm to your loved one (say, for example, Mom suddenly will only eat ketchup on her mashed potatoes), it’s usually best to just let it slide.

Problem #3: Your loved one is eating too much. 

It’s easy for people with dementia to eat too much or too frequently because they’ve forgotten they’ve already eaten or they’re worried they may not be fed again. Overeating can cause health issues including obesity and diabetes, and can exacerbate existing issues if they’re on a specific diet. Instead of trying to restrict your loved one’s intake, change up how you’re serving their meals, like splitting the original portion in two and then offering the second half if they start asking for more. Fill up plates with high-nutrient, low-calorie options like vegetables or salads, and make sure healthy snacks are available if your loved one does get hungry. It’s also possible that your loved one is bored and wants to eat because it’s something to do. Make sure there are activities and distractions available to offer instead of another treat.

Above all, remember the importance of picking your battles. As long as your loved one is getting proper nourishment on a regular basis, it’s okay if there are changes in their diets and preferences from time to time. We all like a little variety!

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