CARING FOR PEOPLE WITH DEMENTIA

It is important to set limits and take responsibility to deliver a consistent schedule to the person with dementia.

Caregivers should remember that the emotional aspect of caregiving is as important as physical care.

ACTIVITIES OF DAILY LIVING

As dementia continues to develop, the senior will increasingly become less interested in personal hygiene. They may forget to bathe, forget to comb their hair, forget to clean their teeth and forget to change their clothes.

Create a consistent daily schedule

Same Sequence of Events Daily: This will deliver comfort to the dementia sufferer and also allow the caregiver to better be able to focus on managing any resistance or confusion that arises each day. The caregiver will be comfortable with the daily schedule and know it well to allow them to better manage behavior challenges.

PERSONAL CARE

Just think of personal care as all the activities you do when you wake up each morning.

Performance of personal care tasks for clients, including bathing, skincare, hair care, nail care, mouth care, shaving, dressing, feeding, assistance with ambulation, exercise and transfers, positioning, toileting, and medication reminders.

Grooming contributes to self-esteem. Getting manicures or hair done can make the person feel good.

Foot care can be done by a podiatrist on a routine basis.

Personal Care Activities can include the following:

  • Bathing

  • Skin Care

  • Hair Care

  • Mouth Care (Brushing Teeth/Denture Care)

  • Shaving

  • Dressing

  • Eating

  • Feeding

  • Assistance with Ambulation

  • Exercise

  • Transfers from chair, toilet, bed

  • Positioning

  • Toileting

  • Medication Reminders

Watch this Video on Dressing and Bathing:

Tips:

  • Talk the person through each step

  • Show the person on yourself, for example, put on socks yourself to show the person how to put on socks

  • Stay positive and reassuring, tone and gentleness is more important than the words you say

  • If you are irritated or angry, the person can pick up on it—remember nonverbal is more important than verbal

Bathing

Watch Video on Refusal to Bathe:

When bathing a person with dementia, allow the person to do as much as possible. Try to offer only the level of help necessary. In the earlier stages, the person may only need a reminder to bathe. As the disease progresses, he or she will require more assistance.

DON’T discuss whether or not a bath is needed, use a matter-of-fact approach.

Prepare the bathroom ahead of time:

  • Gather bathing supplies. Have large towels (that you can completely wrap around the person for privacy and warmth), shampoo and soap ready before you tell the person that it's time to bathe.

  • Making the room comfortable. Pad the shower seat and other cold or uncomfortable surfaces with towels. Check that the room temperature is pleasant.

  • Placing soap, shampoo and other supplies within reach. Try using hotel-sized plastic containers of shampoo which are easier to hold, and have a washcloth ready to cover the person's eyes to prevent stinging.

  • Monitoring water temperature. The person may not sense when the water is dangerously hot or may resist bathing if the water is too cool. Always check the water temperature, even if the person draws his or her own bath.

  • Talk the person through each step. “Put your foot in the tub. Put your other foot in the tub. Sit down here. Wash your leg.”

  • Don’t wait until the last thing at night when the person will be very tired.

  • Never leave the person unattended in the bath or shower.

Tips:

  • Try a little food coloring in the bath to make the water a different color to make it easier for the client to see and interact

  • Try singing to your client or playing soft music they like to make the experience more enjoyable

  • Try different times, maybe the client will be more receptive to bathing in the morning as opposed to the evening

Dressing

Getting dressed for people with Alzheimer’s disease can often be a challenge as they can no longer cope with the sequence of getting dressed. They also may try to wear the same outfit again each day. They will not know which item of clothing to put on first and do not understand why they need to change their clothes.

Tips for Assisting with Dressing:

  • Layout the clothes in the right sequence and focus the attention on the next step

  • Demonstrate what comes next and make dressing one of the main activities each day

  • Try buying similar underwear and exchange it discreetly if changing underwear becomes a problem

  • Buy comfortable clothing that will be easy to put on and wash

  • Buy easy to put on shoes that are non-slip and comfortable and can be put on and taken off easily (perhaps a velcro closure)

  • Don’t use belts or other accessories which just get in the way

Hair Care

Seniors experience the natural aging process with hair care which includes hair loss or natural hair color “going gray” (or white).

The process can be stressful, especially if a senior has hair loss or hair thinning accelerated because of medications or a newly diagnosed disease.

  • Hair Salon or Barber Shop Visit: Try to facilitate visiting a hair salon or barber as long as the senior is able to leave their home as this establishes a feeling of inclusion in social life and also can be a fun activity

  • Dry Shampoo: Available if the senior is bedridden

  • Comb, brush and style hair daily

  • Maintain all facial hair care (waxing and tweezing by professionals if the senior cannot maintain facial hair upkeep themselves)

  • Explore wigs as options

Note: Discuss bringing a hair-care professional to the home for cuts, styles, and waxing if the senior cannot easily go to the salon or barber. Our hair texture, color, and thickness change as a natural part of the aging process. Each person has to decide how to manage these changes. Hair care experts can help to discuss options for caring for these changes.

Shaving

Refer to the Care Plan for the senior’s shaving routine. If the senior can shave themselves, this is preferable, as they are able to maintain their dignity and a life-long routine. However, the caregiver should monitor the senior before and after shaving and assist the process to go smoothly.

Age causes thinning of the skin and dryness which can complicate the shaving process. To prevent uneven hair, cuts and infections follow these basic steps:

  • Prepare the skin by washing with hot water.

  • Apply enough shaving foam on the area and spread thoroughly. Make sure to use the appropriate shaving foam as there are special ones for sensitive skin, depending on the client’s needs.

  • Always use sharp and quality blades. Make sure they are cleaned and regularly changed.

  • Shave in bright light.

  • Rinse the skin with cold water after shaving and use an aftershave balm that suits the client's skincare needs.

Watch Video on Special Care for those with Alzheimer's:

Pay special attention to the little things Lenny does to make the person feel special. It is about how you go about your day with Alzheimer’s clients, the kindness you show and the little things that will help them reminisce and feel at ease. He sprays fragrances, puts on music from Frank Sinatra and even brings an old barbershop style light. He talks to them, uses simple sentences to say what he will do and uses their name.

The old saying, “It’s not what you say, but how you say it that matters” becomes so very important.

Skin Care

Skincare becomes more vital when a senior becomes bedridden. The aging process causes the skin to lose elasticity and become what we call “wrinkled” and thinner and more susceptible to bruising. In addition, dryness can also be a challenge. Avoid bed-sores and maintain healthy skin care by doing the following:

  • Keep skin clean and dry

  • Use mild soaps, rinse well and dry thoroughly

  • Keep bed linens clean

  • Use disposable bed pads to wick away dampness and keep skin dry

  • Reposition the senior every 2 hours if they are bedridden

  • Massage skin gently when repositioning if confined to a wheelchair or bed

  • Use pillows, gel cushions, water cushions, or foam wedges to help reposition the body when a senior must remain in bed or chair

  • Investigate using plush sheep rugs or a foam egg-crate mattress which can spread the weight over a larger skin area

  • Encourage appropriate exercise to stimulate circulation or assist with moving the arms and legs if the senior cannot do so on their own

  • Avoid Moisture: Dampness or thick layers of lotions or general wetness can promote the formation of pressure sores

  • Friction can cause a pressure sore on aging skin—avoid sliding, moving or sitting on a hard surface

  • Rashes or skin irritations may cause a break in the skin and promote pressure sores—mind these closely to prevent a pressure sore from forming

    Just remember skin becomes delicate, just like you must be careful when handling an object you don't want to drop and break, you must be very careful when caring for a senior’s skin.

Hydration

Hydration is always important, but especially for seniors. Because the glands secrete less oil, over 75% of seniors experience dry, flaking skin. The dry, thin skin of a senior can tear more easily, and will be slower to heal, giving bacteria a chance to take hold. Here are some steps you can take as a caregiver to maintain the skin health of your senior client:

  • Avoid long and hot baths and excessively hot water, as they tend to dry out the skin. A lukewarm bath of no longer than 10 minutes should suffice.

  • Glycerin-based soaps are recommended, as is the application of a moisturizing cream when the skin is moist.

  • Avoid or minimize alcohol, caffeinated beverages, and spicy dishes.

  • Increase water intake. The target should be eight glasses per day.

  • Suggest to your Care Manager that the senior client may need a humidifier.

Observe and Report

You can tell when a person has a problem with their skin as it will turn pale, white, red, or even purple in some areas. The person may also get blisters or bruises. Complaints of tingling, warmth or burning are common feelings to observe.

Other symptoms may include:

  • Dry or flaking skin

  • Rashes or skin discoloration

  • Swelling

  • Cuts, boils, wounds, abrasions

  • Fluid or blood draining from skin

  • Broken skin

  • Changes in moistness/dryness

  • Changes in wound or ulcer (Size, depth, drainage, color, odor)

  • Redness or broken skin between toes or around toenails

  • Scalp or hair changes

  • Skin that appears different from normal or that has changed

Watch Video on Dehydration:

Water is your body’s principal chemical component and makes up about 60 percent of your body weight. Your body depends on water to survive.

Every cell, tissue, and organ in your body needs water to work properly. For example, water:

  • Gets rid of wastes through urination, perspiration and bowel movements

  • Keeps your temperature normal

  • Lubricates and cushions joints

  • Protects sensitive tissues

Lack of water can lead to dehydration — a condition that occurs when you don’t have enough water in your body to carry out normal functions. Even mild dehydration can drain your energy and make you tired.

DO NOT RESTRICT FLUIDS unless advised by a physician.

Jellies, custards and ice cream can also add fluid.

Take care with caffeinated and alcoholic drinks, such as coffee, tea or cola as these make the bladder irritable and cause people to go to the toilet more often.

Alcoholic drinks and some medicines make the body produce more urine, so the bladder fills faster than normal, which means that it may need to pass urine more often. It may also mean there is less control over the bladder or bowel.

Teeth and Denture Care

Special dental care needs should be included in the senior’s care plan. Denture care will have a plan of action for cleaning to follow. Regular teeth cleaning includes brushing the teeth after meals and after waking each morning and before retiring to bed. Some seniors will experience challenges with bad breath due to their own loss of smell and because of medications or certain digestive issues. Assist the senior to obtain a mouthwash and mints to maintain fresh breath throughout the day.

Remember, our sense of smell changes as we age too. This is why it can be easier for a senior to have bad breath or spray on too much cologne—they simply are not able to smell as well anymore. Provide kind feedback to them to know if there is an unpleasant odor or perhaps too much of a good thing.

Watch Video on Denture Care:

Dental Tips for Seniors:

  • Toothbrushes: Gums become more sensitive as we age. Brush teeth using a soft toothbrush. One way to make toothbrush bristles softer is to soak the brush in hot water or use a gauze-wrapped popsicle stick or cotton swab.

  • Rinse mouth with baking soda and 2 cups of water if do not have mouthwash.

  • Keep lips moist for mouth comfort: Use lip balm.

  • Use a flashlight to identify specific issues inside the mouth before reporting to a doctor.

  • Contact a Care Manager if: Gums bleed, you find sores or cuts in the mouth.

  • Provide step-by-step directions to allow the person to brush their own teeth.

Toileting

Medical conditions and natural changes that happen with the body’s aging process sometimes impact the ability to go to the bathroom in the usual ways.

The discomfort of bowel and bladder conditions have the added complication of bringing social embarrassment. Caregiving includes showing compassion and understanding, along with assisting with the care needs in this area.

Safety and respect must both be considered when assisting a senior with toileting. As our body ages, the bowels and urinary tract may lose functionality. Diseases, medications, and loss of physical capabilities from a stroke or hip replacement or heart surgery can all cause changes to toileting needs.

Types of toileting assistance include the following:

  • Catheter Care Hygiene (only empty bag)

  • Incontinence Care

  • Constipation

Catheter Care

Follow the instructions provided based on the type of catheter.

  • Usually, you will just need to empty the container the catheter empties into

  • Be very mindful that respecting the challenges of catheter care is vital

  • One of the ways to successfully discuss this challenge is to put yourself in their shoes and tell the senior you know it is a challenge and that you want their feedback on how to make the process go smoothly

  • Discuss the schedule for the catheter care and ask them if they would like you to check it at certain times throughout the day

  • Follow the Plan of Care

DEMENTIA AND INCONTINENCE

Loss of bladder and bowel control are not normal parts of aging. However, women who have had children are very likely to have a loss of bladder control eventually. Medical solutions exist for loss of bladder control and bowel control.

1. If the problem has come on suddenly, the person should see their health care provider. It may be an infection. Try to find out why the incontinence has occurred.

  • Consider using an incontinence pad that will keep the person’s clothing or bedding dry

  • Take the person to the toilet at times close to when they find themselves wetting.

  • Keep track of the time the person urinated to help determine a schedule

  • Males may find using a bedpan more convenient

  • Use a waterproof sheet under the bedsheet

  • Think about non-slip floors or non-slip mats

  • Ensure adequate lighting on the way to the toilet

  • Use walking aids, grip rails, and night lights to assist

2. If the person suddenly CAN’T pass urine, call the office. THIS COULD BECOME A MEDICAL EMERGENCY.

Some medicines cause problems:

  • Antibiotics often cause diarrhea.

  • Pain killers may cause constipation.

Consider using an incontinence pad for protection.

Use a cream to protect the person’s skin, the same ones that are used for diaper rash. Bowel motions and extra wiping can make skin red and sore very quickly.

Watch Video on Dementia and Toileting:

In an older person with dementia, incontinence may become more of a problem as the person:

  • Forgets where to find the toilet

  • Forgets how to unfasten their clothes

  • Forgets what to do when they get to the toilet

  • Is more susceptible to urinary infections because of prostate or gynecological changes

  • Becomes more prone to bowel changes such as diarrhea or constipation from medication side effects

The burden for the caregiver may increase if confusion and memory loss leads to the person resisting assistance with post-toileting or incontinence hygiene.

Briefs or Attends are solutions that can be used. Today’s adult diapers use modern technology and come in many shapes and sizes to make it very easy to be discreet.

Depends or Adult Pull-ups: These are also now available, in all shapes and sizes and even younger people are wearing these for protection—share with seniors that people of all ages are now wearing underwear that protects them from leakage.

In addition, going to the bathroom every 2 hours may be helpful.

Also, discuss bedtime solutions such as special bedsheets or bed pads.

Remember, a regular eating and drinking schedule will result in regular times for elimination and is helpful for seniors who are incontinent.

Watch Video on How to Apply and Change Adult Diapers:

Constipation

Inactivity and medications can contribute to constipation. There are both natural remedies as well as medications that can help “loosen” the situation. Encourage the senior to discuss the situation with their medical doctor:

  • Stool softeners

  • High fiber foods: Fresh fruits, vegetables, prune juice

  • Drink more water: A full glass of water upon waking and throughout the day

  • Avoid foods such as cheese, rice, bananas

  • Exercise as much as recommended

  • Review medication side-effects

  • Call the doctor if bowels aren’t “moving” regularly—daily bowel movements are a sign of a healthy digestive system

Wear disposable gloves to protect yourself as a caregiver

  • Use proper handwashing techniques

  • If possible, have a commode chair handy for the person you are caring for

  • Use air fresheners/neutralizers to clear odors from the air

Cleaning and Washing Clothing and Linen in the Home

  • Wear disposable gloves to protect yourself

  • Dispose of used pads by wrapping in a plastic bag and placing in your garbage bin for disposal

  • For clothing and linen, set up a soaker bucket with water and soaking solution

  • It is important to think about safety, so once you have soaked the clothing or bedding overnight the bucket can be emptied into the washing machine

  • A full bucket is heavy, so use proper lifting techniques

  • Consider wash-and-wear and easy-to-change clothing and bedding

  • Consider the easiest way to clean your floors and chairs

  • Plastic-backed disposable pads can be used around the chairs and beds to protect carpet and rugs

Mobility

People who live with incontinence may be unable to get to the toilet in time because they have difficulty walking or moving. It may be that if the person can reach the toilet in time, they are no longer incontinent.

  • Set up the house to make access to the toilet as easy as possible.

  • For men, try a bedpan/urinal for urine.

  • Alternatively, for either men or women, a commode chair brings the toilet to the person.

  • Make sure walking aids, hand grips, bed rails (if bedbound), wheelchairs and commode chairs with wheels are easily accessible to help with mobility.

  • Make safety your first concern: ensure floors are made “non-slip” by using washable grip-backed rugs and try “stick-on” or “paint-on” etching, tiles or non-slip compounds over linoleum and floor tiles.

The Bladder

Many people believe that drinking water may increase the risk of wetting themselves, so they refuse to drink to avoid this risk.

While this belief is understandable, it is not the whole picture. In fact, not drinking enough water will cause urinary incontinence, constipation, and dehydration.

The normal, healthy bladder can comfortably hold 1 1/2-2 cups during the day and 4 cups at night. It is able to completely empty itself when we go to the toilet.

A healthy adult will only pass urine up to six times in the day and up to twice overnight. More than twice overnight might suggest a problem.

🧠 Did you know?

It’s common for seniors with incontinence issues to become dehydrated, sometimes so severely that they must be admitted to the hospital.

SIGNS OF URINARY TRACT INFECTIONS OR UTIs

Urinary tract infections, also known as (UTIs) are very common for many people and they may develop symptoms including:

  • High temperature

  • Stinging or burning when urinating

  • Urge to go to the toilet more frequently

  • Strong urine smell

  • Confusion

Seniors may not have all of these signs. Instead, they may just have a sudden onset of incontinence or a worsening of existing incontinence.

They may also be tired with less energy than usual and may not be able to tell you how they feel.

When prescribed antibiotics for a UTI, it is very important that the patient finished the full course of antibiotics. If the antibiotics are stopped before the whole course is completed the infection may return. When a person is taking antibiotics to help them recover from a UTI, it is important to remember they need to drink more fluids than usual which may help flush germs from the bladder. The bladder finds it hard to hold smelly or infected urine.

Watch Video on UTIs:

The following will help develop regular bowel movements:

  • Encourage the person to drink more water-based fluids (e.g. fruit juice, mineral water)

  • Encourage a minimum of three servings of vegetables and two serves of fruit daily

  • Fruit can be fresh, preserved or stewed. It is important to mix different fibers from fruit, vegetables, whole grain cereals, bread, and products such as kidney beans, lentils, and butter beans

  • Encourage a hot drink before or during breakfast

  • Train the bowel to pass a motion about 30 minutes after breakfast or lunch

  • Encourage the person you care for to walk whenever they can, even if it is for a short distance

  • If they cannot walk, sitting exercises are helpful

  • Avoid bowel medications (laxatives) where possible

TIPS AND TOOLS TO HELP IN THE HOME

Bathroom

  • If there is limited room in the toilet for a second person to assist, have the

  • door adjusted to open outwards.

  • Make sure the way to the toilet is clear, remove all clutter and loose mats from the bedrooms, hallways, and bathrooms

  • Make sure there is adequate lighting to and from the toilet.

    • Small ‘night lights’ that plug into a socket or sensor lights are useful for directing the way.

    • There are affordable motion-activated, battery-operated lights available that have a peel and stick backing.

  • For someone with dementia, place a picture of a toilet on the door. This will help the person to remember the toilet and find their way there. It is important to keep the sign within their line of vision, so place it at chest height.

  • Make the surface on the toilet floor non-slip.

  • Grab rails mounted on the toilet wall or a toilet surround or toilet seat will help to get on and off the toilet.

  • Wipe up any spills to prevent slipping or falling. Keep cleaning supplies and disinfectants handy.

Bedroom

  • Protect the bed with an absorbent bed sheet.

  • Clean waterproof fitted mattress protectors to keep odors to a minimum.

  • Give men the option of using a urinal.

  • Protect, or if possible, remove the carpeting.

  • Place a rubber-backed absorbent mat on the floor by the bed.

  • If possible, move the person to a bedroom nearer to the toilet. In the living room (some men with mental health problems prefer to urinate outside).

  • Give free access to the toilet by making sure you remove all clutter from doorways and along the passageway to the toilet.

  • Arrange the living room furniture to allow free access from a favorite chair to the doorway.

  • Keep a bedpan nearby in case of emergencies. Make sure it gets washed and disinfected regularly to prevent odors.

  • Protect chair seats with a waterproof chair pad.

Watch Video on Home Changes to Help with Alzheimer's:

NUTRITION FOR SENIORS

As we age, our bodies need fewer calories as we move around less, have less muscle and our metabolic rate goes down.

Nutrition is defined as the process of providing or obtaining the food necessary for body health.

Calories

Fewer Calories are Needed Every Decade as We Age

As we age we are typically less active and lose muscle mass. Due to these changes, people require fewer calories. As you age, your body does need the same amount of protein, vitamins, and minerals, or nutrient-rich foods. Your body needs more of certain vitamins. A nutrient-rich diet is very important for older adults.

The National Policy and Resource Center on Nutrition and Aging from Florida University reports that:

Males aged 50 to 70 need approximately 2,200 calories per day Females aged 50 to 70 require 1,980 calories per day.

The calories required after age 70 will lower slightly if the person is living a more sedentary life (mean sitting most of the day).

The US Department of Agriculture defines a sedentary lifestyle as one in which the person is limited to the activities of daily living. Walking briskly for more than 3 miles a day is considered active.

A person needs more or fewer calories than what’s recommended based on their metabolism.

Protein

  • Males over 70 should aim for 56 grams of protein a day

  • Females over 70 should get 46 grams of protein a day

Foods high in protein: meat, chicken, fish, beans, and dairy products

Beans, lentils, and nuts are good sources of plant-based proteins.

Fiber

  • Males over 70 should take in 28 grams of fiber daily

  • Females over 70 should consume 22 grams of fiber a day Fruits, vegetables, legumes (beans, lentils), nuts, seeds

Fiber moves quickly and easily through your digestive tract and helps it function properly. A high-fiber diet can also help reduce the risk of obesity, heart disease, and diabetes.

It is important to drink plenty of fluids when eating a high-fiber diet.

Vitamin and Mineral Needs for Seniors

  • B-12: After age 50, the body's ability to absorb the vitamin often lessens due to less stomach acid.

  • B6: Seniors can have a lower ability to absorb from diabetes, kidney problems or rheumatoid arthritis. Found in whole grains, organ meats such as liver and potatoes.

  • Vitamin D: Aging skin loses the ability to change sunlight into Vitamin D which then impacts the body’s ability to absorb calcium.

  • Calcium: For strong bones

  • Folate: Folic Acid helps the body make and maintain new cells and prevent changes in DNA which can lead to cancer. Found in broccoli, spinach, nuts, and citrus.

  • Potassium: Lack of potassium can raise blood pressure, can be found in bananas, potatoes, yogurt.

  • Fiber: Found in beans, whole grains, and veggies, fiber keeps you regular for intestine health and prevents diabetes.

Both Vitamin B-12 and D are needed to prevent bone loss.

Breakfast cereals with added vitamins are one way to make sure you are eating enough of the B-Vitamins and Folate, or Folic Acid.

🧠 Did you know?

Too many vitamins can be bad? Many vitamins can be toxic at high levels.

Watch Video on Heart Healthy Aging with Nutrition:

Learn and Understand Doctor Suggested Nutrition and Meals for your Senior Clients

  • Review special diet requirements

  • Understand areas of caution or possible deficiencies

Always follow the senior’s Care Plan for meals and aim for a balanced plate.

Make notes in the Care Plan and call the Care Manager to discuss if there are issues with eating certain foods.

NUTRITIONAL SUPPORT

Coping with Loss of Appetite

  • Relax and do not rush through meals

  • Eat in the company of friends

  • Plan small, frequent meals: snacking every 2 hours can achieve the same nutritional goals as eating 3 meals

  • Serve colorful food

  • Sip a glass of wine with a meal, if approved by a doctor

  • Rely on favorite foods to help improve a healthy appetite

  • Keep snacks on hand

  • Leftovers may be reheated as snacks

  • Consume nutrient-dense foods (nutrition bars and shakes)

  • Eat the largest meal at noon

  • Drink fluids at the end of the meal

  • Keep high-calorie foods and beverages in easy-to-grab locations

  • Create a pleasant environment for eating

  • Medications: work out the best way and time to take

Medications and Meals: Manage medications so they do not negatively impact mealtime, based on the senior’s preference.

Some medications can take away appetite, like pain meds.

There could be small changes made to medication schedules to help improve a senior’s appetite.

TASTE AND SMELL CHANGES

The ability to “smell” foods you taste weakens as you age and a large part of taste happens because of the nose’s ability to smell the food.

Aromas are detected in your mouth and in your nose, as you chew food, releasing certain molecules.

Medications and age-related physical and mental changes and dentures will affect the ability to taste and smell.

Be aware that a lower interest in eating may be connected to the loss of taste and smell.

Find out what foods may still spark interest and what textures will still be appealing such as:

  • Mashed potatoes (soft and mushy)

  • Ice cream (cool and melting)

  • Pasta (shapes and fillings)

  • Pie (soft or crunchy)

  • Soups (warm and soothing)

Talk with your senior client to learn about their favorite foods and think about how you can match the sensations of eating these items, from melting cheese on top, adding ice cream on the side, or slicing crunchy celery to sprinkle on top.

Ideas for Coping with Taste and Smell Changes and Dis-Taste of Medications

  • Seasonings: experiment with favorites such as cinnamon, mint, bacon bits, or lemon juice to add a spark of flavor or tingling on the tongue

  • Serve food at room temperature or cold: REDUCES smells or flavors

  • Serve food warm or hot: INCREASES smells or flavors

  • Offer liquids such as juice or lemonade to disguise the taste of medication

  • Offer applesauce with medications

  • Offer chicken broth (bouillon cubes for instant broth are available)

  • Add a multivitamin with minerals such as Zinc (with approval) which can improve taste detection

  • Rinse mouth before eating and after eating

  • Notice foods that are satisfying and serve more foods with the same texture and feel

MEMORY LOSS AND RESISTANCE TO MEAL TIME

Some seniors with memory loss sometimes begin to resist meal time or become suddenly agitated about sitting down to eat.

Repeated research studies, both clinical and impromptu studies conducted at nursing homes and Assisted Living communities show that serving food on a blue plate provides a sense of calm and can increase a willingness to eat for those with memory loss by as much as 40%.

Blue plates do better than any other color for a solid plate.

Nobody knows exactly what may be happening in someone’s mind at mealtime when they have memory loss.

Serve food on a solid blue plate.

Buy paper plates in solid blue to test this out, perhaps, and if it makes a positive difference, let your Care team know.

Serving food on a Solid Blue Colored Plate lowers agitation and increases the willingness to eat for those with memory loss.

Studies show that many seniors with end-stage Alzheimer’s or other dementia still have a craving for sweet foods.

Making a healthy, somewhat sweet smoothie, could be welcomed instead of savory food.

Other tips/tricks:

  • Give one utensil at a time.

  • Remove clutter from the table to avoid accidents, like salt being put in coffee or ketchup on ice cream.

  • Present one food at a time, don’t worry about normal meal orders. Maybe dessert is given first.

  • Use real silverware, cups, and plates. Plastic forks can be bitten off. Plastic cups can be squeezed. Don’t fill cups to the top.

  • Don’t rush. Repeat the same phrase slowly. “Eat your sandwich.”

  • Try finger foods if using utensils becomes difficult so they can still feed themselves. Think of different ways to serve food, maybe meatloaf goes between bread to make a sandwich.

SWALLOWING DIFFICULTY

Sometimes a senior will have difficulty with swallowing caused by illness or ongoing chronic conditions. As Alzheimer’s disease progresses, swallowing difficulty is common.

  • If the throat is swollen: serve thick liquids.

  • Problems using the tongue or ability to chew: serve light foods that stick together + smoothies

  • Offer easy-to-chew foods

  • Allow the person to feed themselves

Discuss serving a pre-packaged nutrition shake with your Care Manager as there is a variety on the market now offered in many flavors and textures.

Learn Meal Plan Suggested by Medical Doctor for your Clients

Record daily meals in the Care Plan to monitor. Typically, you should not be alarmed with moderate weight gain in clients with dementia, as weight loss later in the disease is common.

ALZHEIMER’S/

DEMENTIA AND MEDICATION SELF-ADMINISTRATION

Getting a person with dementia to take their medication is often difficult, and is a common problem that is faced by caregivers. This can be one of the most exasperating challenges faced by Alzheimer’s caregivers and dementia professionals. Too much information tends to confuse people living with dementia. Once confused they don’t understand what you are asking them to do. In this instance telling them lots of information and what each pill is for can quickly become too much and they can become combative and/or resistant.

Tips for Medication Monitoring for Seniors with Alzheimer’s Disease or Dementia:

  • Create a consistent routine around the medication time

  • Minimal words may be the best solution

  • Become a “Medication-Buddy” and take your own “pills” at the same time (which can be candy, gummi-bears or your own actual vitamins)

  • If the senior is resistant, discuss if a liquid form for the medication may be possible (the pharmacy will know if another format is available)

  • Reward the senior for swallowing all of their pills with music or a dessert or activity you know they enjoy

  • Combine the medication routine with mealtime and simply make them seem like part of the meal service (when possible to take the meds with food)

If self-administration is no longer possible, consult your employer to take the necessary next steps. Remember to know and understand your state laws around medication self-administration.

💡 Tip Sheet

Bathroom Safety Equipment Includes Grab Bars, Shower Chair, and No-Skid Rugs, Avoid Bedsores by Repositioning Every 2 Hours, Exercise to Stimulate Circulation, Use Soft Toothbrushes for Sensitive Gums, Check with Doctor about Over-the-Counter Medications