Dementia is a complex disease, chronic and progressive in nature, in which cognitive functions such as thinking, memory, reasoning and behavioral abilities deteriorate. As a result of this loss, a person’s daily life and activities are affected, which has a negative impact not only on the person but also on the caregiver, said Neha Sinha, CEO and co-founder of Epoch Elder Care. and specialist in dementia.
“Eat well, eat well; we’ve all heard this so many times during our childhood, and regardless of age, good nutrition is vital for overall health. However, as dementia progresses, eating and maintaining nutritional status becomes difficult. Patients may forget to eat, be overwhelmed with too much of the thali, or have difficulty verbalizing dental issues or mouth ulcers. In the later stages, when chewing and swallowing become difficult, caregivers find it difficult to maintain the balance between appetite and food texture, ”she added.
Maintaining good physical health and a good weight is an important aspect of good performance management in dementia. The presence of multiple comorbidities, especially diabetes, where restrictions on diet or medication would require constant reminders and explanations makes the task even more delicate. “It is important to provide a balanced diet, to avoid diets high in fat and cholesterol, to reduce processed foods as well as the consumption of sugar. Adding green leafy vegetables and following the Mediterranean diet of fish, grains, fruits and olive oil have also shown promising results in reducing further risks, ”she said. declared to indianexpress.com.
Besides managing nutrition, planning meals and meal times is also an important aspect of dementia care. Sinha said if the elder begins to resist meals or to eat poorly, there may be more than one cause involved. “Start by eliminating distractions around meals – loud backgrounds and loud conversations can add to their confusion. Lack of physical activity, poor dentures, and side effects of medications can all contribute to reduced appetite. They may also reach a stage where they may not be able to recognize the food or incorrect color coding of the dishes (white rice on a white plate) can make them even more perplexed, ”she explained.
It is important to maintain independence in the diet for as long as possible. Although it may need a considerable amount of support and time to facilitate, it is essential for the dignity and respect of the elder. It’s a good idea to pre-portion / pre-mix their meals, make shorter meals according to their likes and dislikes, and garnish foods to make them appealing, especially semi-solid foods like khichdi. “Always taste their food before serving, as they may not be able to comment on the taste. Also, opt for sturdier cutlery and handles that they will find easier to hold. Always keep food on hand, in case they want to eat in the middle of the day (or night) rather than convincing them that they have already eaten, ”she suggested.
Older people with dementia are also at increased risk of dehydration, which leads to co-morbidities like urinary tract infection, or headaches and this can lead to restless behavior. One should encourage fluid intake which could be sips of plain or flavored water throughout the day; feed fruits and vegetables with high water content or just make smoothies or fruit juices.
“For a family member, managing meals at the table with a loved one with dementia can be demanding. Have patience and don’t rush the elderly during meals – give them all the time they need. Since the person may be lacking in judgment, make sure that the temperature of foods or liquids such as dal, soups is moderate, and not hot (or icy). Eating with them will also promote the feeling of being together and can even be a good appetizer!
“Involving seniors (with or without dementia) in making treats for festivals together is always a great idea! Just rolling laddoos or filling the maker with gujiya can not only help bring back great memories, but also be a great motor activity, ”she said.
Finally, in these times of pandemic, work to strengthen the immunity of the elderly with herbs and condiments such as ginger, garlic, jeera, turmeric and tulsi. Offer such things as part of a diligent routine and they can work wonders, Sinha said.