DIN­ING WITH DE­MEN­TIA

The Mail on Sunday - You - - First Person -

Some 800,000 peo­ple in the UK have a form of de­men­tia and, shock­ingly, stud­ies show that up to half of them are likely to end up suf­fer­ing from mal­nu­tri­tion. I know through those who visit my clinic how de­men­tia can af­fect a pa­tient’s de­sire and abil­ity to eat. And through my fa­ther, I’ve learnt first-hand how nu­tri­tional well­be­ing is not yet a high enough pri­or­ity within the health ser­vice: no one treat­ing him has yet ad­dressed the is­sue of his diet.

Dif­fi­cul­ties that can arise in­clude lack of ap­petite be­cause of low mood or, con­versely, overeat­ing and weight gain be­cause the pa­tient can for­get they have al­ready eaten. The abil­ity to judge tem­per­a­ture may dis­ap­pear, mean­ing that food served too hot can burn lips and throats. Chew­ing and swal­low­ing be­come harder when phys­i­cal skills such as keep­ing our mouths closed di­min­ish. Con­sti­pa­tion through lack of fluid or fi­bre, or as a side-ef­fect of drug treat­ment, of­ten has an im­pact. Th­ese sim­ple strate­gies are de­signed to help those di­ag­nosed with de­men­tia and their car­ers to cope.

KEEP CALM A reg­u­lar rou­tine is re­as­sur­ing and eat­ing at the same times of day at the same ta­ble may help avoid up­sets. This can be iso­lat­ing for car­ers, for whom eat­ing is more plea­sur­able when flex­i­ble and so­cia­ble. One way around this is to feed the per­son you are car­ing for in the usual way, and then eat separately af­ter­wards.

SLOW DOWN Car­ers are jug­gling so many tasks that it can be tempt­ing to hurry meals, but the re­sult can be that meal­times be­come stress­ful and less gets eaten.

TAKE OFF THE PRES­SURE When con­cen­tra­tion needs to be max­imised to get fork to mouth and to avoid chok­ing,

it can help not to have the tele­vi­sion or ra­dio on, so I ad­vise min­imis­ing dis­trac­tions. How­ever, I have some pa­tients who find that lis­ten­ing to med­i­ta­tive mu­sic can de-stress a chal­leng­ing meal­time. And if the per­son you are look­ing after is find­ing it all too much, a plate of some­thing easy to nib­ble such as sand­wiches or cut-up soft fruits while they sit in a comfy chair watch­ing their favourite pro­gramme may be the an­swer. Don’t be fright­ened to ex­per­i­ment.

TEMPT­ING TAC­TICS Of­ten the less we eat, the less we fancy eat­ing. Mal­nu­tri­tion can kick in, which can lead to myr­iad prob­lems in­clud­ing pres­sure sores and de­pres­sion. The first step in try­ing to avoid this is to em­ploy some tempt­ing tac­tics – does the per­son you are car­ing for en­joy favourite fam­ily recipes? The smell, taste and look of tried-and-trusted dishes from the past can trig­ger a de­sire to eat and pro­vide vi­tal nour­ish­ment.

CRE­ATE A FOOD MOODBOARD Of­ten mem­o­ries are linked to foods we loved eat­ing on happy oc­ca­sions. A per­sonal food moodboard made up of pho­to­graphs of dishes, peo­ple and places can be a great way to stim­u­late a jaded ap­petite.

BE­COME A NUI­SANCE If your friend or rel­a­tive is in a care home and you are con­cerned he or she is not eat­ing well, in­sist they are given sup­port and, if nec­es­sary, ask if you can bring in food.

STICK TO A BAL­ANCED DIET Some re­search sug­gests that omega-3 fatty acids may help to slow down the progress of de­men­tia, so do serve a cou­ple of por­tions of oily fish a week. But most im­por­tantly, en­sure a bal­anced diet of whole­grains, fruit and veg­eta­bles. My web­site has many quick, easy recipes to in­spire and make feed­ing and eat­ing eas­ier for pa­tients and their car­ers. I’ve done it all for you, so please en­joy!

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