Meaning Behind the Behaviour Story for May 2015

Observing The Behaviour

A good meal in the company of friends and family is a pleasure to be savoured. However, I have observed several clients with dementia struggle with different aspects of meal time. Whether it’s trouble holding a fork, understanding when it’s time for a meal, or being unable to communicate why they aren’t eating. When looking for solutions for meal time problems. Start by observing eating habits and pinpointing reasons for the difficulty by asking “WHY” the behaviour is occurring.

I used this strategy at a recent dinner attended by a client named Clark. Who is exhibiting moderate stages of Alzheimer’s. Clark was socialising with others at his table but didn’t seem to be eating much. I suspected that it wasn’t a curbed appetite or physical discomfort that was the culprit. But rather he didn’t appear to know what to do with the food in front of him. I decided to put this hypothesis to a test. The meal was served on a large plate, alongside a small bowl of chilli and two sides which included coleslaw and a dinner roll. Clark seemed satisfied with the chilli, finishing it quickly, but hadn’t touched the rest.

Gathering Evidence

Asking questions are a great way to gather evidence, so I asked Clark whether he usually enjoys coleslaw. To decipher whether he did not like the food in front of him. He responded that he likes coleslaw.  At this point, I began to wonder if he was confused about what to do with the other food on his plate. I decided to use visual cues to help prompt him. I started picking up items to clear the table, as a waitress would. Including the finished bowl of chilli, and then I placed his fork on the plate with the coleslaw. So that it could be scooped up. Moments later he looked down and picked up the fork and began eating. After he had finished all the coleslaw. I returned to his table and noticed that he hadn’t touched his dinner roll. I offered to butter it and cut it in half for him. And after doing so he picked it up and ate both pieces.

Clark’s story shows how a few gentle “non-forced” cues can be introduced to help at meal time. Next time you notice an individual with symptoms of dementia not eating the food in front of them. Consider that changes in their brain may be confusing them about what to do with the food. Cues can act as simple but effective guide posts pointing in the right direction. When cues no longer work, other strategies can be used. Such as hand-under-hand support to bring food to the mouth and assistance with each bite. Using creative strategies, meal times can once again be enjoyed!

If you have any questions or need guidance about cuing and other strategies to help at meal times, please contact me at [email protected] or 778-789-1496.