Frances Shani Parker, Author

Did you know that malnutrition is one of the most important conditions that negatively affect the health of older adults? This is especially true with those who have dementia. In a study of nutritional status of patients affected by Alzheimer’s disease living at home and the nutritional status of their caregivers, malnutrition was prevalent among both patients and their caregivers. Corrective measures included a nutrition education program and other intervention policies to restore nutritional status.

A hospice volunteer in Detroit, MI nursing homes for many years, I often sat during mealtimes at a table with several residents who had dementia. Due to ongoing staff shortages, I supervised everyone at the table in addition to the hospice resident assigned to me. Because I was also a school principal familiar with multi-tasking, I did not mind assisting in this manner. It became clear to me early on that some residents would eat minimally or not at all without my additional support. This is an example of a typical mealtime scenario:

“Petra, your food is just sitting there getting cold. You have a whole tray of delicious things to eat. You should eat some and see how good it is. You’re a good eater. Eat your food.”

“Food? What food? I don’t have none.”

“Watch me point to your food. You have coffee, juice, milk, mashed potatoes, fish, broccoli, bread, and fruit. That’s your name spelled P-e-t-r-a.”

“That’s not my name. My name is Petra. That’s somebody else’s name. That’s not my name. I know my name.”

“You should eat before it gets cold. Go ahead and eat. Give it a try.”

“Eat? Eat what?”

From previous experience, I knew that Petra and I could go on roaming forever around this same circle. Luckily, she was sitting next to me that day. I gave her a taste of the fish, something I knew she liked. Because I was aware that she was capable of feeding herself, I placed her fork in her hand and started her off eating. I did this in steps by steering her hand and giving her directions on putting food into her mouth, chewing, and swallowing. Residents with dementia needed tasks broken into simple steps.

Usually, she ate for a while by herself, even with her hands, after somebody started her off. In fact, some nursing homes serve regular meals in the form of finger foods to further assist residents with dementia. But without any help from me getting her started and restarted, she would sit and look at the food she said was not there. While this was going on, I also assisted my assigned hospice patient who usually ate well on her own, and I continually corrected and praised everyone else at the table. Like my students at school, someone would often say, “Look how I’m a good eater, too!” when I praised another resident. Everyone loves a word bouquet!

Featuring eating and drinking, this video is an excerpt from the program “Advanced Care in Late Stage Dementia” with dementia expert Teepa Snow.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.