Feeding Techniques and Nutrition

Feeding Techniques and Nutrition



eating is a life pleasure that we all share well-fed residents tend to be happy residents most Alzheimer patients develop nutritional problems in the middle or later stages of the disease these nutritional problems can lead to difficulty with weight strengthen healing ability today we're going to talk about ways to better feed residents who suffer from Alzheimer's disease but first let's talk a little bit about how the brain helps us to eat residents with dementia often have trouble eating when they don't or can't eat they don't get the nutrition they need to stay healthy comfortable and strong eating is more than just swallowing food first you have to get hungry once you're hungry you find something you'd like to eat then you have to get the food into your mouth you sit down you use a spoon or fork you open your mouth and put the food in your mouth once you've got a mouthful you chew and then swallow your food I bet you never thought there was so much involved in eating your brain is involved in all aspects of eating when parts of the brain are damaged by dementia residents have trouble eating some residents may not want to eat and others may not be able to feed themselves some residents even forget how to chew and swallow remember to be patient helpful and attentive while feeding residents let's look at the parts of the brain that are involved with eating there are three basic regions that we need to know about the frontal lobes located right here on top of your eyes are involved with motivation in other words wanting to eat the parietal lobes located back here behind your ears are involved with coordination and remembering how to use a spoon or a fork and up here in the frontal lobes right here is where the chewing and swallowing Center is located let's look at this on the bigger model your frontal lobes tell you that you want to eat your parietal lobes back here tell you how to use utensils like knives and forks and then this part of the brain down here at the base of the frontal lobes tells you how to chew and swallow these are the same brain cells by the way that also help you with speaking let's see what happens to these brain regions in a patient with Alzheimer's disease here we see a half brain from a normal individual and here we see a half brain from a person with Alzheimer's disease nope the atrophy or the shrinkage that has occurred in this brain that makes it look like a walnut now this is the part of your brain right here the frontal lobe that makes you want to eat gives you some Drive and some appetizers this is the part of your brain back here the parietal lobe that tells you how to sit at the table and and feed yourself with your spoon in your fork as opposed to this part of the brain right here that tells you how to chew and swallow that's the same part of the brain by the way that does some of your speaking for you now what you see in out the Alzheimer patient is the part of your brain that tells you to eat the part of the brain that tells you how to eat and the part of your brain that does your chewing and swallowing for you are all affected by the disease now let's look at some sections to the frontal lobe here the frontal lobe here in the purr over here we see a frontal lobe from a normal individual as compared to a from a mild to moderate dementia in a severe end-stage Alzheimer patient look at the shrinkage here in comparison to the normal this person would be apathetic and wouldn't care whether they ate or not now let's go to the back of the brain to the parietal lobe here you see a normal pariah two lobe a mild to moderate dementia and a severe dementia notice how this part of the brain is severely shrunken in comparison to the normal individual this patient would forget how to use a spoon or a four or even perhaps how to drink from a glass now let's look at the third part of the brain right here in the frontal lobe that tells you how to chew and swallow compare the normal right here to the mid stage right here to the end stage right here compare the normal to the end stage frontal lobe where you're chewing and swallowing is located this patient would forget how to chew and swallow or perhaps may just simply hold the food in his mouth for a long period of time in conclusion then patients with Alzheimer's disease have trouble with motivation to eat they have trouble using utensils and then in the end stages they forget how to chew and swallow the best way to see if a resident is not eating enough is to weigh them each resident should be weighed once per month on the same scale at the same time of day re weigh any residents with significant weight loss make sure you report any major weight loss to your supervisor immediately well we find with an Alzheimer's patient they pretty much forget how to feed themselves you may have to feed them by spoon to the mouth some kind of remember after you've worked with them awhile they can remember upon prompting to take the spoon pick it up and bring it to the mouth sometimes it takes hands-on contact and also with this it also takes a lot of patience some patients eat a lot slowly than other patients and it does require a lot of patience winifred is very her moods changed quite a bit she can be very pleasant but then you can go back and approach her and she doesn't want to be bothered she can't become aggressive I find that I have a lot of problems with her when I try to get her to come and eat at mealtime she will think that all of her meals are oxtail soup she told me you know that she'll say that God told her not to eat it or that she might think it's poison in her food and we have a hard time convincing her you know just to come and look at her meal and if she doesn't want it then that's fine and it takes a lot of patience and you have to really reassure her you know that she's gonna be okay there are three parts to a good feeding program one encourage residents who may have lost interest in eating residents with mid stage dementia can get distracted and lose interest in eating if residents prefer certain foods you should try to accommodate their tastes talk to families about what types of food residents prefer and what time of day they are used to eating to organize food containers utensils and food to make it easy for residents to eat residents with mid stage dementia often have problems using utensils and usually need some assistance check residents dentures at the beginning of each meal make sure that they remain seated during meals if residents start wandering away gently guide them back to the table if they need to use the restroom during a meal make sure that they return to the dining hall to finish eating three help residents who have trouble chewing swallowing and drinking residents with late stage dementia who have difficulty speaking usually have trouble swallowing to pay special attention to these residents and help them avoid choking on their food feed them slowly and make sure they have swallowed each bite before serving them another remember even if residents do not know that they are hungry everyone needs to eat if residents miss meals they won't feel well and may become grumpy well-fed residents are happy residents my husband gets really frustrated with mother about things like she can't cut up her meat but I can't do it for her I mean I offered to and know she's going to do it but she'll turn the knife the wrong way she'll cut in the wrong way and he'll fuss at her you know let let me leave letting and do it and all this but but you have to let her do what she can as much as she can because she's lost so much she's lost her independence she's lost control of her life you have to let her do what she can so what I'll do the lot of times is just cut her meat up before I give her her plate and which you just have to learn how to do how would you feel if all of a sudden you didn't have any control over your own life you couldn't drive you couldn't do grocery shopping you couldn't clean house these are these were productive active people they made normal lives knowing that it could be you it couldn't be me it is important to feed residents correctly prepare the dining area by getting the food and utensils ready tell residents it is time to eat help them come to the table and sit down make sure they are comfortable check to make sure residents remember their dentures open any containers and make sure food is bite-sized some residents are able to feed themselves others need encouragement and help getting started a demented resident may need help picking up a spoon and even remembering what to do with a spoon residents also need constant encouragement to continue eating residents will sometimes wander away from the dining area during mealtime it is important to calmly guide them back to the table and encourage them to continue eating residents may wander if they have to use the bathroom make sure you ask residents if they need to use the restroom before you return them to the table residents who use the restroom still need to return to the table and continue eating many demented residents have trouble feeding themselves residents who are not eating may need your help first try encouraging them to eat by asking if they're hungry and telling them how tasty the food is if that doesn't work then put the utensil in the residents hand and guide the utensil to the mouth if residents do not respond to your encouragement you need to hand feed them when feeding a resident gives small bites and make sure the resident choose each bite completely before moving on to the next bite you must be patient if you try to feed residents too quickly they may choke residents with mid stage dementia may have trouble feeding themselves because the part of the brain that tells them how to eat is damaged residents with late stage dementia may also forget how to chew and swallow you need to pay special attention to these residents during mealtimes because they are in greater danger of choking significant weight loss is very unhealthy if you notice that a resident has lost a lot of weight reweighed n't to make sure if it was not a mistake report the weight loss to your supervisor immediately residents should be weighed at the same time of day on the same scale once per month you find yourself in a strange restaurant and you don't remember how you got there a waitress brings you bizarre food that you do not recognize and hands you chopsticks you are very hungry but you don't know how to use the chopsticks and you can't pick up your food soon your waitress returns and begins to feed you like a small child how would you feel what would make you feel better please stop the tape and discuss how you would feel in this situation demented residents face strange foods and unmanageable utensils at every meal they feel hungry but they can't eat remember the last time you were hungry and couldn't eat demented residents need your patience kindness and guidance to help them eat and get the nutrition they need mr. Jones has mid-stage Alzheimer's disease he often gets up from the table during dinner and wanders off why does mr. Jones leave before he finishes his food he's done eating mr. Jones doesn't like his food mr. Jones is stubborn in me mr. Jones is disoriented but he still has to finish his meal in order to get the nutrition he needs Miss Smith has Alzheimer's disease and has trouble speaking sometimes she coughs when you feed her and occasionally she even starts to choke what's wrong with Miss Smith she doesn't like her food Miss Smith is trying to make things harder on you because she doesn't like you Miss Smith brain is damaged and she has trouble swallowing and chewing Miss Smith is being mean because she doesn't like the assisted living facility Miss Palmer has mid-stage Alzheimer's disease she only likes to eat sweets and refuses to eat her meat what should you do don't give Miss Palmer dessert until she eats all of her meat encourage Miss Palmer to eat her meat but give her sweets if she won't eat anything else ask Miss Palmer son to tell her that she needs to stop acting like a child tell the cook that the residents don't like the food mr. Carroll has dementia he takes a long time to eat and he plays with his food he never opens his milk carton sometimes he just sits in front of his food and doesn't eat at all what can you do to help mr. Carroll open his milk carton for him he has forgotten how to open containers encourage him to eat by placing a spoon in his hand and helping him start to eat scold mr. Carroll for acting like a baby scold him for trying to get extra attention tell him that we don't have enough staff to hand feed every resident tell mr. Carroll's daughter that he has an attitude problem you

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