On Friday 5th June, Evelyn Newman, a dietitian from NHS Highland led an AHP webinar, where she shared practical tips, ideas and resources to help support people living with dementia to eat and drink well. You can watch the full webinar again here https://youtu.be/jV_s4gGyRPw
Please leave any further comments on this blog post for Evelyn to continue the conversation with you or link with Evelyn at @evelynnewman17. During the webinar, participants asked lots of great questions and today we are posting Evelyn’s replies.
Questions by you and Answers by Evelyn
QUESTION For a carer for someone with mild dementia, who is not keen to eat and his partner gets uptight re him not eating. Any suggestions and is this a common issue?
ANSWER It is very common and we see this with people who have cancer too. It’s natural to worry about loved ones –especially if you feel unable to help them yourself. Try to understand why his appetite is poor e.g. is the texture right for him? Try tasting activities with little bits of new foods/drinks that involve his partner too. He may do better having 6 small meals/snacks/finger foods rather than a sit down meal. If you notice he is losing weight, you may need to self refer to a local community dietitian.
QUESTION Could you give more information on the contract with Apetito for providing freezers and microwaves? Is that an NHS contract?
ANSWER NHS Highland has a contract with Apetito for people receiving care at home but individuals can arrange to purchase products themselves too. The freezer and microwave are provided by the company for the duration of their using the products. Contact the company for a discussion about what they can offer your service users locally.
QUESTION One of the biggest concerns carers have about supporting a family member with dementia is that they are not taking enough fluids. Short of prompting, or providing appropriate cup or drinking vessel, are there any other innovations for encouraging fluid intake.
ANSWER You could try offering ice lollies, jelly, sorbet, ice cream or get them to help make Angel Delight (or similar) Juicy fruit like oranges and melon also have a higher fluid content, so chop them up and keep in the fridge for a refreshing snack. I am also regularly asked about “jelly drops” They are now being produced and the company has contacted people who have already registered an interest in them. Look at their website for more details www.jellydrops.co.uk
QUESTION When preparing meals what are your views on seasoning? Especially salt.
ANSWER Taste sensation is altered during illness and aging or with certain medication. Stronger flavours are encouraged to stimulate tastebuds whether it’s salt, pepper, sauces and pickles. Using garlic e.g. garlic bread/kievs or herbs/spices if food can also reduce menu fatigue, which is a common problem in care home setting especially
QUESTION At the beginning you mentioned risk of dehydration and malnutrition, are there statistics for people with dementia on a texture modified diet? Do you have a reference for this please? Thank you, excellent presentation
ANSWER Please contact www.dysphagiagame.com as they developed this great educational game to help people understand more about swallowing difficulties
QUESTION Have you got any advice about how to support people when they have very repetitive cravings eg compelled to eat large amounts of biscuits, cakes, sweets in one go or very restricted to eating one particular type of food?
ANSWER Try to understand repetitive behaviour – are they bored? can you alter routine or food available? People who have dementia often prefer sweet foods so maybe try lower calorie options to improve diet quality and reduce risks of tooth decay or obesity. Encourage other sweet tasting food e.g. (homemade) ice lollies, sorbets, carrot/celery, cucumber, pepper sticks, cherry tomatoes or fruit (may need to be chopped up) or get them involved in preparing food
QUESTION what is the name of the app again?
QUESTION Hi Evelyn. Would love to know the name of the IDDSI app/details on it so we can download it. Thanks
ANSWER Just go to the App store and search for IDDSI. Otherwise look on the website www.iddsi.org Another helpful site is www.oakhouse-kitchen.com or at the Care Inspectorate hub where they have advice for supporting people with dysphagia www.careinspectorate.com
QUESTION Any other tips to prompt and encourage people with dementia to eat and drink ANSWER Look for ways to stimulate their senses; engage them in cooking, growing/gardening; meet with other people-social interaction can help; try using coloured/adaptive cutlery/crockery (local occupational therapy service can assess and advise if necessary)
QUESTION Can Dementia Link Workers refer to or seek advice from AHP directly?
ANSWER Most AHPs take direct referrals but you should call them and ask what happens in your area. There are other sources of information too such as www.nhsinform.scot or professional associations such as The British dietetic association www.bda.uk.com or the Care Inspectorate hub www.careinspectorate.com.
Alzheimer Scotland also developed a leaflet in partnership on who AHPs are and how you can refer to an AHP in Scotland
We invite you all at the end of each webinar to share something you might try out or change following today’s webinar” here are a short selection of your replies
- I loved the idea of trying out a taster menu or maybe small plates like tapas style.
- To incorporate Dieticians and speech and language therapy into our Memory Assessment Service formal post diagnostic group
- Will try and eat maybe weekly with my mum to encourage her to enjoy a meal, once lockdown is over of course. She often asks to go out to eat with me, maybe this is to not eat on her own. She lives alone. I had not thought of this as a reason.
- I will take this information into practice when I graduate, especially the roles of other professions in nutrition and when it is beneficial to refer on.
Evelyn Newman @evelynnewman17