Viewing eating as a social activity and being flexible about making changes, both in the appearance and environment of the meal, are helpful, in getting the patient to eat.

Patients may gain weigh in the early stages of the disease, but in time, eating can become a problem due to short attention span, environment or physical overstimulation, the inability to remember how to bring food to the mouth, or given too much food.

Patients may play with their food, eat to fast, swallow without chewing, or chew one bite forever. The inability to recognize, chew, and swallow in the last stages of Alzheimer's disease eventually leads to severe weight loss.

Following are some mealtime suggestions to help make eating simplier:

* Cut food carefully in to bit-size pieces. Remove all bones, garnishes, and non- edible items from the plate. Avoid using styrofoam cups and paper napkin, which might be mistakenly eaten.

* Monitor the patient constantly to discourage overstuffing the mouth. To prevent choking, remind the patient to chew and swallow properly.

* Simplify the meal. Present one course at a time--the salad then the meat, then the bread and butter.

* Use one utensil, such as a spoon. Remove the others from the table. A damp washcloth under the plate will prevent the plate from slipping.

* If necessary, place the spoon in the patients hand, put your hand over his or hers and guide the food to the mouth. The patient may be able to continue independently after a few assists.

* Weigh the patient weekly. If weight is lost, double food portions, especially at breakfast. For example, serve eggs, cereal, and pancakes. This is usually the best eaten meal of the day.

* Use a heavy chair that can't be moved easily. If the patient won't sit down at all, make sandwiches that can be carried, so the patient can eat while pacing. Sandwiches can be made out of most anything. Mashed potatoes makes good glue for holding sandwiches together.

* Don't rush the meal. The patient may start and stop eating many time. Have four to six small meals a day if your patient eats too little at one time.

* Watch for continual changes that may be due to a physical problem. Report such changes to the doctor. In time, the dementia person will slowly stop eating. They will need to have their food chopped and later pureed. Patients will continue to drink. Puree food can be put into milk and high protein or instant type drinks. Don't give up -- keeping trying to introduce their favorite foods.

In time, the dementia person will stop eating. They will need to have their food chopped and later pureed. Patients will continute to drink. Puree food can be put into milk and high protien or instant type drinks. Don't give up---keep trying to introduce their favorite foods.

By Kathrine Martin ACSW

(c) copyright 1992

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