In skilled nursing facilities, one of the busiest and most hectic times of the day is mealtime. For dementia patients, mealtime is an extremely significant indicator of quality of life. Recently, a study titled “Factor’s Affecting Independence in Eating among Elderly with Alzheimer’s Disease” was published in the journal of Geriatrics & Gerontology International. Researchers who conducted the study noticed that patients who suffered from dementia often experienced a decline in the ability to eat independently. Because of their need for feeding assistance, it is important to recognize the signs of dementia by monitoring residents during their mealtimes.
The study observed that patients with dementia and other cognitive disorders, such as Alzheimer’s disease often had difficulty beginning their meals by themselves. This could be a result of an inability to recognize the material on their trays as food. Sometimes, even when patients were able to identify their food, they were unable to comprehend how much food to transfer to their mouths, and by what means to do so. For example, patients with dementia often had difficulty using their utensils properly to scoop the proper amount of food, either scooping too little food or too much food all at once.
Often, dementia patients also had difficulty distinguishing between food and non-food items. Even when they were able to identify their food, as a result of visuospatial impairments, these residents sometimes only recognized portions of their meals as food, and left the remainder untouched. Other patients with dementia who suffered from attention disorders or disorientation were unable to stay focused on eating during the entire mealtime. Some were distracted by other activities, while others were unable to remain alert and fell asleep during their mealtime.
Unfortunately, nursing homes are often inadequately staffed and unable to provide their residents with the one-on-one feeding assistance that they often need. Especially in patients with dementia, nursing home neglect during mealtimes has serious consequences. According to the study, one of the most common symptoms of dementia during mealtimes was the inability to begin eating. Consequently, patients often become anorexic or malnourished because facilities are understaffed and nurses are far too overwhelmed during mealtimes.
The study also pointed out that in most skilled nursing facilities today, each individual care provider is permitted to use their own judgment on how to feed patients. While this may be acceptable in nursing homes with qualified and well-trained nurses, such as licensed practical nurses (LVNs) and registered nurses (RNs), many facilities leave meals to the discretion of care aides and certified nursing assistants (CNAs) who often are not thoroughly educated on the dangers of malnutrition and dehydration. Therefore, skilled nursing facilities should have set guidelines or rules that must be followed during mealtimes. Instead, trial-and-error experiments are generally accepted in determining the best foods to feed residents. However, this is extremely dangerous, because just one simple error in feeding that is not in adherence with physician’s orders can have serious consequences, and even lead to death. For this reason, nursing homes should also employ dieticians during mealtimes, to ensure that doctor’s orders are being followed and to maintain the highest practicable nutrition and physical health of patients.
The study suggested altering the texture of meal or adjusting the patient’s posture in order to encourage independent eating. Additionally, certain therapies exist to improve and maintain the swallowing function. However, once dementia reaches more serious stages, it is difficult to perform these rehabilitation exercises. Therefore, nursing staff need to be aware of the symptoms discussed above that patients with dementia often show during mealtimes. It is the responsibility of the nurse to identify the onset of dementia early on in its progression, and to implement the proper therapies and treatments to encourage independent eating.
f you feel that your loved one’s nursing home has failed to provide adequate care
during mealtimes, please contact us today, especially if your loved one suffers from dementia, as neglect during mealtimes can have serious health implications.