In this modern time, the demand for care placement for elderly particularly with dementia patient is increasing thus, provision of proper nutrition is very vital. The rate of malnutrition for older people in care homes and hospitals are increasing especially those with dementia simply because the sufferers are not eating enough and this may cause difficulties for the carers. This article discuss some contributing factors that can seriously affect unplanned weight loss, how to overcome these problems and it suggest some useful tips that health care provider may implement in feeding the patients.
Dementia is not part of a normal life. Indeed, it affects older people and most of the individuals diagnosed are people 65 years and above, albeit it also occur at an earlier age. Dementia is a syndrome that caused changes in the brain considerable enough to hinder with Activities of Daily Living (ADL). This includes impairment of cognitive function like the ability to think, memorize, communicate, judge and others. Also, it is commonly explained as progressing but it varies among individuals. (Knapp et al. 2007) presently it is expected that in United Kingdom there are almost 700,000 individual living with dementia. By 2051, it is projected to mount to more than 1 million. As, the person becomes older the incidence rises. Majority of the cases account to Alzheimer’s disease which is the most common type of this disorder. Multi-infarct or commonly known as vascular dementia accounts the second spot. Lewy bodies (DBL) and fronto temporal dementia (FTD) are the other forms of dementia. People with dementia often have a low body weight as a result of dietary behavior.
Thus, it is vital to know if this is due to inadequate energy intake or the root of the syndrome itself (Barrett-Connor et al, 1996) suggest that weight loss may be a physiological response to dementia or that may be part of the ageing process (Morley and Thomas, 1999). However, research also reveals that they can gain weight (Baratt, 2004). There are various reasons that cause those with dementia to become underweight, one of this is changes in food intake, but this may link to physiological reasons such as, the movement of food to the Gastrointestinal Tract (GIT) becomes slower.
Also older adult is less able to discern among salty, sweet, sour and bitter tastes. The sense of smell is also decreased thus, further reducing taste which contribute to reduce food intake. Consequently, it is essential to recognize whether decreased ingestion of food is related to ageing process which is normal for adult person or associated to mental health reason such as paranoia and depression. Feeding difficulties is another reason for having an unplanned weight loss for people with dementia especially if they are lack of concentration, feels agitated and restless, difficulty in swallowing which be the cause of aspiration.
Another contributing factor for weight loss is the skills needed by the carers or nursing staff in feeding the residents which is imperative in achieving the desired weight for the patients. Assessment is the key factors to prevent weight loss for dementia patient. The main objective is to find out what is the central to their concerns and to help find solutions. Having a high-quality assessment gives clear picture about the person and what specific foods they need.
Encouraging them to eat a healthy diet is very important to prevent confusion and becoming ill. It is essential to provide foods that are high in nutritional value. Atmosphere also plays a vital role on how individuals eat. Providing a relax and calm environment during mealtimes can help residents to eat better. Aquarium placed in the dining room enhanced food intake (Edward and Beck, 2002). A separate setting for those who can eat alone should be considered to increase concentration on their meals.
Patient with dementia should be taught to become independent to promote self-being by offering little assistance such as placing utensils into person’s hands and cutting up foods. Difficulty swallowing can become difficult as dementia progresses, nevertheless consistency meals can be provided to achieve goon nutrition. However, the consistency of foods should be safe and acceptable. Those with difficulty chewing find a textured soft diet helpful and those with severe swallowing find pureed meals significant.
People with advanced dementia may not cooperate to eat which can be very distressing to the carer. Therefore, it is important to determine the root. There may be mouth sore or because they find the food unpleasant. There are other recommendations that carer can take during mealtimes such as; giving adequate time to eat, serving one course at a time, having eye contact with the person, using verbal cues or listening to patient’s cues and avoid distractions during meal time.
Providing a balanced diet with patient with dementia sufferers is very vital to avoid unwanted weight loss. Although carers may experience problems in giving nutritious foods there are number of ways that can be carried out. Moreover, even though providing good support during mealtime is very time consuming this help can be rewarding for those sufferers which enable them to become independent, increased self-esteem and improved quality of life. Also, with support, carers play a part in providing optimum nutrition for patient with dementia.
Reference Lists: Barrat J (2004) Practical nutritional care of elderly demented patients. Curr Opin Clin Nutr Metab Care 7(1) 35-38 Barrett-Connor E. et al. , (1996) weight loss precedes dementia in community-dwelling older adults. J Am Ger Soc 44 1147-1152 Edwards N, Beck A (2002) Animal assisted therapy and nutrition in Alzheimer’s disease. West J Nursing Res 24: 697-712 Knapp, M. et al. , (2007) Dementia UK, Alzheimer’s Society, London. Morley J. Thomas D (1999) Anorexia and aging: pathophysiology: Nutrition 15 (6) 499-503