Choosing identifiable & simple food

dancsfo

I realize this depends on the stage, but have you had success serving food that is easy to identify, one at a time? I see that finger foods are discussed elsewhere in the forum.

I've read the suggestion below, on serving food and eating tips

https://www.alz.org/help-support/caregiving/daily-care/food-eating

and this may be related. I noticed PWD was interested in spicy condiments lately (was putting salsa on a burger), and eating lots of pickles, so I said I will get an Indian curry as take out.

When serving it, PWD could not tell whether it was chicken or fish, thought it was a Chinese take out and also misidentified jalapeño pepper as green beans, and ate a mouthful of it, which was too spicy.

So I figure that the PWD is losing capability of recognizing food, as the tips page suggests. So rather than a stew type meal, I am thinking of just serving something simple like a piece of fish, some steamed broccoli and other items that are easy to identify, and serve it one after another. They are easy to identify and tell apart.

I also am spending more time helping cut the food with a knife and fork on the plate, as PWD is having more problems cutting food. I understand that this is not suggested (encouraging independence in eating) but PWD does not seem to mind, so I do that.

I think I also may need to resort fo finger foods. Lunch is already almost always sandwiches (as finger food) but I have tried to make evening meals more conventional, but maybe it's time to make things easier to hold and eat. Maybe I can serve most food as a sandwich, so rather than cold cuts or tuna in a sandwich, I can take pieces of baked fish and put it between bread? I may have to resort to that eventually, but I think there will be resistance at first as PWD may not want sandwiches for lunch and dinner.

harshedbuzz

@dancsfo

I think what works in feeding as it relates to dementia caregiving is going to be very dependent on the PWD and the stage in which they age.

You have to factor in the typical changes around this sense with age— a reduction of the number, size and sensitivity of taste buds changes people age. I found my MIL and both my parents more accepting of new flavors and more seasoned/spicy foods— of the 3 only dad had dementia. I also found all 3 of them more interested in sweets as they aged as well.

I don't feel like cutting meat before plating it would interfere with independence— the opposite, by cutting it your LO can manage on his own rather than need to be hand-fed. You are setting him up to be successful using the skills he has.

If you don't mind the mess, pretty much any solid can be a finger food. Chicken strips, fish sticks, drum sticks, chops, roasted or raw veggies. I found dad did better with sauced foods around stage 6; I think the gravy or sauce made things easier to swallow. One concern about offering one food at a time is that many PWD don't have much appetite so you could inadvertently fill them up on whatever you offer first.

The goals at some point become safety and calories in to maintain weight. Some of the concerns you have may not play out. As dementia progresses, most PWD become disoriented to time so breakfast-for-dinner or sandwiches wouldn't strike them as unconventional. Or they may showtime during normal dinner hours, so offering more dinner-like food at lunch might be better. In fact, in many SNFs and MCFs, the most substantial meal is served mid-day when residents are most likely to be at the daily best and a lighter soup/sandwich meal is offered at dinnertime.

HB

M1

I think your sandwich idea is a good one—our MC many times serves a meat entree with a big soft yeast roll, and I many times make a sandwich out of it so she can hold it herself. I don't think she remembers from meal to meal, so I wouldn't worry about her being bored with sandwiches all the time. If it works, it works….

dancsfo

Thank you @harshedbuzz and @M1 for your suggestions, These forums are so useful due to learning from others' experiences. There are so many trade offs I was not aware of, such as calorie intake. I think I just need to experiment to see what works.

It's natural for me to go down one path, and trying to refine it. I instead ought to just try very things, such as switching meals so that the lunch hours meal is a more substantial meal and have a light supper.

As I learned elsewhere in this forum, I may use an Instant Pot or a crock pot to make a substantial lunch, and prep meals the night before, so that I mornings are not too busy with cooking.

HollyBerry

I'd love to have a conversation about food! My partner is telling me that whatever I offer "doesn't taste like anything." She also wants her food to be almost hard - the toast is too soft, the fried potatoes not crispy enough, wants crunchy granola bars rather than chewy. Her sister was here last week and made casseroles with very small pieces of things (sister's teeth aren't great) and my partner didn't like all the mush (I could have predicted that, if she asked). Has anybody noticed these things as a sensory seeking behavior? sometimes I wonder if that's a component of Alzheimers that we've missed.

harshedbuzz

@HollyBerry This is one of the ways in which dad's dementia progression reminded me of a form of acquired autism. He didn't become sensory seeking but swung into sensory defensiveness— becoming very picky about things like light, the softness of clothing and taste.

OTs who specialize in sensory issues have explained this preference for "hard" or chewy foods as related to seeking joint compressions as a calming strategy. In kids on spectrum, biting is a behavior that is sometimes due to this need. Given that the TJM is a powerful joint, it is often used for those with sensory issues by giving chewing gum or chewy fidgets in a classroom or other seated setting. Other rowdier options are wall climbing, mini-trampolines, jumping jacks. Your wife might do well with something like that or a weighted lap throw.

HB

HollyBerry

Thanks, HB, that's interesting. I'm probably getting away from the original poster's conversation about food, but the sensory stuff comes to mind because she was always super active, someone with ADHD that needed movement and input. Now she clomps around the house, sits heavily on chairs, slams the car door, and I swear some of the arguing comes from a need to create some stimulation or arousal. For people who had these sensory needs throughout their life, it's interesting to think about how Alzheimers would change that, or not. Wrapping all this back around to food - crunchy food, loud food (biting into an apple), stronger flavors, certain mouth feel… could be part of the same?

@dancsfo , my mom was in AL at the end of her life, and they were super about having a few favorite foods available for people who weren't in the mood for the daily menu. I think my partner would happily live on granola bars but for my mom it was cookies, grilled cheese, scrambled eggs and toast - carbs! and spaghetti sauce and gravy. And they did provide single foods more often than salads or casseroles.

dancsfo

https://alzconnected.org/discussion/comment/218135#Comment_218135

Thanks @HollyBerry about keeping favorite foods around. It's hard to predict, but you're right that stuff like cookies always around may work. I tried banana bread with walnuts today, and it was "too sticky". The unpredictability day-to-day is the most difficult part for me. I can stock on some snacks, and it may be rejected one day, and savored on another.

So I'll keep trying different things, and going heavy on carbs makes sense since there isn't a lot of appetite on some days and I need to find a way to keep the weight stable.