Challenges in eating for seniors often begin with vision loss, dental problems, cognition loss, or digestion-specific issues. These struggles can result in frustration and stress for everyone. For seniors, feeling that they have lost some of their dignity can make meal time difficult and emotional. There are ways to maintain dignity for our loved ones as they age, even when they struggle with daily living activities such as eating. Here, we discuss how caregivers can assist in this challenge.
Identify Their Challenges
Make a list of the specific steps involved in eating a typical meal or types of meals and what your loved one needs to do to be successful when eating. For example, soup typically features bite-sized items that don't require cutting. But it doesrequire some hand-eye coordination and steadiness to avoid spilling anything from a spoon. If your loved one has problems with cutting or holding larger items like sandwiches, soup might be a better food for lunch and dinner. Planning ahead can make a big difference. You should make only a few meals a week that potentially could be frustrating and avoid stressful days for those meals. For a senior who does well with chewing and swallowing but struggles with cutting food, you should save steak for a low-stress, low-activity day because it may take more time and emotional energy to eat. After a day of doctors appointments or traveling, they may enjoy meals that are easier to consume. Because this may not always work for both of you, the more you plan the less stress mealtimes cause.
When possible, allow your loved one to do as much eating themselves. Rather than insisting on doing everything for them, as many caregivers do with good intentions, find ways to support your loved one. If they struggle to cut food, do it for them--but then step back and allow them to consume each bite alone. Consider cutting the pieces during meal prep rather than after the food is cooked. This usually cuts cooking time and means they are not embarrassed at waiting for you to cut food for them. You can also identify the foods they may need help with and serve those less often. You may modify recipes to make them easier on yourself and your loved one--like eliminating messy sauces or preparing salads rather than cooking tacos. However, remember that messes are sometimes unavoidable. The older your loved one gets, the more likely that messes will occur during meals. This is normal.
If your loved one can meet with an occupational therapist, chat with the therapist about mealtime modifications you can make. In the case of vision loss, for example, many health insurance or community programs offer occupational therapy to re-learn basic skills. These therapists are trained to help persons do as much on their own as is safe. This means that they can offer information about how to foster independence at mealtimes. They are the local experts for your loved one's specific challenges; use their expertise, if you can.
Continue as Normal
Your loved one may feel more embarrassed by food messes if you react to them. Strike up interesting conversations. Do not stare or stop when food or drink is spilled. Continue as if it hasn't happened, even (and perhaps especially) if you need to help your loved one clean up. Expressing frustration or irritation can make them feel guilty or embarrassed. Keep in mind that, as frustrating as helping them eat might be for you, it is more frustrating for them to make the mess and require your help. Mealtimes may also take longer, so plan for more time at the table. Accept that a positive attitude and patience can go a long way toward keeping your loved one's dignity intact around mealtime.
Keep an Open Ear
Check in with a senior in your care about their self-esteem and independence. Listen with empathy, even when they express frustration or anger. If they feel like you could allow them more space or independence, try it for a few weeks. You can return to helping them more if a change is not working. Listening to their concerns and emotions can go a long way toward making mealtimes less stressful and keeping their dignity intact. Open lines of communication about mealtimes. Don't be afraid to ask how they feel.Always be available to listen. Maintaining the dignity of your loved one at mealtimes comes down to how well you work as a team.
Alzheimer Society. Meal Times. Alzheimer.ca, September 2012. Available at http://www.alzheimer.ca/~/media/Files/national/brochures-day-to-day/day_to_day_meal_times_e.pdf. Retrieved December 4, 2016.
National Institute on Aging. Promoting successful eating in long-term care: Relationships with residents are key. National Institutes of Health, February 26, 2015. Available at https://www.nia.nih.gov/alzheimers/features/promoting-successful-eating-long-term-care-relationships-residents-are-key. Retrieved December 4, 2016.
Social Care Institute for Excellence. Dignity factors--Eating and nutritional care. SCIE.org.uk, May 2013. Available at http://www.scie.org.uk/publications/guides/guide15/factors/nutrition/. Retrieved December 3, 2016.