Dietary and eating changes

Brucie

Registered User
Jan 31, 2004
12,413
near London
When I visited Jan yesterday she was being fed lunch.

The person who was with her informed me that as of that day, she had been moved from a normal diet, to one which is soft food, because she has started having problems chewing and swallowing anything with lumps.

This is a moment we have put off for as long as possible. When Jan went into the home in 2001, the manager explained that they try to keep people eating normally for as long as possible since. When food is made softer, the digestive system learns it needs to do less work, and the patient becomes reliant on soft food after that. There is little going back.

From observing, there seem to be several stages to soft food.

Yesterday, Jan had minced lamb, mashed potatoes, and some soft green vegetables. It smelled great and she clearly was enjoying it. Afterwards, trifle.

Other patients have the same, only all has been run through a liquidiser, so it is very soft indeed.

Other patients simply have specially formulated drink-based foods.

Just progression, I guess.

There was a quiet, nicely dressed man on the table nearby, eating his lunch. He tried to use the spoon provided, but his failing spatial awareness would not enable him to find the dish and load the spoon. He took the practical route and simply used his fingers. Messy, but effective!

I should say that the staff try to let residents eat whatever way they can, unaided, for as long as possible. All too often, dementia patients feel that things are being taken from them [faculties, money, friends], so this is, I believe, a sensible way to go.

Challenging behaviour often comes into these things. After eating a bowl of trifle with his fingers the man looked as if he had been in the custart pie throwing scene from "The Great Race". When staff wanted to try to help him clean his hands, he became very agitated - and would have become violent except the staff talked to him kindly for five minutes, then he was okay with it.

The staff at Jan's home are very caring. One said to me yesterday "I think Jan is putting on some weight, on her upper body" I replied that the change since 2001 has been dramatic, from the pictures I have taken. She then asked if I could bring the pictures in, because they seldom can see the beneficial effects of the care they give in a clear form. I'll do that for them. They are family now!
 

daughter

Registered User
Mar 16, 2005
824
Hi Bruce,

Sorry to hear about the changes in Jan's diet, yes it's just the progression but I know it's still hard to accept. Dad is still in the pick-it-up-any-which-way stage and, as you suggest, I'm pleased that the staff let him do this, although I have to admit that at first I was thinking, "how could they let him get this messy"? I suppose it goes to show that these things need to be thought through before jumping to conclusions.

Dad's staff and the other resident's relatives have become like a family to my Mum too. She sometimes goes in feeling very tearful and there's is nearly always someone who will give her the time to talk, a welcoming shoulder or even a glass of sherry has been known! I am so grateful that they look after my Dad and my Mum.

Thinking of you Bruce. x
 

Grannie G

Volunteer Moderator
Apr 3, 2006
70,710
Kent
Dear Brucie, I am so impressed with the standard and calibre of care at Jan`s home, although it`s sad she`s having more problems eating.
It`s all relative.
My husband is now having some problems eating with a fork. The food keeps falling off. I also remember the first time my mother had to wear a full length plastic apron [ bib]. Both were and are upsetting.
Even so, it`s lovely you see the home staff as family. Take heart from that.
Love Sylvia
 

Brucie

Registered User
Jan 31, 2004
12,413
near London
Thanks Hazel and Sylvia,

originally I was simply going to show the staff member the pictures of Jan over the time she has been at the home, but have decided that, in addition, i'll do a formal letter to the manager and staff, and a copy of the pictures too, as follows:
Dear [manager]
It’s a new year and I thought it would be a good time to write about Jan and [the care home].

Jan moved to [the care home] in November 2001, after five awful months at the assessment centre at [nearby], and staff at the home had a major challenge to bring her back to some form of normality.

Since then, the levels of care have been outstanding. It would be unfair to single out individual members of staff, because all have shown wonderful care to Jan.

I will, however, highlight firstly the management of [the care home], both at local and regional level. Without your dedication and grit, Jan’s placement would never have been such a success.

Secondly, the provision of food to residents is absolutely excellent, and [the chef and her daughter] and others who work to provide the food do a spectacular job.

Of the medical staff that I know, [the GP and consultant] have provided excellent medical care, in addition of course to the nursing staff at the home.

At one time or another staff in all areas, including maintenance, have been truly helpful to us.

We spouses and relatives are understandably usually totally immersed in our concern for those for whom we have responsibility and I don’t recall that I, at least, have been forthcoming officially with sufficient praise for the work that you all do.

I hope this will serve to rectify that!

On behalf of Jan and me, thank you.
Yours sincerely
 

CraigC

Registered User
Mar 21, 2003
6,630
London
Hi Sylvia and everyone,

I noticed this thread on eating and
My husband is now having some problems eating with a fork. The food keeps falling off. I also remember the first time my mother had to wear a full length plastic apron [ bib]. Both were and are upsetting.
Just wanted to say that they use a special device to help with this at dads home. It is a rim that fits around the plate on one side. This stops the food falling off and allows dad to feed himself without it continually falling off the plate. The contraption clips on to an ordinary plate and is about an inch high semicircle shaped. I'll try and find out more if you are interested.

Kind Regards
Craig
 

Lonestray

Registered User
Aug 3, 2006
236
Hereford
Hi Bruce, can only say wish I'd been so lucky in finding such a NH as you have. My wife would not be alive to-day had I not removed her from a home where I witnessed a lady with AD, who I came to know, was walking and talking when she arrived only lasted around six months.
I learned a lot about what not to do during my long visits to the NH, and a lot more since on how to care for my wife. Without advice or help I have got her from around five stone to nearer nine stone.
Hope they keep up the good work. Padraig
 

Brucie

Registered User
Jan 31, 2004
12,413
near London
Hi Padraig,
sorry to hear of your experiences in your posts on TP.

I put the posts about Jan's care home on TP because care homes get quite a bit of bad press. Often that is warranted, but I want others to realise that there are really good care homes out there as well.

I think I have mentioned elsewhere, in the past, that Jan's home is in the process of a planned re-building some time this year. The standards are, apparently, too good, and the number of residents is to be raised greatly, and the facilities reduced.

It's a sad old world when something that should be used as a template for all homes needs to be reduced, rather than bringing everything else up to the standard.

Grammar schools come to mind..... IMHO

[let's not start a thread on pros and cons of grammar schools... please!]
 

Amy

Registered User
Jan 4, 2006
3,453
Had to smile when you talked about different degrees of soft diet Bruce - mum is on a soft diet too. Loves scrambeld egg, but if it is overcooked she coughs a lot - recently one of the care assistants took it back to the kitchen and cooked her some more 'because I know how she likes it!'.
Love Helen
 

Michael E

Registered User
Apr 14, 2005
619
Ronda Spain
Shows how useful this TP place is....

I have been having 'eating' problems/issues with Monique recently... She will not eat anything 'hard' and it is of course her 'spatial awareness' (I had not realised it was that) that has moved her fairly rapidly from Knife and Fork a few months ago to Fork to Spoon and now mainly fingers... Much prefers fingers so what the hell.. also on likes 'Atlantic Salmon' (square frozen blocks of pink fish) and chips and my superbly prepared Chicken bits (squares) cooked in garlic, mixed herbs, olive oil and tomato sauce.. with chips!

Tried her on delicious boiled potato - in squares but they got the big heave ho!

Seems to like mussels now and then... and crevette......

Now all of the above are quite soft - except the chips - but cos I got an electric chip fryer and use frozen chips they are not particularly brittle...

I wonder if I have inadvertently gone down the path of feeding soft food? Mind you she won't eat anything else......... difficult - has to be finger portions these days... Am I doing harm with this diet I wonder?

Michael
volunteer poster.
 

rummy

Registered User
Jul 15, 2005
700
Oklahoma,USA
Hi Bruce,
Thanks for the enlightenment on food ! We are having our quarterly meeting on the current condition of Mom tomorrow and this information is very helpful. Just last week I noticed that Mom's plate which was supposed to be turkey and dressing, looked like a pile of mush to me. It didn't even occur to me that they may have changed her meals to something easier for her to eat.
I knew they were having to crush her pills and put it in strawberry preserves for her but it just didn't occur to me that food in general was a problem!
I will go into the meeting better informed and perpared to ask these questions now.
Thanks,
Debbie
 

Brucie

Registered User
Jan 31, 2004
12,413
near London
Hi Michael
I wonder if I have inadvertently gone down the path of feeding soft food? Mind you she won't eat anything else......... difficult - has to be finger portions these days... Am I doing harm with this diet I wonder?
my own view is that you have to do what works. For many things our body will tell us what it needs and how it needs it - we just don't listen always.

If Monique eats and is well on whatever she eats, in whatever form it is given, then I'd say it is fine.

P.S. Nina makes a quick and delightful potato and onion soup that is put through a blender before eating. Hasn't done me any harm, and it is the most soft a soft food meal can be!
 

mel

Registered User
Apr 30, 2006
1,656
62
Sheffield
Hi Bruce
Mum has been put on a "soft diet" in hospital
When I visited her the other day she was also tucking in to minced lamb and mashed potatoes.....(with a bit of tissue mashed in:eek: ......mums addition.....!). Like Michael I wonder if I have adopted the soft diet without fully realising it....mashed potato and homemade soup always seems to go down pretty well.
Mum gets really annoyed though if the nurses try to feed her.....its then that the food is thrown back at them.
Mums tastes are continually changing.....in hospital she eats fish.....never did before...
She eats minced lamb.....never has before.....
Its all trial and error....
And yes......fingers seem to be the easiest utensils to use......

I'm so glad to hear the care home is so good ...from what you've written today and from previous posts.....It has to make the situation a lot more bearable..
Love
 

Michael E

Registered User
Apr 14, 2005
619
Ronda Spain
If Monique eats and is well on whatever she eats, in whatever form it is given, then I'd say it is fine.
'But there's the rub' I am certain - know she is loosing weight - mind you that's after putting on a lot of weight during the earlier AD years. Originally was a well bilt broad (not fat just a good healthy shape) she became 'fat' - Tubby - and now that's going down.

Her Cholesterol is high - Doc has prescribed a vitamin course - and she has another 'doc' interview in a month so I'll check it out there...

Do care homes in the UK ask for a 'Medical Analysis' of the patient's condition before admittance for a short (respite) period?

Michael
 

Amy

Registered User
Jan 4, 2006
3,453
Hiya Michael,
Mum has eaten far more since having dementia, yet still the weight drops off. Before she lost the ability to walk she used to be constantly walking - so we put it down to that. All we can do is our best. And no. we had no medical analysis before respite, just a chat with the Manager.
Love Helen
 

Lila13

Registered User
Feb 24, 2006
1,342
Not in the place where my mother went for 12 days, just a few general questions.

Lila



Michael E said:
Do care homes in the UK ask for a 'Medical Analysis' of the patient's condition before admittance for a short (respite) period?

Michael
 

Grannie G

Volunteer Moderator
Apr 3, 2006
70,710
Kent
Dear Brucie, What a wonderful letter to be able to send. I wonder how many homes receive that kind of praise. Not many I`m sure.

Dear CraigC, Thank you for responding. My husband doesn`t spill the food from his plate, it seems to slip from his fork just before it reaches his mouth. It`s so sad to see.

It`s interesting to note how some homes are good communicators re changes in diet and others just make the changes without informing any family members.
That`s what makes the difference.

Regards, Sylvia
 

janjan

Registered User
Jan 27, 2006
229
59
Birmingham
When dad used to go to day centre they gave him a spoon to eat with because they said he found it easier to use than a fork. Now he's in a n/home they all have the tables set with forks, knifes and spoon's and i've noticed how everyone manages to eat their dinner's differently. Some eat with just a knife. I think it's nice that they allow people the chance to manage their dinner how they want to. The carer's feed who isn't able to manage themselfs and it's so nice that everyone get's to be together for at least their main meal in the day. Dad as his good day's and bad day's when he need's a bit of help. I have alway's visited during the day but i decided to pop to see him for a short visit tonight. They was just bringing him back from having a shower and he was ready for his tea. It was so nice to see him smile as he came round into his room when he saw me. It's such a relife to know he is being so well cared for. I never thought i would reach this point where i could leave him there without the guilt monster jumping on my back on the wayout the door. But i do think it's part of his AZ why he's still losing weight when he has three good meals aday. I's a puzzle i can't quite work out. :confused: Janet:confused:
 

connie

Registered User
Mar 7, 2004
9,519
Frinton-on-Sea
I spend a 'full day' with Lionel every third day, and therefore have the midday meal with him. I eat in the dining room on the dementia unit, and it is interesting to see how individuals manage.

Lionel uses just a fork, and a plate guard, so needs his food cut up first. Today he informed me it was Scampi, this from a man with very poor short term memory.
It was, for him, he forgot that he had ordered me pork fillet.

His taste is changing. I used to have to bully him into eating any type of fish, now he orders it two or three times a week.

Well done Bruce for pointing the way to "praising" the care home. After all we complain quickly enough.
 

Nell

Registered User
Aug 9, 2005
1,170
68
Australia
Dear Bruce,
Like other TPers I was touched by your letter and have decided to think about something similar for Mum's home. I am there about 4 times a week for several hours each time and my sisters (who live further away) spend a whole day there once a week each. We do notice the care and attention but can easily be distracted by Mum's complaints. (Mum has always been a champion complainer and AD has not slowed her down in the least! It's just that now her complaints are often baseless - but still occasionally "spot on"!! :confused: "Go figure!!")

With so many people agonising over the decision to move loved ones into care homes, I think it is really important for people to know there are good ones as well as bad ones. Like most peope, I'm inclined to be quick to whinge and slow to praise! Thank you for pointing out a better way!
Cheers!
Nell