October 2017 | Wesley Hospice

Nutrition for Dementia and Alzheimer’s

Dementia is the loss of memory, cognitive reasoning, awareness of environment, judgment, abstract thinking, or the ability to perform activities of daily living. The most common form of dementia is Alzheimer’s disease, a type of dementia that involves slowly developing symptoms that get worse over time. Dementia resulting from vitamin deficiencies, or caused by underlying disease (such as brain tumors and infections) may be reversible. Other forms of dementia, such as Alzheimer’s and vascular dementia, are not reversible, and are often treated with medications.

As dementia progresses, changes can occur that may affect someone’s ability to obtain adequate food and nutrients to maintain their health status. Such changes will vary depending on the type of dementia, as well as the stage of the disease. Some of these changes include:

  • Altered sense of smell and/or taste
  • Inability to recognize food or distinguish between food and non-food items
  • Poor appetite
  • Chewing difficulties (pocketing food, repetitive chewing, etc.)
  • Swallowing difficulties
  • Forgetting to eat
  • Shortened attention span leading to a loss of interest in eating
  • Difficulty using eating utensils
  • Increase in pacing or walking
  • Drug side effects

The symptoms of dementia vary, and the treatment and nutrition care should be determined by these symptoms. Some techniques to consider for continued delivery of food and nutrition include:

  • Provide kind reminders to eat.
  • Provide meals in a low stress environment, minimizing noise and visual
  • distractions.
  • Develop a meal routine that can be repeated over time, to provide meals at
  • similar times, or even similar meals every day.
  • Have someone eat with the individual to provide assistance and reminders
  • on how to eat.
  • Have family join the individual at meal times to encourage eating.
  • Pay attention to other health issues, such as infections, fevers, injuries, or
  • other illnesses, as these may increase food and fluid needs.
  • Provide well-liked food and drinks to encourage eating.
  • Limit the amount of food served at one time so as not to overwhelm.

Provide finger-type foods for individuals struggling to use utensils:

  • Hamburgers
  • French fries
  • Carrot sticks

Check with a dietitian or doctor for any specific dietary needs.


How to Cope with Grief During the Holidays

Thanksgiving, Christmas, Hanukah, Ramadan, Kwanza and New Year’s Day are annual holidays that can be a very difficult time for people who have experienced the death of someone they loved.

Memories during the holiday season serve as reminders of our loss. Watching others who are feeling thankful and are celebrating when you feel overwhelmed, lonely or sad can be very painful.

The first step in coping with grief during the holidays is to acknowledge that the first holiday season is difficult, and then to prepare for it, in advance, by making specific plans and obtaining the support that you need.

Remember too that sometimes anticipation of a holiday can be more difficult than the arrival of the day itself.
Set realistic expectations for yourself. Remind yourself that this year is different. Decide if you can still handle the responsibilities you have had in the past. Examine the tasks and events of celebrating and ask yourself if you want to continue them.

Surround yourself with people who love and support you. Share your plans with family and friends and let them know of any intended changes in holiday routine. Memories can sometimes be a source of comfort to the bereaved. Share your memories with others of holidays spent with your loved one by telling stories and looking at photo albums.

Try to avoid “canceling” the holiday, despite the temptation. It is fine to avoid some circumstances that you do not feel ready to handle, but avoid completely isolating yourself. Allow yourself some time for solitude, remembering and grieving, but balance it with planned activities with others.

Allow yourself to feel joy, sadness, and anger – allow yourself to grieve. It is important to recognize that every family member has their own unique grief experience and may have different needs related to celebrating the holidays. Not one way is right or wrong. Experiencing joy and laughter does not mean you have forgotten your loved one.

Draw comfort from helping others. Consider giving a donation or gift in memory of your loved one. Invite a guest who might otherwise be alone for the holidays. Adopt a needy family during the holiday season.

Take care of yourself. Avoid using alcohol to self-medicate your mood. Try to avoid the hustle and bustle of the holiday season. Physical exercise is often an anecdote for depression. Writing in a journal can be a good outlet for your grief expression.

Create a new tradition or ritual that accommodates your current situation. Some people find comfort in old traditions. Others find them unbearably painful. Discuss with your family the activities you want to include or exclude this year.

Some examples of new rituals and traditions include:

Light a candle in honor of your absent loved one.
Put a bouquet of flowers on your holiday table in memory of your loved one.
Visit the cemetery and decorate the memorial site with holiday decorations.
Have a moment of silence during a holiday toast to honor your loved one.
Place a commemorative ornament on the Christmas tree.
Dedicate one of the Hanukah candles in memory of your loved one.
Play your loved one’s favorite music or play their favorite game.
Plan a meal with your loved one’s favorite foods.

The most important thing to remember is there is no right or wrong way to celebrate the holiday season after the death of a loved one.


Who’s Involved in Hospice Care?

Typically, hospice teams work alongside your caregivers to develop an individualized comprehensive care program.  The hospice team usually consists of:

RN Case Manager

This is the person who will coordinate the various elements of your care. Their goal is to coordinate care in the most effective way possible for each individual, and their family.

Hospice Aide

This person can provide care in the home, community or hospital. This can include overnight stays, bathing, and other care to ensure that the individual, and their family, is comfortable.

Social Worker

Social workers often start by assessing the situation. They determine the wants and needs of the families we serve. They also educate individuals and give advice on the dying process. But, they also advocate for the patient’s final wishes.

Spiritual Counselor

Spiritual care can be an important aspect to emotional support. The spiritual counselor is there to develop a plan for each person’s beliefs. Then, they act as resource to carry out this plan.

Medical Director

Any medical needs will be handled by the medical director, in collaboration with the individuals’ physician. This person will ensure that the medical wishes are fulfilled for each person. But, this person’s duties may also extend to the families, and/or caregivers.

Volunteer Coordinator

This person coordinates the volunteer schedule. They match volunteers where with the people they believe they will work best with.

Bereavement Coordinator

This person provides counseling services to those who have been affected by a death.

Volunteers

Hospice volunteers are an important part of the hospice team. They are there to provide a helping hand, support and compassion to the people served. The volunteers may provide transportation, preform household chores, and prepare meals.

Administrative and Support Staff

The administrative and support staff is there as a resource if families need any assistance, or if they have any concerns. These are typically the people to call if you have general questions about insurance coverage, or services.

Hospice care requires a full team working toward a common goal. All of these people are equally important to providing quality hospice care.


How to Keep Your Loved One Comfortable in Their Last Days

When your loved one has been diagnosed with a life limiting illness it’s important to understand their wishes. One of these wishes may be where they would like to spend their last days. For many people, this is at home or at a close family members house. But, this can be a challenge when it comes to care.

If they wish to be at your home, many challenges present themselves. Even though you would love to, you may find yourself asking, “how am I supposed to take in a family member when I have my own emotions and responsibilities to deal with?” And, this is a completely common and valid response. It can be hard enough to raise a family and continue working, knowing your loved one has a life limiting illness. And, even if they are comfortable in their own home, care is probably necessary.

But, don’t worry. Hospice Care can help. Hospice Care allows individuals with a life limiting illness to stay happily where they are comfortable, while obtaining care. This often takes a weight off family and friends who are already battling the emotions of the situation.

Hospice Care is often available 24-hours and, Hospice Care can visit homes, hospitals, and nursing facilities. Often, Hospice finds that people want to stay where they are comfortable. This could be the retirement community they have lived at for 5 years, your home or their own home. But, no matter the situation, Hospice Care should be considered to help keep your loved one comfortable, and you at peace.