Dental Skin And Foot Problems
Dental, skin, and foot problems may take place in early and moderate stages of Alzheimer’s disease, but most often happen during late-stage Alzheimer’s disease.
Dental problems. As Alzheimer’s disease symptoms worsen, people will need help taking care of their teeth or dentures. Brushing and flossing help to maintain oral health and reduce bacteria in the mouth, which may decrease the risk of pneumonia.
Make sure the person’s teeth and teeth surfaces are gently brushed at least twice a day with fluoride toothpaste. The last brushing session should take place after the evening meal or after any medication is given at night. You may find that using a child’s size toothbrush is easier for the person.It is also best to floss once per day, if possible. If this is distressing to the person, an interdental brush, which is a small brush designed to clean between the teeth. Try to check the person’s mouth for any problems such as:
- Food “pocketed” in the cheek or on the roof of the mouth
Be sure to take the person for regular dental checkups for as long as possible. Some people need medicine to calm them before they can see the dentist. Calling the dentist beforehand to discuss potential sensitivities may also be helpful.
Skin problems. Once the person stops walking or stays in one position too long, he or she may get skin or pressure sores. To prevent them, you can:
To check for pressure sores:
Change The Foods And Drinks
Some foods and drinks are harder to consume than others. Hard and chewy foods take extra effort to eat, and someone with dementia may not have the ability to chew and swallow these foods with the muscles involved.
To fix this, switch to softer, easier foods to make it easier on the patient as they eat. Avoid stringy foods or anything thats spicy. Refraining from fizzy drinks may also be a good idea.
What Can You Do To Help
If they refuse food or wonât open their mouth but donât seem seriously sick, they may not realize the food is something to eat. Let them smell or feel it to give them a chance to recognize it. It may also help to serve food on dishes that are a different color from the food. This makes it easier for them to see it and know what it is. Keep the area clear of dangerous things like sharp knives, or things they canât eat, like ketchup packets or paper napkins.
Serve their largest meal at the time theyâre most hungry. Offer food at the same time each day. When someone is on a routine, theyâll be hungrier at mealtime. Make sure the food isnât too hot or cold. People with Alzheimerâs often have a change in tastes, so you may have to try different foods until you find something they like. Your loved one may not remember to open their mouth. Gently remind them, but don’t force the food in. It might hurt to chew or open their mouth.
Check for sores, redness, bad teeth, or other signs of irritation in their mouth. If you think thereâs a problem, take them to a dentist. Help them take care of their mouth. They should brush their teeth two times a day. If possible, clean between teeth with floss or an interdental brush. Most cavities and mouth infections start between the teeth, so this is especially important.
You can also try to eat with them. They may copy you and eat, too. If they still wonât eat, take the food away and try again in 15-30 minutes.
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Encourage Them To Eat Every Two Hours
Instead of two or three large meals, encourage individuals to munch throughout the day. A dish full of food might be intimidating, and thus the burden to clean it up isnt healthy for them.
Maintain a supply of healthy snacks and attract your loved ones focus to them on a regular basis. Nuts and seeds, crackers, cheese, fruits, and juices are good options.
Eat Less But More Often
Suggest your patient to have a snack during the day between meals, and avoid giving them big meals. While a big meal might be alluring, the quantity and the pressure they might feel to eat everything is not.
You should always keep healthy snacks nearby, and encourage your patient to have some from time to time. An example of healthy snacks includes mixed fruits, fresh fruits, dried fruits, crackers, yogurt, and other dairy products, but make sure he or she is not lactose intolerant.
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Dementia And Appetite Decline
Persons living with dementia commonly exhibit challenges with eating, but the reasons vary. Lets explore a few possible causes of appetite decline.
Memory trouble. In the early stages of dementia, when a person may still be caring for himself or functioning with limited assistance, the problem might be simply forgetting to eat. When this problem is discovered, its a sign that care partners need to provide more frequent living assistance and check-ins.
Vision decline. As we age, we naturally experience a narrowing of our field of vision. For a person living with dementia, this process is on overdrive and it may cause him to not see a caregiver approaching from the side, or even a plate of food in front of them if he is not directly looking at it. Additionally, the ability to detect color and contrast becomes impaired the person may have trouble, for example, seeing light-colored food on a white plate and, thus, think hes finished his meal.
Lack of physical activity. Simple activities such as going for a walk and helping with basic household tasks like washing dishes can boost mood and energy, which, in turn, may help increase appetite.
Tips To Help Make Mealtime Go Smoothly
Theres no one-size-fits-all method to combat feeding challenges, so try out a few of these methods to see what might work for your patient.
- Provide a calm environment free of distractions like television and loud conversation.
- Play relaxing music at a low level.
- Keep the table clutter free. A busy tablecloth design, a centerpiece of fake fruit, and stacks of paper items can confuse a person who already struggles with sight deficits.
- Serve only one or two food items per meal and keep portions small.
- Be flexible. Start with known food preferences, but dont be discouraged if the old stand-bys arent always well received.
- Ensure dentures fit correctly.
- Be patient. It may take up to an hour for him to finish, and thats okay.
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Problems At The Table
Pouring a glass of juice into a bowl of soup, buttering the serviette or eating dessert with a knife indicate that a person with dementia is having difficulty at the dinner table.
What to try
- Serve one course at a time and remove other distracting items from the table such as extra cutlery glasses or table decorations
- Ensure that the crockery is plain and is a different colour to the plain table cloth
- If the use of cutlery is too difficult serve finger food
- Eat with the person with dementia so that they can copy you
- Make sure that they are not rushed
- Keep noise and activities in the environment to a minimum
- Ensure there is adequate lighting
- Serve familiar food
How Hospice Can Help With End
In addition to helping you in recognizing the signs of dying in the elderly with dementia, bringing in hospice care will help with the physical and emotional demands of caregiving. Nurses will be able to adjust medication and care plans as the individuals needs change. Aides can help with bathing, grooming, and other personal care. Social workers can help organize resources for the patient and family. Chaplains and bereavement specials can help the family with any emotional or spiritual needs. Additionally, family members can contact hospice at any time, and do not need to wait until it is recommended by the patient’s physician.
To learn more about the criteria for hospice eligibility or to schedule a consultation, please contact Crossroads using the blue Help Center bar on this page for more information on how we can help provide support to individuals with dementia and their families.
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Taste And Smell Changes
Significant deficits in the perception of taste preferences, quality, and intensity are caused by peripheral loss of taste/smell receptors or neurons. Olfactory deficits occur in the ageing progress alone but also early on in dementia. Apolipoprotein E is a polymorphism associated with an increased risk of developing AD. Individuals carrying the APOE4 allele seem more prone to suffer from impaired olfactory function before the onset of cognitive impairment.8 To date, studies have shown inconsistent findings on the olfactory profiles for each type of dementia.9 Olfactory dysfunction can be used as a pre-clinical biomarker for dementia and olfactory testing may become a supplementary tool in early detection of dementia.10 People living with dementia were found to have a strong preference for sweeter foods and carbohydrate over protein and fat.11
Refusal to eat
Table 1: Nutritional problems arising over the course of dementia
What Can I Do To Help
First, rule out any physical problems such as mouth sores, a toothache, ill-fitting dentures, infections or medications that could be affecting appetite. Then, try changing the food or drinks offered. Give soft but flavourful food that requires minimal chewing, and a variety of temperatures with each meal. Avoid hard foods, foods with stringy textures and mixed foods like cereal. Use smaller utensils and specially designed drinking cups. Have the person sit upright in a comfortable position. Allow extra time as it can take some extra effort, but will be worth it as you see them enjoy a meal.
Disclaimer: Please be aware the above article is merely information not advice. If you need medical advice, please consult your doctor or another healthcare professional.
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How To Help A Person With Dementia Manage Overeating
- Giving the person healthy snack options when they want to eat can help. Snacks like fruits and nuts can satisfy their hunger in between main meal times.
- In general, try to buy and cook healthy foods. Too much of anything is bad for you, but youd probably rather have them eat too many carrots rather than too much lasagne.
- Make sure most of their plate is salad or vegetables.
- Ensure that theyre drinking enough water. Sometimes they may have mistaken thirst for hunger. Make sure theyre hydrated and give them a glass of water with their meal.
- Another reason they could overeat is if they feel bored or lonely. Try to keep them occupied. Here are some memory care activities that you can do at home.
What If The Individual Simply Refuses To Eat
As Alzheimers disease progresses, there will most likely come a time when the individual will simply refuse to eat no matter what you do. At this stage, the weight loss can be severe and there is obvious evidence of malnutrition and failure to thrive. In this scenario, caregivers and families are left with difficult decisions. The first thing to do is to speak to your healthcare provider. The decision to use forced feeding is not recommended as not only does it not help reverse dementia, but there are also complications associated with tube feedings. Plus, the quality of life is very poor. The best recommendation at this stage is to seek hospice care where the primary goal is comfort, alleviation of pain, and minimization of suffering. Speak to your healthcare provider about hospice care. It is a recognized form of healthcare for those nearing end of life situations and it can also ease the burden on the caregiver and family.
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Reasons Why Your Loved One Has Stopped Eating And Drinking
There are many reasons why a person with dementia may lose interest in or turn down, food, and drink.
- Depression: A common sign of depression is a loss of appetite, and depression is common in people with dementia. If your loved one has depression, then their appetite should improve if their depression is treated appropriately.
- Communication: As dementia progresses, people with dementia have difficulty communicating their needs including the need that they are hungry or dont like the food they have been given.
Alternative methods of communication and speech therapy to help your loved one express themselves better is often the solution for poor eating and drinking-related to communication difficulties.
- Pain: Weve all experienced a bad toothache or sore throat. Your loved one may be having problems with their dentures, teeth, or gums. If they have difficulty communicating, then they wont be able to tell you theyre experiencing pain.
Oral hygiene and regular mouth checks are essential to prevent oral pain and discomfort.
- Tiredness: If your loved one is fatigued, then they may stop eating partway through a meal or simply not eat at all. This can also cause concentration and coordination difficulties, so its best for your loved one to eat while theyre most alert.
- Medication: People react to medicine differently, and changes in brand or dose can result in appetite changes. Monitor your loved one carefully and speak to their doctor if you have any concerns.
Tips To Improve The Appetite Of Your Diagnosed Loved One
There are a range of different ways to improve your loved one’s interest in food and their appetite. Fortunately, you already have a head start knowing your loved ones likes and dislikes can be a huge help in offering what will make them salivate! Here are a few tips and ideas that may help:
- Try different types of drinks or foods, flavors, smoothies, and milkshakes.
- Help the food be more appealing by using different colors, tastes, and smells. Use the aromatic appeal of food to stimulate your loved one’s appetite.
- During the late-stage, achieving a balanced diet may be less important. Instead, give your loved one with dementia the foods they will enjoy.
- Keep the portions small.
- Because food tastes change, try sweeter foods or stronger flavors.
- Never stop your loved one from eating their dessert even if they didn’t eat all of their meal.
- If your loved one has problems swallowing, try serving softer foods.
- Encourage your loved one to get involved at mealtimes by suggesting they help lay the table and prepare food.
Make drinking and eating an opportunity for social stimulation. Taking the time to talk about different foods, for example, from your loved one’s childhood, may encourage an appetite.
Anytime your loved one refuses to eat, try again later. If this continues, make sure to speak to their physician about your concerns.
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How To Test For Dementia
There is no single test that can determine a person is suffering from dementia. The doctor can diagnose different types of dementia such as Alzheimers based on their medical history.
This has to be done very carefully. In addition, the doctor may conduct laboratory tests, physical examinations, and changes in the way the patient thinks.
When all things are considered carefully, a doctor can be able to determine that a person is actually suffering from dementia with certainty. Determining the type of dementia can be hard, especially due to the fact that brain changes and symptoms that are associated with the different types of dementias sometimes overlap.
It is normal for the doctor to give a diagnosis of dementia without really specifying the type. In such a case, it is important for the patient to visit a specialist in this area like a psychologist or neurologist for a more specific diagnosis.
What Are The Early Signs Of Dementia
The onset of dementia is not obvious because the early signs can be vague and quite subtle. The early symptoms usually depend on the kind of dementia that one has and therefore can vary greatly from one person to the next.
Even though the signs can vary, there are some that are quite common and they include:
- Depression, apathy, and withdrawal
- Memory issues, especially when it comes to the most recent events
- Inability to handle the everyday tasks
At times, it is easy to miss to appreciate that the above symptoms could be an indication of something that is not right. Yet there are those who assume that the signs are normal and are associated with aging. It is also possible for one to develop the symptoms in a gradual manner and they may go unnoticed for quite some time.
People may not act even when they can tell that something is definitely wrong. It is important to have a checklist of all signs related to dementia and get the person the needed help when several of such signs are observed. It is important to get a more detailed assessment.
Memory loss and dementia: while it is normal to forget some things and remember later, persons with dementia tend to forget more frequently and they do not remember later.
Tasks: distractions can happen and you may forget to, say, serve one part of the family meal. For a person that has dementia, preparing the meal could be problematic and they may actually forget some of the steps that are involved.
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Should Food And Drink By Mouth Be Continued
If the person wants to eat or drink but struggles with swallowing, it is important to have a healthcare professional assesses their ability to swallow, such as a Speech Therapist or General Practitioner. A balanced diet at this stage is not so important. Rather, offer the person foods and drinks that they appear to be able to swallow and appear to be desirable foods. If they want only sweet things or cold things, accommodate them.