Additional Resources Mentioned

• Episode 13 – Incontinence Overnight here 

 

These resources contain affiliate links so we may receive a small commission for purchases made at no additional cost to you.

• Bibs here 

• Spork here 
• Lowbowls here
• Grippy placemats here 
• Other great caregiver dining aid products here

 

Takeaways

Tip 1: Observe Their Natural Eating Habits

• Observe and record how they naturally eat and drink (e.g., time of day, order, how they cut their food, which hand they use for each utensil).
• Continuously observe, adjust, and share with others who are helping your care receiver with their eating and drinking. 

 

Tip 2: Utilize Pre-made Meals and Visual Cues

• Leave pre-made meals in easily accessible places (e.g., eye-level in the refrigerator).
• Use visual cues like notes on the refrigerator or preset table settings with a note where the plate will go that tells your care receiver where the meal is.
• Check to make sure they have actually eaten their food and finished what they had to drink so you know if they’re able to understand what to do.

 

Tip 3: Pre-cut Food, Adjust Portions, Observe How They’re Able to Eat and Drink

• Pre-cut food into manageable pieces.
• Consider converting sandwiches and other foods into finger foods.
• Be aware of changes in hand stability, grip strength, vision, and coordination.
• Some people with dementia diagnoses lose regulation with their appetite. It’s important for us to observe how they’re eating and the portions they’re eating to make sure they’re getting the proper amount of food. 
• Introduce non-breakable drinkware, consider tops or adult sippy cups. 

 

Tip 4: Prepare for Messier Eating

• Consider using regular bibs or large disposable bibs 
• Place a towel on the chair to catch spills.
• Keep a basket of cleaning supplies (e.g. paper towels, hand wipes, table wipes) handy for quick clean-ups.

 

Tip 5: Simplify Eating Utensils and Tableware

• Low bowls with a slight rim make it easier to push food onto utensils
• Sporks combine the functions of spoons and forks, so one utensil can be used.
• Grippy placemats keep plates from sliding.

 

Tip 6: Monitor and Adjust Nutrition

• Watch for unexplained weight loss or gain.
• Consult with doctors if you notice sudden changes.
• If you move your care receiver to a memory care community, develop nutrition plans and weight monitoring processes and stay actively engaged with them. 

 

Tip 7: Gradually Take Over Feeding and Hydration

• Position yourself closer to them at mealtimes to make assistance easier.
• What begins as prompting them to eat or drink and gradually increases to handing them their utensils and/or putting food on their utensils, showing them their drinking glass becomes modifying their drinking glass to make it easier for them to use, to eventually fully feeding them and controlling their beverages.

 

Read More in This Blog here

 

Full Episode Transcript

Nancy Treaster 

We wish we had known about sporks and low bowls when we first started helping our care receivers with eating. We sure do.

 

Today we are covering seven tips to help you help your care receiver with eating and drinking. You ready to get started? I am ready to get started. 

 

Sue

Our goal with the eating and drinking throughout the caregiving journey is that as often as possible we’re doing everything we can to help them maintain their independence and their dignity. And this goes from observing them. The reason that we’re observing them is for us as well as for them. And then we’re going to gradually start prompting and inserting ourselves and then ultimately taking over the process completely. 

 

Nancy

Exactly. How about tip one? 

 

Sue

Tip one. Well, since we talked about observing, tip one is observing. One of the things that I found really, really helpful is observing our loved ones natural way of eating the pattern they use. If they drink while they’re eating, if they drink before, how they want their food on their plate, how they eat, how they cut their food, all the things. And it is as much for us to be able to support them throughout the process as long as possible. It’s to support us as we go through that process of gradually inserting ourselves and then ultimately taking over the feeding. And then there are gonna be times when somebody else is feeding them. So us being able to prepare them to provide the best level of care and it’ll cause less frustration. Much less. And less angst if the care receiver is getting fed or eating in the same way they normally eat. 

 

Nancy

That’s really important. I love that idea. I hadn’t ever thought of understanding how they naturally eat and being more supportive of that.

 

Sue

And it helps the care receivers be able to support them, whoever it is, whenever they’re feeding them. That’s really smart. I’m more conscious of what they like and don’t like than I was about how they physically do it. I think that’s both are very important. 

 

Nancy

Tip two is about pre -made meals and also an opportunity when your loved one is going to be alone and no one’s there to ensure that they’re eating. You’ll notice some of the early signs is just preparing the meal is a struggle. Getting their own meal pulled together. Right. So early on,

 

You may leave meals if no one’s going to be there to prompt them about or put it together for them and put it in front of them. You may leave a sandwich in the refrigerator. If you do, leave it at eye level so it can be seen. Maybe leave a note on the refrigerator that says there’s lunch in here. Maybe preset the table and where the plate goes, leave a note there. Do what you can to prompt and support their continued independence and their dignity, but also make sure that they’ve got food to eat. Same thing with when I was traveling, pre -made meals for the evening. And some people who are supporting people who are living independently continue to put pre -made meals in the freezer. So I was doing that when I was traveling. I’d have pre -made meals in the freezer. And for months this works perfectly. My husband would go to the freezer, he’d get his dinner, it’s already proportioned, put it in the microwave. Microwave his dinner, he’s good to go.

 

My best friend lived a few houses up the street. She’d come down around dinner time. She’d just check on him without saying anything. She’s making sure he’s gotten his dinner out of the microwave. I mean, out of the freezer and he’s microwaved his dinner and he’s actually eating something until one day he wasn’t. She called me and she said, okay, well, I got down there today. I asked him, he didn’t have his dinner out. I asked him where his dinner was. He said he didn’t have any food and did not only not know that there was such a thing. And then when I told him about, there’s food in the freezer, didn’t know anything about it. No idea about the whole process. Or how to microwave. Nothing. So that of course was the end of that. Yes. So pre -baked meals are a way to at the beginning, be supportive, but that’s eventually going to go away as well. 

 

Sue

So tip three on the pre side of it is we can also then pre -cut their food and it’s really important to start pre -testing their food. So as the diagnosis progresses, they’re going to struggle more with some of the food. They’re gonna struggle with cutting it into bites. They’re going to struggle more and you wouldn’t think about it. You’ve a sandwich cut in half. Well, there’s a lot to think about with a half a sandwich over time and they get bored with it or they’re done with it and they just put it down too much to go on. So we want to start observing where they stop eating or where they’re struggling eating and continue to adjust. So one of the things that you do is you will have more finger foods. And you cut the sandwich in, for example, in quarters. make it another thing that happens. In many of the dementia diagnoses is that hand stability begins, your husband. 

 

Nancy

Essential tremors.

 

Sue

Grip strength diminishes, their vision changes, their hand -eye coordination changes, their depth perception changes, and so there are a lot of things that impact their ability to eat. And then finally, one of the things you may want to consider is they can’t tell you if something is too hot or too cold. They don’t really know that it is. 

 

Nancy

I noticed at some point that my husband just couldn’t or didn’t understand how to cut food. I mean, it’s just a thing of something he lost. So we pre cut his steak or whatever and try to keep that, keep things in bite -sized pieces because he just didn’t know how to use the knife anymore. And at that point, taking it away is a great idea because you don’t want to leave the knife around for other reasons. 

 

Sue

Okay. So let me say, and then there was something else that you had observed about 

cutting the sandwich in smaller bites. 

 

Nancy

So for some reason, this is both with my husband and my father -in -law, a whole sandwich was too daunting. Yeah. And they’d quick after a few bites. But if we cut the sandwich into fourths, they would eat the whole thing. OK. Now, my husband would get up and walk around as well. And so a fourth of sandwich had a lot less chance if it fell on the floor. didn’t lose the whole sandwich. also just it’s more finger foodish, if you will.

 

So being able to manage a fourth of sandwich when you’re walking around, but it did make a difference in terms of even my father -in -law would cut the sandwich into fourths. He would eat much more of the sandwich than he did if it was a whole That’s amazing. Yeah. 

 

Nancy

All right, so tip four is about cleaning and simplifying the area around them and cleaning the cleaning process. So I told Sue, my first recommendation here is just get a dog. I don’t have a dog.

 

Sue

Maybe a Roomba. 

 

Nancy

A Roomba, that’s a good idea. So, you know, just like obviously a child, we already talked about there’s depth perception problems. So getting the food all the way to their mouth begins to be a challenge. Holding it, the utensil correctly so that it doesn’t fall off is a challenge

getting the food specifically onto the plate. We talk about low balls and the wish we knew, but just making sure it stays on the plate and doesn’t fall on the floor, also a challenge. So there’s going to be more mess at this point. You need to try to just relax about that, be okay about that. This is just a natural part of the process. The things you can do, you can get bibs if you think that your loved one would be okay with that.

 

Sue 

Try a bib. They have beautiful bibs. And if they’re resistant to it earlier in the journey, they won’t be later in the And it can catch some of the food. 

 

Nancy

My mother, because my dad had Parkinson’s, would put a towel in his shirt just to keep as much mess off him as possible. Because obviously they have tremors and such. can put a towel in the chair because the chair is going to be a mess at some point. Things are going to fall in the chair. You can get a dog for the things that are on the floor. 

Sue

You’re committed to that dog, aren’t you? 

 

Nancy

Or you can just reach around and keep some paper towels close by so that you can pick up things so nobody’s stepping on them on the floor. But just be ready. It’s gonna get messy. 

 

The reality is there’s gonna be a bit of a mess. Just be ready for that. This is not gonna be the cleanest part of your journey. And we talk a lot through everything we’re talking about in the caregiver’s journey about giving ourselves and our loved ones grace. This is a huge area for grace, both for them. Yes. Because like you say, if they could eat correctly and keep it on their plate, you know they would want to do that. The other side of that, and this is really big. I learned about this in a support group. 

 

Sue 

Let’s go on now to tip five, which is to simplify their participation. So now we are inserting ourselves even more in order to help them again, remaining independent and having dignity as long as possible. And we’re going to just continue on this observe and adjust. We’ve talked about serving finger foods. Now it’s even harder for them, even though the foods have been simplified, either cut and bite sized pieces or the finger foods to have them actually be able to pick it up on their spoon or their fork or be able to keep it on their plate. And so we want to simplify that as much as possible. Depth perception and vision. 

 

And then there’s Nancy’s tip, which I really wish I had known about. This was very helpful. There’s something that you that are called low bowls.

 

Nancy

Thank you. Sue already made fun of my Southern accent once when I tried to say it earlier. So low bowls and these are not plastic. But I think for the weight, I think plastic cups is critical and maybe at lunch, you know, with sandwiches on something. But if they’re pushing, trying to push food on their plate and they need a lip to push against, you probably don’t want it to be too light. So these are, you know, normal bowls. I mean, they’re plate size bowls, but they have like a inch or so rim around them. And just Google low bowls and we’ll put it in the show notes as well.

 

And then when they’re using their spoon or their fork and they need something to push up against the edge of the bowl is there. It’s really their plate now becomes a low bowl. It looks just like a plate with a little lip on it. Also Sporks, my husband was stabbing things with this spoon and scooping and having with his fork and having everything fall off of it and then pushing up against the side of his plate. And of course everything’s falling off the plate. So Sporks, I was thinking, you know, we could surely we can solve this. Sure.

 

So I thought of Sporks, but I’m thinking the old plastic Sporks you used to get when you went to Kentucky Fried Chicken. That’s not going to work. No. But I found on Amazon, metal, tablespoon -sized Sporks. Fabulous. And I just wish I’d thought of them earlier because I only got a couple months use out of them. And if I introduced them way early in the process, he would have been able to enjoy his independence a bit more. But that solves this stabbing and scooping problem.

 

And the funny thing is, I still use those sporks all the time. Well, they are pretty handy. They are. 

 

Sue

One of the things you said that reminded me of something that we started doing is that with the plate, I got grippy placemats. Yeah. So that the plate was not just on the table moving around. So whether it’s a paper plate or a plastic plate or the low bowl.

 

There’s a grip so it really doesn’t move quite as much. So that was really very helpful as well. Yeah. There you go.

 

Sue

All right. Tip six. right. This one is a really, really important tip that there’s going to be a lot of shifting with throughout their journey. And it is helping figure out how much they need to eat. Part of the reason it’s a little bit more complex is that it’s not the same for everyone and it shifts over time. And as your example is going to highlight, it could just all of a sudden start happening and you don’t know why. Our disclaimer on this tip is that neither Nancy and I are medical professionals. If you notice a sudden weight gain or a sudden weight drop in your loved one, talk to the doctor. And actually, Nancy, why don’t you go ahead and give your tip and then we’ll go through that because this was really important.

 

Nancy

All of a sudden, my husband’s eating the same amount he always ate. And within a couple of months, we looked at him and said, I said, does anybody else think he’s lost a lot of weight? I mean, he just looks so much thinner. And we kind of all agreed that he had really lost weight within a couple of months. It was amazing. So we called the doctor. They came and tested and they took blood and checked him for a thyroid problem and some other things that I can’t remember. But

 

I know diabetes and some other things and they all his blood work was fine. So then the nurse said, effectively, there is brain chemistry changes with dementia that are unexplained, but it can cause them to just lose weight. Yeah. So we’re gaining weight. You know what? Our game weight that’s an end. Well, finish my sense and then that’s actually a good point.

 

And so we literally started increasing the amount he ate by about a third at every meal. We added a fourth meal. He has a snack at three o ‘clock that’s cake and pudding. And we just added a lot more calories to his day because we couldn’t explain it. And he stabilized, which is good. Now on the dementia support Facebook page that I’m on, it’s really interesting, but half the people are complaining their loved one won’t eat anything. And the other half are complaining their loved ones eating them at a house and home. So when Sue says this is complex, this is not one where we some real commonality amongst our care receivers. And you even have your care receivers were different. They were, it was a lot different. 

 

Sue

My dad always had a very high metabolism. And so it was making sure that we kept him within a couple of pounds and made sure that when we moved him into memory care, they understood that he needed to eat every few hours. There was no medical, we did have him checked medically. That was just the way that it was. Now, here was the thing with my husband.

 

And this was one of the things that I asked about. So when you’re gonna move your loved one into a continuing care community, I asked them about the nutrition side of it. I said, how do you determine what the food is that they get? What are the kinds of meals that they can have? What are your policies and things like that? I also asked, I said, what is traditional within the first two months for somebody in memory care and gaining or losing weight? And so I had all of that information.

 

My goal, you know, I’m the primary caregiver for some things and then I’m a care partner for others. So being the best care partner with those who are gonna be feeding him, part of it’s the instructions and things like that. And part of it was making sure that he was not going to be gaining weight which would make him harder for them to care for. And so we put together a nutrition plan for him that would give him all of the right kinds of things and treats and things.

 

but that everybody would understand the kinds of foods that we’re gonna eat to help keep his weight stable. So we made sure we weighed him and kept his weight very stable. So that was on the eating side of it. And then on my side of it, also, some mornings I was there for breakfast, sometimes at lunch, afternoon snack, dinner. So I am helping them monitor, because with different people coming in to cook and serve and the things, that they were getting those instructions. 

 

The other side, we’re talking about feeding. There’s also,the hydration side. Hydration is so important. We do not want them getting dehydrated. Urinary tract infections, most of us on this have heard about them and understand that symptomatically, there is a wide range of the kinds of symptoms and they’re not always necessarily going to be pointing directly at dehydration. So take that out of the equation. What we did with my dad and my husband is that we pre -portioned for the day, every single day.

 

We had out exactly how much they needed to drink in the day. So throughout the day, we made sure. Now my dad did not like to drink while he ate. So as long as he was able to know what he was doing, we made sure he drank before. And what I’m now thinking about that would have been good is to pause the meal, if it wasn’t really a hot meal or something, pause it for a little bit, then give him some things and then bring him back so that his interest level, but whatever you do, continue to be creative to make sure they get that liquid throughout the day so that they’re not dehydrated. 

 

So those were the kind of things that were really, really important. As they get farther down the journey, you’re going to navigate the time of day where you’re having them have more liquids. we have in one of our podcast episodes, we’re talking about incontinence overnight and cleaning our care receiver for overnight incontinence. So we want to cut back on the liquids later in the day. So you can also be scheduling, but just make sure they’re getting plenty throughout the day. And that’s episode 13.

 

Thank you very much. Great memory. All right. Are we ready for tip seven? 

 

Nancy

We are ready for tip seven. So tip seven is about inserting yourself in the process and eventually taking over feeding and responsibility for their hydration. Yes. And let me kind of talk you through how this will likely unfold. First, you will begin prompting them. Have another bite of your pancakes.

 

Then you’ll begin, notice they’ll eat like half of their meal and then they seem to have lost interest, but it’s half of what they would normally have eaten. So you know they can’t be full. At that point, you might need to restart the process. So dip a couple of pieces of pancake on your fork, hand it to them or feed it to them. Sometimes you could just hand them the fork and they’ll start back up again or begin feeding them and then they’ll pick that process back up again. Eventually, you’ll be doing the lion’s share of all the feeding. Well, eventually you’ll be doing all the feeding. But that will gradually increase how much you have to be the one physically feeding them. You’ll also be stopping periodically either handing them, have, take a little drink or handing them the glass or eventually taking the glass up to their lips so they can drink some. Eventually feeding and hydrating will roll into your complete responsibility. 

 

Sue

Exactly. And when that does, and again, let’s kind of walk back on the observing and adjusting part of that, is that early in the process, one of the things that we could be doing is, for example, with my care receivers, depending on how the table where we ate was structured, you’re usually sitting across the table from them. Sometimes you’re sitting around the corner from them, but each of you is in the middle of the side and whatever it is. I began moving closer to my care receiver. So I was either really catty corner to them and just visiting with them and then so it was easier to interject myself when it needed to be done. And then also to prompt them and all of the things of the face. So you’re getting closer to them.

 

And I did it so gradually they didn’t really even notice. That’s really important. totally important. Think about this. At some point you’re going to be wanting to hand them the fork or give them a couple of bites or whatever it is you’re trying. They’re trying to eat. Position yourself before you have to do that. 

 

Nancy

Change your position in the table so that number one, if you’re right handed or left handed, you’re positioned in a way that’s comfortable for you to be feeding them. That’s so important. And then make sure that it’s great to do it, as Sue did, before it even becomes a challenge so that it’s just one less dramatic thing that’s happening at the same time. 

 

Sue

It is. what I had observed is that when, for example, let’s say your caregiver dropped a bite of food, and early in the journey that might be… And you don’t have a dog. And you don’t have a dog. And you leap up to go to make it easier for them. Right. Well, that’s overwhelming for them, because all of sudden something’s changed and you’re coming toward them and you’re not at eye level with them anymore and they can feel threatened. And so the easier you make this process and the more gradual you make it, the easier it’s going to be for them. It’s just all the things that you’re like, I wouldn’t have even known to think about these in the beginning. agree. Yeah. 

 

Nancy

Okay. We ready for some final thoughts? I think we are. As many of the topics that Sue and I discuss, the first things that you’re going to do is observe because we want to respect the way your care receiver goes through the process. That’ll make things less confusing for them and less frustrating for them when you’re taking over the process and all the steps in between. We’re going to prompt, then we’re going to inject ourselves in the process, and then we’re going to eventually take over the process. And also remember this is not just about eating, this is also about drinking. Absolutely. Because hydration is key. Now, give yourself a lot of grace through this process because things are changing, that’s always very frustrating. Give your care receiver a lot of grace in this process. I’m sure they would rather be feeding themselves and rather drinking themselves. Absolutely. 

 

Of course, if you have tips, in addition to these tips, we’d love to hear about them. Please go out to our Facebook page or our Instagram page. Those links are in the show notes and put your tips out there for other people to see.

 

If you like this podcast, please subscribe or follow on whatever platform you listen to this podcast on and please rate and review this podcast as well. Any products that we mentioned will also be links in the show notes as well. 

 

Yeah. We’re all on this journey together. Yes, we are.