Q: Dear Regina, My mum has diabetes and Alzheimer’s. She is newly diagnosed with diabetes and it is not controlled. She hates to take pills and her memory to take the medication is not working well. When we try to help her, she gets mad and says she doesn’t have diabetes. I am so worried about her but do not know how to help her. Any suggestions?
A: A new diagnosis and dementia normally do not work well together. It takes a lot of effort on the family care partner. You will not convince your mom that she is diabetic in the normal way. Her brain is not able to retain the information and stay. She may understand and agree to do all you ask her that moment. But the next day it will all be out the window. Why do that to yourself or her?
You are going to have to think outside the box. Get your vitamin bottle and an empty one for her and put her medication in. Make sure the directions match the bottle and don’t leave it for her to do on her own without putting them in a medi-tray first. If you think she will be offended by this, buy a tray for yourself.
Try not to make her feel incompetent. Allow her to feel you are doing it together and you both have a goal to make better health choices. Ask her to help you. Let her see you put the “vitamins” (her medication) in the box for her or let her do hers while you fill your tray. If possible, take your real vitamins while she takes her medication. The other thing you can do is help her change her diet and eat with her.
I am not sure as to what level she is with her dementia but if she is in the early stages, you might want to have the doctor or nurse call her or have a friend call as a nurse to advise her to take the medication. Early stages dementia usually responds to authority figures well.
Q: Miss Regina, My granny with dementia has lost so much weight, she looks unhealthy. We put food out for her and she just doesn’t eat it. She says she likes food and that she ate already when clearly the food is still there. I tried to feed her and she was not having that at all. How can I get her to eat?
A: There are many reasons a person with dementia doesn’t eat. For now, we have a few things that may help you figure out what the cause is and how to potentially solve it.
First ask yourself a few questions:
• Can granny see the food?
• Can she see it the way you see it?
• What medication is she taking that may affect appetite?
• Can she use utensils?
• Can she swallow easily?
• Does it seem like there is too much food to her?
The abnormal protein cells that build up in the brain that cause Alzheimer’s or related dementia can affect many areas of the brain that support a person’s ability to eat and drink. Among the suggestions to help encourage someone eat better would be creating a positive environment.
There is nothing worse than feeling chastised during meal time. For example, “Come on, Gran, let’s eat! You have lost too much weight. You need to eat. Sit down and eat!” Instead, take your time to see the problem. What are her favourite foods? When preparing, sing positive songs or music she likes.
Statistics report that using red plates encourages 25% of appetite. Use a red plate put her favourite food item on the left side of plate (if she is left-handed, do the opposite) and the other food item on the right.
When it is time to eat, eat your meal with her. Sit in front of her for eye contact as much as possible with a smile and do not say anything. Talking is distracting unless you are saying with your smile, “Mmmm, this is delicious.”
Eating small portions here and there throughout the day is another possibility. If your granny likes smoothies, give her vegetable smoothies and add Boost or Ensure to it. Her taste buds may have changed and she may only be able to taste sweet and salty things. Add honey or pink Himalayan salt and these are usually safe. Guiding her to eat is the goal.
We receive and we lose, and we must try to achieve gratitude; and with that gratitude to embrace with whole hearts whatever of life that remains after the losses.
— Andre Dubus, from Broken Vessels
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