Dementia pts refusing to eat.

  1. 0
    Anyone have any tips on how to get confused patients to eat?

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  2. 19 Comments...

  3. 10
    r/o constipation, pain.

    i've had aides that add sugar to their food.
    and, pt needs to trust person feeding/caring for them.
    if all else fails, give them food of choice.
    i don't give a darn if they want to live out their life eating ice cream.

    leslie
    Last edit by leslie :-D on Jul 17, '08 : Reason: added
    husker_rn, SunnyAndrsn, santhony44, and 7 others like this.
  4. 6
    What I have tried in the past that has worked is to have finger goods that they can pick up and eat on the move and at will. If you try to force them to eat the just refuse even harder and like previous post find what they like even if it is icecream
  5. 0
    Some Dementia patients literally forget how to eat.They are a big challenge.I have one just now,wasting away before our eyes.
    We thicken all fluids with supplement so that when we do get something into her it counts.She clams up her mouth and fights you away because you are poking this metal thing at her mouth and she doesn't know why.If food does go in her mouth she doesn't always swallow.I have found food still in her mouth several hours after being fed and had to evacuate it for fear she chokes.We do not use IV's where I work so getting enough fluids in to keep hydration is a lot of work.Sometimes we us sub cut fluids ,depends on the wishes of the relatives and the doctor.Stroking the tip of the spoon on the bottom lip can sometimes provoke an opening mouth reflex but again there is no guarentee she will swallow.Stroking gently down the neck will sometimes get a swallow reflex as well.At this stage swallowing medication becomes impossible as well and we try and get the medication in liquid form as much as possible and discontinue those drugs that are not required any more.
  6. 0
    Quote from nightmare
    Some Dementia patients literally forget how to eat.They are a big challenge.I have one just now,wasting away before our eyes.
    We thicken all fluids with supplement so that when we do get something into her it counts.She clams up her mouth and fights you away because you are poking this metal thing at her mouth and she doesn't know why.If food does go in her mouth she doesn't always swallow.I have found food still in her mouth several hours after being fed and had to evacuate it for fear she chokes.We do not use IV's where I work so getting enough fluids in to keep hydration is a lot of work.Sometimes we us sub cut fluids ,depends on the wishes of the relatives and the doctor.Stroking the tip of the spoon on the bottom lip can sometimes provoke an opening mouth reflex but again there is no guarentee she will swallow.Stroking gently down the neck will sometimes get a swallow reflex as well.At this stage swallowing medication becomes impossible as well and we try and get the medication in liquid form as much as possible and discontinue those drugs that are not required any more.
    nightmare, you are referring to those w/very advanced staged dementia/alzheimer's.
    when they reach this point (of forgetting how to eat), it is risky trying to even get them to swallow.
    aspiration is a major cause of death in this population.

    when it reaches this point, it's time for comfort care (if poa refuses fdg tube).

    leslie
  7. 0
    I have had some success finding food they like that they can suck through a straw. Ice cream was a popular choice - I just let it soften to the point where they could suck it through a straw. My theory is the sucking instinct present at birth stays intact until death.
  8. 1
    Quote from earle58
    nightmare, you are referring to those w/very advanced staged dementia/alzheimer's.
    when they reach this point (of forgetting how to eat), it is risky trying to even get them to swallow.
    aspiration is a major cause of death in this population.

    when it reaches this point, it's time for comfort care (if poa refuses fdg tube).

    leslie
    That's the trouble though,we don't use tubes either!!In all the years I've been there I've seen one Ng tube and one PEG.They just don't like nursing homes using these at all.
    Tash4nvyblues likes this.
  9. 2
    Well, I'm not a fan of keeping people this sick alive. At the point at which they stop eating it's time - but under the law, you get cited if the patient loses too much weight.


    Ice cream and pudding work well. I've seen pudding and food alternated.
    oldiebutgoodie and racing-mom4 like this.
  10. 0
    Some people are overwhelmed with the amount of food served at meals. Try putting a small amount of food of one type on a small plate and giving them the food that way. You will need a couple of plates and when they finish one, put another in front of them. Red plates and small red glasses also help as it is the last color they see. Keep distractions to a minimum, no tv, loud noises, music etc. It should be a quiet calm environment. Help them get started eating. You may have to give them the first bite or two and them let them eat on their own if they will.

    If they like ice cream make them a shake with ice cream, whole milk and carnation instant breakfast.

    Hope this helps.
  11. 1
    for all you future nurses/aides who read this:

    if any of you ever come across an elderly red-headed pt with big, brown eyes and an equally big mouth to boot, don't ever, ever force-feed her green veggies.

    it will likely result in being spat on your face:
    and this poor pt (), being zapped w/haldol and 4 pt restraints.

    leslie
    casi likes this.


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