Saturday, November 19, 2011

"I'm not hungry"

This is a common statement among people with dementia.  They stop eating gradually until they reach a point where their body just isn't hungry anymore and just the sight/smell of food makes them sick.  This is a sensory problem and must be approached as such.  The last "taste" group that an individual eats prior to stopping eating completely are sweets.  So to stimulate the appetite - use sweets frequently throughout the day in small doses.  Sometimes I have to start with a little bit of soda in a tiny plastic med cup.  Encourage them to drink this little bit every hour or so.  Sometimes they eat a 1/2 tsp of ice cream frequently through the day.. sometimes it's graham crackers...sometimes it's chocolate...sometimes it's fruit or yogurt.  Start small and gradually build up the amount they eat/drink at a time and/or the frequency of their intake.  These items will "drive" the patient's appetite.  I use essential oil placed on cotton balls placed in the patient's pocket or near them...oils that stimulate appetite such as peppermint or citrus smells.  Also great is boiling apple cider in a small saucepan nearby.  Bake bread in a breadmaker..anything to use smell as an appetite stim.  Sometimes it's a visual processing problem - so I put a tablespoon of food in the center of an over-sized bright colored plate.  That's their meal.  The next meal (if they ate everything for the prior meal) I increase the amount in the center of the plate...gradually.  Until their mind's eye accepts a full plate as a meal.  Appetite re-stim is so easy and sooo rewarding to watch your patient become stronger and able to participate in his/her other therapies or activities of daily living.

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