Caring for a person with dementia can be challenging. Negative behaviors often arise during meals. Care for behavioral symptoms of dementia needs to be individualized based on examining the entire picture of personal and environmental factors (such as living situation and what is going on around them). However, some general approaches to managing certain behaviors can be helpful. Here are some suggestions for issues with eating or feeding.

Thoroughly prepare meal trays (open cartons, cut food).
Offer small, frequent meals and snacks.
At meals, provide one food and one utensil at a time.
Provide nutritious finger foods.
Provide nutritional supplements, if indicated.
Offer fluids in containers that can be self-managed (“sippy” cups, sports bottles).
Request speech therapy (ST) and occupational therapy (OT) services, if needed.
Provide adaptive utensils, if indicated. An OT can order these as needed.
Assist the client to feed self, rather than feeding, whenever possible.
Use “hand-over-hand” feeding (your hand guides theirs).
Gently cue the person to continue eating, chewing, and swallowing. Make your cues short by breaking the process into small steps.
Avoid making comments about manners or messiness.
Provide the person with dignified protection for clothing.
If agitation develops during feeding, stop and retry a little later.
Avoid force feeding.
Reassure the person that his or her food has been paid for (a common concern).
Monitor body weight to detect gains or losses.

Adapted from Schwartzkopf, C. E. & Twigg, P. (2014). Nursing management of dementia. In K. L. Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Burlington, MA: Jones and Bartlett Publishers. Used with permission.

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