Easing the Burden of Mealtime Caregiving

April 17, 2024

Mealtimes present special challenges for people with Alzheimer’s disease and those who care for them. But there are ways ease the stress around mealtimes in those with dementia, according to two new reports.

In one study, researchers in Malaysia surveyed 31 people who were caring for a loved one with Alzheimer’s disease at home. Most of the caregivers reported high levels of stress related to their caregiving, with meals presenting unique challenges. An alarming 96.8 percent of the caregivers reported feelings of sadness, helplessness and social isolation around their caregiving duties, which can take a toll on caregivers’ mental health, including a high risk of depression and anxiety. 

“Caring for someone is good, but it can be overwhelming. It’s hard to balance personal life,” said one caregiver about caring for a grandparent with dementia. Another caregiver lamented: “I have to do everything. When others try to do it, it is not right and I have to re-do. More stress like that.” 

People with Alzheimer’s often refused certain foods, or help with eating. They became easily distracted and didn’t finish a meal, or had trouble using utensils or bringing food from their plates to their mouths. Difficulty in swallowing foods or liquids and appetite changes further made mealtimes problematic. As the disease progressed, mealtimes became increasingly difficult to navigate. The level of distress felt by caregivers was positively correlated with the severity of dementia in the care receivers.

Most participants said they had adopted coping strategies to help ease the stress of caregiving, including asking others to help during mealtimes; joining a support group for caregivers; staying organized by making lists and establishing a daily routine; setting boundaries to the obligations or tasks required of them; and seeking professional help on eating and feeding problems. Many also reported that praying and singing helped them get through the difficulties around preparing and administering meals. The findings were published in the journal Healthcare.

In a second study, in The Gerontologist, researchers at Ohio State University asked 20 health professionals for practical advice on how to establish a safe and workable mealtime routine for people with dementia who were living at home. They included registered nurses, speech-language pathologists, social workers, occupational therapists, counselors and registered dietitians whose work involved providing community-based care to people with dementia.

Among their suggestions were reducing distractions and clearing away clutter; providing written cues around mealtimes; and getting help from community programs such as Meals-on-Wheels.

“It comes down to keeping things simple,” said Lisa Juckett, the study’s lead author and an assistant professor of occupational therapy at the Ohio State University School of Health and Rehabilitation Sciences. “How do we keep that environment as simple as possible so people’s eyes and ears aren’t distracted and taking their attention away from their food?” 

Among the strategies they recommended:

Lower auditory and visual distractions. Avoid patterned tablecloths or dishes, which can be distracting and visually confusing to someone with Alzheimer’s disease. Loud TV or radio can be distracting; turn down the sound to help focus on eating.

Eliminate household clutter. Clear pathways and improve lighting. Cluttered home environments can pose a fall risk.

Establish a routine. Eating at a table can help patients establish a routine. For those with Alzheimer’s who prefer to eat on a couch or plush chair, make sure they are sitting upright to help keep things safe when swallowing. Written instructions or notes can also help guide mealtime activities.

Get outside help. Organizations like Meals-on-Wheels can ease the burden of preparing meals. Staff can also help assess the home environment to keep it as safe and efficient as possible.

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Eric Schmidt, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.  

Sources: Shobha Sharma, Nur Atigah A. Halim, Puspa Maniam: :”Caregiver Experiences with Dementia-Related Feeding/Eating Difficulties.” Healthcare, January 2024

Lisa A Juckett; Mequeil L Howard; Beth E Fields; et al: “Supporting mealtime participation among people living with dementia at home: Challenges and strategies for caregivers.” The Gerontologist, December 19, 2023. The Ohio State University press office (Emily Caldwell).


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