Posted on Thursday, 18ᵗʰ July, 2024
At the recent Aged Care Catering Summit in Sydney, Liz Keating from Dementia Australia presented the latest thoughts on how Aged Care Chefs can assist in improving the health and wellbeing of people living with dementia.
In her talk, she focused on three key areas;
- Communication
- The (dining) environment
- Creating opportunities
What we now know about dementia
It is estimated 50% of people in residential aged care homes have dementia, currently there are approximately 420,000 people who have been diagnosed with dementia in Australia and it is anticipated there are many more who are undiagnosed.
While dementia is often used as an umbrella term to cover any degenerative brain disease in the elderly, it is widely understood to affect the following cognitive and physical activities:
- Planning ability
- Decision making
- Memory (typically short-term memory)
- Communication
- Mood
- Personality
- Physical ability - importantly, eating and the ability to swallow.
How dementia impacts health and wellbeing in the elderly
Because dementia has a huge impact on people’s relationship with food and their ability to eat enough to stay healthy, it is critical for everyone involved in food in aged care to be aware of the association between dementia, physical health, mental health, and weight loss and malnutrition.
The inability to swallow easily - coupled with declining communication skills means many people eat less, eat slower or simply start avoiding eating. When they are unable to communicate why they don’t want to eat, not only does their health and wellbeing suffer, their mental and emotional health is significantly impacted as well.
What Aged Care Chefs can do to improve the lives of those living with dementia
Fortunately, there is much that can be done to improve the lives of those living with dementia. Two things which can have a significant impact are communication and the overall dining experience.
Understanding how people with cognitive decline communicate can be one of the most impactful changes aged care homes can implement not only in their mealtime experiences, but across the whole care environment.
Because it can take longer for a person with dementia to hear, understand, formulate a response and verbalise that response, it is important for people to leave an appropriate amount of time for them to respond to a question. Rather than repeating the question, often in a louder voice which can overwhelm them, leave space and time for them to answer.
Incorporating visual cues to interactions can also aid their ability to understand what the question is and give them the option for a non-verbal response. Presenting menus with images of food, making sure all dining room signage such as wall menus and chalkboards are at eye-level, fonts are large and clear and ambient lighting is bright enough.
The importance of creating a positive dining experience for those who live with dementia cannot be overstated.
The environmental changes with the biggest impact:
Noise - if you only make one change to the dining area, it is to reduce the amount of ambient noise during mealtimes. For those living with dementia, noise is very distracting and overwhelming.
Aroma - it is well known; smell is one of the deepest memories held in the brain. By infusing the dining area - and beyond - with smells such as coffee, or freshly baked bread, even people with advanced memory decline will respond positively when they can smell familiar aromas which are associated with foods and meals they love.
Choice - there is mounting evidence buffet style mealtimes improve interest in food, intake and the likelihood of trying something new. It can also reduce waste. Giving people autonomy over what goes on their plate and in what portion size can make a huge difference to healthy eating habits.
While there is no way to reverse dementia, implementing small changes to the dining experience, and communication about food can go a long way towards improving the lives of those living with dementia by ensuring they are eating a nutritional diet in a positive environment and every effort is being made to keep the lines of communication open.
Related resources:
Dementia Australia provides a range of workshops and support for those working with people living with dementia
Butterfly Household method of care and the positive effect on dementia residents
Managing dementia with food
