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caregiver24x7 Asked May 2020

Does anyone else have issues with food with their dementia patient?

My Mom just turned 93 and has mild dementia. We moved her in with us two and a half years ago as we promised not to put her or my Dad in a facility. Dad passed away two years ago. Mom has confusion over time of day, what she is supposed to be doing when, and is totally incontinent. She is receiving home hospice care now. She has good days when she gets up, washed, makes her bed, gets dressed and asks for her breakfast at 8 am. Other days she wants to sleep around the clock and will sleep days away if we let her. Over the past few months, she has started 'picking' at her food. If I give her one of her favorites, like blueberry waffles, I go to take her empty plate and the rim is lined with the blueberries she has carefully removed and put to the side. I ask if she doesn't like blueberries anymore, and she says she does. I try changing to regular waffles, and she removes all of the outer edging and puts those on the rim of the plate. If I give her chicken noodle soup, all of the chicken gets extracted and put to the side. Most recently, I gave her a bowl of her favorite, mint chocolate chip ice cream, and yes, she extracted every single chip and stuck them all around the rim. There were hundreds of sticky melted chocolate chips to chisel off her bowl. Most recently, she has been chewing pieces of food and spitting them back on her plate. When I confront her and ask 'what is this?' she says 'I don't know. I didn't do that! It's getting to the point that my husband and I are at our wits end. She has dropped at least forty pounds and is not getting most of the nutrients we are giving her because of this nasty new habit. This happens even when I make her a favorite meal. She will pick out anything with a texture that is any different, and spit it out. I've asked her if her teeth hurt, or if she needs to go to a dentist, but with this COVID-19 that isn't even an option. We are not sure what to do at this point. Last night, her plate was full of chewed up, spit out food and looked like she hadn't eaten anything. She then asked for a bowl of ice cream. Looking for suggestions.........???????

JoAnn29 May 2020
Talk to the Hospice Nurse about this. What she is doing is part of the desease, I think. Or it can be what has been suggested.

cwillie May 2020
My first thought also is that she is having difficulty with chewing and/or swallowing - this isn't necessarily a dental problem but can be related to problems manipulating the food in her mouth with the tongue and actual dysfunction of the swallowing reflex (which is actually a very complex mechanism) - this is known as dysphagia. I wouldn't bother with a formal evaluation at this point, you are going to have to learn to focus on giving her foods that have an even, smooth texture.
And a word of caution regarding meats - we had a couple of horrible episodes where my mom struggled to completely swallow things that I thought were "safe" (like hamburger patties and meatloaf). And keep an eye out for difficulty with fluids as well, it was very early in my mom's journey that she began to choke on water and other thin liquids.

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earlybird May 2020
Agree with Grandma about pureed foods, She has some great advice Your mom seems to be aware it is becoming difficult to chew these foods and wants to be safe from choking. My mother had some of those issues. Primary ordered a swallow evaluation. I was able to be in the room with my mom and saw on the screen food that aspirated into her lungs. She was placed on honey consistency liquids and pureed thickened foods. At first it was difficult, but with experience I am making the same foods she loves and she is gaining weight. She lost 10 pounds previously. I have some great recipes if interested such a pureed salmon with a creamy dill sauce, sweet potatoes, mixture of veggies with seasoning, pancakes with blueberry sauce, baked fish with crumb topping to name a few. Also hired a senior personal chef for my mom for a few months. got some good tips. I was frustrated at first, that is why I hired him, but it gets easier with experience. I love creating different dishes .and I do a taste test with family. My mother actually likes my cooking better than the chef. Hope you find a solution to the problem and your mom start to eat and enjoy her food again.

Grandma1954 May 2020
It could be any number of things.
This sounds like a texture "thing"
Try a mint ice cream with no chips.
Try pancakes not waffles. Waffles get crisper (aka harder) the pancakes stay soft over the whole thing.
Try pureed blueberries or cook real blueberries, push through a sieve to remove skins.
Soups, try creamy soups or soups that have been thickened by vegetables rather than flour and cream. Then puree the soup so there are no lumps.
Cereals like cream of wheat. If you do oatmeal process the dry oats to a powder then cook just like cream of wheat so the cereal will be smooth. Cream of rice is another option.

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