Feeding Somebody Who Has Alzheimer's

I visited a relative who had Alzheimer's and succeeded in getting her to eat, although nobody else had managed to do so. The carers said she had not eaten all day. She had been into hospital after a 'nasty turn' but tests showed nothing wrong.

But she had slept most of the day. It was dark. Late afternoon to early evening. Because she had just woken up she thought it was breakfast time.

It's my policy not to argue or disagree or point out she is wrong. Getting angry just causes an argument and makes both parties unhappy and aggrieved and hostile. If the 'patient' gets hostile you lose co-operation. If you feel hostile, you are reluctant to visit again and then you turn up hours or days late and find the patient has deteriorated and you regret being absent.

I've received a carers' newsletter which reinforces what common sense, observation and experience tells me. Just smile and wait until she asks what time or day it is. Then tell her the truth. Explain everything cheerfully and matter of factly. "You were in hospital and they checked you over but found nothing wrong so now you are home again.

She has a plate of sandwiches and a small chocolate muffin in front of her. The office has told me she hasn't eaten, despite their effort to cajole her.

She has not eaten so she has low blood sugar and cannot get up the enthusiasm to eat or reach for the plate.

First we have to establish enthusiasm. That's easy. I show her my new Wellington boots with a flower pattern. She admires them. 'They are wonderful. They are gorgeous. Lovely colour.'

She is happy to have a visitor. She is well disposed towards me. Let's keep up the positive thinking.

A little NLP - linguistic or language programming. Bad or negative things are in the past. Good things are in the present or future.

If she says she's not hungry, I ignore that. I ask if she's eaten. If she says no, I can tell her that she'll want to eat shortly. If she says yes, I'll ask if she enjoyed it and tell her it'll soon by time to eat again.

It's my policy is to keep looking at the food, talking about the food, discussing what she likes to eat, get her to eat or drink something to restore her blood sugar and energy. She has her right arm in a plaster and not enough energy or enthusiasm to lift the left hand.

She does move her left hand, to pull at the white bandage around the plaster. She thinks the white bandage is a hanky. So I cover the white bandage with her black cardigan sleeve and fetch white paper tissues which I place the other side by her left hand and I point to them and say, 'there are your hankies'.

Now we've got rid of the distraction we can go back to the food.

When my late father wasn't eating the chicken I'd taken him, eventually I gave up trying to get him to eat the chicken and sat down and ate it. He watched me licking my lips and saying, 'This is tasty chicken.' Eventually he said, 'I'll just try a little bit.'

I gave him a mouthful which he ate. I put a small piece on a plate. As he ate it I added some more. He ended up eating a large portion. After that he was ready for a cup of tea.

I am always hungry. Besides, cajoling a sick person is quite tiring.

So I tried the same tricks on my female relative. First I discuss all the food on the plate. What's in the sandwich? She doesn't like the sandwich. What's the cake? Does she prefer the cake to the sandwich? I ask her, 'May I have a tiny morsel of your cake? It's delicious. Would you like some. Just hold it for me.'

She takes it and grimaces, 'It's hard.'

Yes, the outside is hard. Not appetising. It's been sitting around too long. And her teeth aren't strong. She hasn't the energy to bite, only suck.

So I break the cake and find the soft part in the middle and give her just a teeny piece the size of a sugar cube. I ask, 'Just lick that and tell me if it's chocolate or coffee? She tries it and tells me, 'It's chocolate.'

I hand her another teensy morsel. It takes about 10-15 minutes to get her to eat half a chocolate cake.

I go back to the office to tell them. They express delight and surprise.

My helper has now made her a cup of tea. After moving side tables around so the table and tea ar in reach, the teacup is in her hand, she can put it down without dropping or making a mess. All is going well, slowly.

I report to the office that she has had half a cup of tea. They add that to the list to tell the doctor tomorrow.

My helper is getting agitated with the 'patient' - 'You should be eating a sandwich - not the cake - all sugar.'

No good putting her off eating anything. Even the sugar is better than nothing, if we can get her to start eating and drinking.

Now we are ready to move onto the sandwich. I take the sandwich apart and show her the inside. I say, 'What's this? Do you think it's salmon? Have you had it before? Do you prefer the white sandwiches or the brown ones? You like the white ones. I like brown. So I'll have the brown and you have the white.'

It takes about ten minutes for her to eat half the sandwich. I race back to the office in triumph. She's now eaten half a sandwich.

They don't have time for all this. They have 50-70 patients to look after on two floors of a building.

Whilst I'm up in the corridor a man lurches towards me pleading, 'Help me! Help me! Help me!' I don't have time to help him. But I have time to open the door to the hall and call to the assistant, ' man's wandering about calling for help.' She comes out of her office to help him find his room, and stop walking into my relative's room.

Finally, we get to the chocolates. My helper removes one of the hard chocolates - chocolate-covered toffee. It could choke our relative or get stuck on her teeth. Next time we must look for a box called, All soft centres.

We discover that the nearly empty box has a second layer which nobody had found on the previous visits. We cajole her into eating a chocolate.

A diet of sugar and flour is not good. I had suggested to the day staff that a lunch of grapes could be left. I was told that would give her diarrhea. It doesn't do that to me. But it's not my entire diet, but a section of my diet.

Maybe now she is eating other foods we can sneak in the odd grape. Maybe cut in half so it's not large enough to choke her if she swallows it whole.

Anyway, we've got her eating. So she's in a better mood. And the staff are happy. And now they'll be encouraged to try again. Today's job well done.

I can't say that what I did should be copied by anybody else, only that it worked for me. If you've had the same results or different results. or found an alternative way of getting the old, sick, weak or confused, with Alzheimer's or not, to eat, I'd love to hear about it.