Sometime during the course of Alzheimer’s disease, self-feeding gets tricky. It usually starts to decline during the middle stage, when the ability to complete a task wanes due to attention span and memory loss.
And because the language centers are already so heavily damaged, exploring the environment by handling everything becomes the equivalent of an informative seminar. It’s the only way someone with Alzheimer’s disease can make sense of what’s around them.
So what you see at the table is someone who is highly distracted by all the utensils, the napkin, the glass, the cup, and vase with the lovely flowers. All of it, including the meal, needs to be touched to be recognized. This looks as though he or she is “playing” with their food.
Verbal redirection is the norm in this situation: “Mrs. Smith, you need to stop playing with your food and eat. Stop grabbing Mr. Jones’s glass, this one is yours…”
Verbal communication will fail to make your point understood.
The best approach to this extremely common issue is to limit the distractions and keep mealtime about eating, rather than about the dining experience.
I usually recommend one dish, one utensil, one drink, and one food item be placed in front of the individual. When the first (and nutritionally most important) item is finished, present the next one. Do this until all courses are consumed.
Do not take over feeding when the task becomes messy or inconvenient. It is a really important skill to maintain. Assist with feeding only as needed for nutrition- but when utensils become difficult to manage, switch to finger foods. Don’t transition he or she straight to “feeder”.
It is important that the act of self-feeding not be taken away too early in the disease. Eating, and the hand to open mouth movement pattern, is a primitive survival function that is hardwired and resistant to Alzheimer’s disease (resistant in the sense that our older memories are more deeply entrenched and not hippocampal-dependent). We were born knowing how to eat; it should be one of the last functions to go.
Try to maintain self-feeding for as long as possible. Reduce distractions and worry less about the social ambiance, and more about maintaining function.