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Self-feeding: Improving Nutritional Intake and Functional Ability



There is a growing body of evidence in the literature to support what many caregivers of Alzheimer’s patients have known all along: when it comes to maximizing nutritional intake and functional abilities for self-feeding, the environment matters.

Things like lighting, contrast, noise level, ambient music, dining room size, and table settings can have a tremendous impact on successful self feeding.  Here’s the scoop:

Lighting:  A mixture of direct and indirect lighting, a combination of pendant and cove lighting, is best.  In the presence of low vision due to cataracts or macular degeneration, direct spotlight on the plate (being mindful of glare) is helpful.

Contrast: Dark placemats under white plates or colored plates.  Highly contrasting food and drink colors were also associated with greater oral intake.

Dining room size:  Less than 25-30 residents in a single dining space is optimal for reducing distraction and promoting feelings of privacy and personal control.

Music: In one study. caloric consumption increased by 20% with familiar mealtime music as compared to no music.  Two other studies showed a decrease incidence of agitated behaviors when quiet music was played at mealtime.

Table settings:  Family style food service vs. preplated food trays was also associated with higher caloric intake.  A homelike setting, with the dining room situated near the kitchen, has been shown to provide an increased sense of belonging and well-being.  Round tables are easier to negotiate around, but square tables provide a sense of privacy and personal space.  Too many utensils, centerpieces, and dishes can be distracting as well.  Sometimes less is more.

Noise levels:  Greater nutritional intake can be achieved when the lunch carts, trays, staff, and overhead intercom noises are reduced.

This is just a small sampling of what the research is telling us about common sense dining and dementia- reduce distractions and noise, make it homey and familiar, and provide plenty of lighting and personal space.




Source:  American Journal of Alzheimer’s Disease and Other Dementias 28(5), August 2013

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  1. I love this post. I recently completed a report that supported services of OT ad SLP with weight loss in our AL community. Assessing 7 patients that were Identified in our Nutrition at Risk program secondary to weight loss were referred to OT and/or SLP. In all the 7 residents had significant weight gains in a 2 week period. A whopping 32.8 pounds in total!

    The bottom line is modifying their environment. In addition, to limiting utensils providing 1 food item at a time. Increasing the amount of finger foods, offering increased high calorie snacks throughout the day are essential. Provide food on the run. Many of our residents no longer sit for meals so be prepare to hand them high calorie food they will walk and eat with.

    Decreasing the resident distractions are imperative. Additionally, it is essential for caregiver to be educated, discover why the resident isn’t eating. Adapt to the individual. Most importantly, modify meal time to suit the need of your resident. Although socially we look at meal time as being a requirement in the residents social lives. Unfortunately, with disease progression our resident may no longer be able to enjoy the socialness that dining once offered.

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