How to do it: Memory care dining program

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Memory care often calls for unique and innovative approaches in every facet of dementia residents' facility experience, and dining is no exception. Experts offer valuable tips on how to minimize stress and promote a safe, pleasant and healthful dining experience.

1. Meal and menu planning require special care. Ruth Drew, director of information and support services for the Alzheimer's Association, advises serving only one or two foods at a time. “Too many foods at once may be overwhelming,” she says. Still, be mindful of each resident's individual preferences and choices whenever possible, urges Christopher Krause, director of rehab at iN2L. Many dementia patients can be finicky, making ample menu choices important. “You have to anticipate what a resident likes to eat,” says Cheryl Frazier-Trusty, MS, RD, LDN, a long-term care consultant dietitian with Dietitians on Demand. “Having different choices is imperative.” Liberalizing a dementia resident's diet regimen is important to optimize meal planning, she adds. Moreover, dementia patients may suddenly develop new food preferences or reject foods that were liked in the past, as Drew observes. One way to help ensure residents will at least nibble is providing plenty of “finger food.” “Be prepared for grazers, with portable food options ready any time,” says Lindsay Casillas, senior vice president of business development, Sodexo Seniors. Another plus with finger food is it avoids the cognitive challenges some have with utensils, Krause adds. Finally, consider visually plating two main entrees instead of printed menus, says Jenny Overly, MS, RD, the director of nutrition, health, and wellness for Unidine.

2. Presentation is a critical consideration. Drew encourages high contrast solid colors in dishes and placemats and avoiding overly complex table settings. And it helps to make the food as visually appealing as possible. “For the most part, residents eat with their eyes,” says consultant Frazier-Trusty. “Something as simple as a garnish or a dipping sauce may help to make a meal more appealing.” Inviting smells from the kitchen also are sensory pluses, according to Jacki Zumsteg, director of interior design for Invacare Interior Design. Both Overly and Casillas encourage preparing meals in visual range of residents as one important way to set the stage for a pleasant meal.

3. Quick meals have no place with dementia resident dining. Always allow more time than usual for meals. Most say 45 minutes to one hour is typical. This accomplishes many things. One is ensuring that residents are relaxed, not rushed. It also gives time for individuals to carefully chew and digest their food.

4. Take extra safety precautions. Many memory care residents have difficulty discerning extreme hot and cold, so make sure to check the temperatures of foods and beverages before serving, says Drew. Avoid glassware and sharp atware. Krause advises providing adapted utensils for those who need and can use them. And as Zumsteg cautions, “mood lighting” should be avoided during meals to better maximize high contrasting colors and various textures. If you insist on using china, choose a plate that has an increased center depth that creates a “ledge” prior to the outer ring. This minor feature helps individuals push the food onto their forks or spoons, says Overly.

5. The physical environment is important. It's all about creating a warm, relaxing, uncluttered and inviting ambience. This is not unlike dining areas for other populations, but dementia patients views and preferences sometimes are given short shrift. “You want to have a dedicated dining space that is calm, quiet and relaxing,” says Zumsteg. “A person with dementia tends to get distracted more easily. So keeping interruptions to a minimum is key.” Ensuring residents sit in the same location each meal also is a plus. Anna England Chaney, lead contract designer-healthcare, for Flexsteel Industries, advises use of specially designed dining chairs that offer maximum comfort and stability. No one likes to be distracted by furniture that needlessly draws attention to itself or makes it hard for someone with a lesser attention span to concentrate.

6. There's no substitute for dining among familiar faces. This is especially crucial with memory care residents. “If family members can accept a ‘new normal,' mealtime can offer an incredible opportunity to connect,” Drew said. “The experience of sharing a meal with family can be one of life's great joys. The disease steals a lot of that, but we often see moments of connection during mealtime, even during later stages of the disease.” And remember, as Casillas urges, “Make dining a social experience. A leisurely meal is engaging — not a task to be completed.”

Mistakes to avoid

■ Offering a highly restrictive menu. Memory care residents can be picky eaters, and their preferences can sometimes turn on a dime.

■ Neglecting distractions such as complex table arrangements and excessive noise. Create a calm ambience that allows diners to focus.

■ Ignoring safety hazards. Unlike typical senior dining, glassware and sharp flatware can be dangerous. Encourage finger food as another way to minimize risks.