Literature Review Introduction Essay

Submitted By saviiyer
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Dementia and eating/drinking
Savithri S Iyer
Maryville University
Dementia and eating/drinking:
A person with dementia as such faces a variety of issues and it gets complicated when eating and drinking become a struggle. It is observed that as dementia progresses, eating and drinking become difficult as the person has problems with memory and judgment. He or she may forget to chew or swallow causing poor food intake and dehydration.
This behavior can be seen in early as well as advanced dementia. In early stages, symptoms can have a significant impact on food intake and the body’s nutritional need. In advanced dementia, the impact is more severe where people can’t request for food or drinks, unable to feed themselves, unable to recognize food, refuse to eat and have significant swallowing difficulties. Swallowing difficulties include pocketing food, improper positioning leading to risk of aspiration.
A person with dementia may no longer recognize the food in front of them. They may struggle to use a knife and a fork as coordination may become difficult. The person may not open their mouth as food approaches and may need to be reminded to do so. People with dementia may become dehydrated because they are unable to communicate that they are thirsty and even if they are offered the drink, they may forget to drink.
There are many reasons why a person with dementia may turn down food or drink. Poor appetite, cognitive impairment and disabilities, which include physical and sensory skills, contribute to the fact.
Depression is very common for people with dementia and one common symptom is loss of appetite. Also, these people may not be able to express their dislike for the food, which in turn reduces their food intake. Pain could also be a major contributing factor, for example – problems with dentures, painful teeth, sore gums etc. Inactive lifestyles also lead to loss of appetite and dementia contributes to this as well.
Also, people with dementia may not be able to concentrate well which means that they may not be able to focus on their meal till it is finished. Temperature sensation of the food may also be affected due to dementia and they may find it difficult to distinguish between hot and cold. People with dementia could also overeat due to memory loss forgetting that they already ate.
Research indicates that malnutrition and dehydration are serious concerns with patients living in nursing homes. 54% of all newly admitted patients are malnourished and these patients have a diagnosis of dementia. This clearly indicates the relationship between dementia and malnutrition.
In the United States, nearly 14% of people over the age of 71 have some form of dementia. People with dementia constitute roughly 25% of hospital patients - ages 65 and older and 47% of nursing home residents. And more than half of them lose some ability to feed themselves, which puts them at high risk for inadequate food intake and malnutrition.
Nursing implications
Due to dementia, it becomes difficult to maintain good nutritional status resulting in weight loss, dehydration, electrolyte imbalance, and constipation and decreased activity. It also impairs medication administration and may get difficult to treat underlying disease condition.
Nursing interventions involve management of variety of signs and symptoms.
- Maintaining a meal schedule is very important.
- Avoid distractions and help keep place as quiet as possible.
- Allow plenty of time and make sure patient is not rushed and provide for as much independence as possible. For example, when the patient is agitated or anxious, wait till person is calm and try again afterwards.
- Recognizing food preferences and having individualized meal plans. This can increase food intake. People may have preferences with sugar, salt and some flavors. Also adding herbs, spices helps in enhancing flavor of the food thus making it more palatable.
- When a person is having difficulty in using
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