Posted on Thursday, 20ᵗʰ August, 2020
With the ongoing spread of COVID-19 in Australia, Aged Care facilities are again facing tighter restrictions on visitors to Aged Care homes in order to protect their residents.
Facilities which house high care and dementia residents face additional challenges as these people can be especially vulnerable.
Unfortunately, the COVID-19 situation has necessitated many changes to the day to day running of Aged Care facilities. These changes can impact dementia residents, especially if their routines are altered.
For those with dementia, changes in environment and routine present particular challenges. Those with cognitive decline are often less able to process and incorporate change easily and can become agitated and anxious.
We spoke to Colin McDonnell, who is part of the leadership team at The Lantern Project and a leading expert in dementia and the dining experience.
Colin says the biggest issue for those with dementia and the COVID-19 situation has been the inability for family and friends to visit and help at mealtimes. Where facilities have not put a plan in place to compensate for this, there have been significant examples of weight loss in those with dementia.
He suggests there are many simple things which can be done to ensure ideal weight is maintained even in restricted conditions.
When faced with environmental change, find food which individual residents love to eat, and let them have it as often as they like.
The regular intake of food - and of equal importance, fluid - will help dementia residents stay strong, healthy and in good spirits.
Starting with a sip of fluid to moisten the mouth and signal to the stomach there is food coming. Discussing the type of food the Chef has cooked for the meal when the residents are being escorted to the dining room will help them cognitively understand what is coming next. Ensuring the dining room is exclusively for eating food and not disrupting people’s meals with medication or other non-food related activities. Making the dining room a warm, aromatic and welcoming space and helping residents relax and enjoy their food the same way anyone would at a restaurant.
- Starting with a sip of fluid to moisten the mouth and signal to the stomach there is food coming.
- Discussing the type of food the Chef has cooked for the meal when the residents are being escorted to the dining room will help them cognitively understand what is coming next.
- Ensuring the dining room is exclusively for eating food and not disrupting people’s meals with medication or other non-food related activities.
- Making the dining room a warm, aromatic and welcoming space and helping residents relax and enjoy their food the same way anyone would at a restaurant.
- Play background music (hint, check your residents’ music preferences - they will surprise you - Pink Floyd anyone?).
- Set the tables with flowers, condiments and fresh white tablecloths.
- Remove all walkers, and medicine trolleys.
- Allow residents to sit with people they are friends with and let them enjoy the meal without any non-food related activity.
One of the most successful techniques for helping dementia residents stay connected to food and engaged generally is to have them help prepare meals. It is important to note, the tasks do not need to be connected directly to the food which is served at mealtime - rather it is the involvement in food preparation which triggers ‘implicit memory’.
For example, if mashed potato is to be served for dinner, have residents peel some potatoes during the afternoon ‘in preparation’ for the Chef. As Colin said, it is a simple task which most people can do, and the potatoes don’t need to actually be used - but it is the connection between the activity and the meal which they will be served.
Understandably, it is difficult for food service staff to keep to a routine when almost everything within a facility must change in order to keep residents extra protected and healthy.
Where things do need to change, make sure people are not left with nothing to do - for example, if a visitor usually arrived to share a meal or an activity, and suddenly they cannot visit, make sure the person is not left with nothing to do during that period of time.
You can easily help them understand why things might be different by preparing them for the change.
So instead of “Your family can’t come to visit you today for morning tea.” you can say something like:
“Chef is making your favourite tea cake today, and because I love tea cake too, I’d like to join you for morning tea today, would you like that?”
While many things may change, there is a surprising number of things which can stay the same, such as some of the activities they are accustomed to.
Regardless of what is happening in the outside world, Aged Care environments are as they are designed to keep residents protected from not only illness, but also the mental triggers which can impact their appetite.
Colin suggests the following:
- Turn off the television - especially if it is showing the news cycle.
- Keep residents as engaged as possible by making sure they are not alone in their rooms for any length of time.
- Help them connect with family and friends during COVID-19 by helping them with technology, window visits and phone calls (remember, they grew up with the landline, and might be more comfortable with a simple phone call).
- Try to keep food at the forefront of their minds by talking about what meals are coming up, offering snacks and mid-meals, making sure dining rooms smell like food, and the food looks like food.
COVID-19 is certainly an additional challenge we can all do without. We hope you will find Colin's tips and ideas helpful in supporting your most vulnerable residents through these difficult times.