When you are working with elderly patients it can be a challenge to get them to eat their meals, or anything for that matter! When you are working with elderly patients who also have Alzheimer’s disease, the problems with eating can get even worse. When you are dealing with an Alzheimer’s patient, anything can happen. The symptoms of this horrible disease can vary widely for each individual. For some, the part of the brain that is heavily affected is the hypothalamus. The hypothalamus is what triggers our feelings of hunger. If this part of the brain is affected by the disease then the patient may never actually feel hungry.
I had a patient like this when I first began working in the Alzheimer’s unit at a local nursing home. Whenever she was told that it was time to eat, her response was “I am full” or “I have already eaten”. Of course these things were not reality, but they were nonetheless real for her. She honestly did not feel hungry and this was because her brain was not receiving signals from the digestive system that hunger was present. Even though she did not want to eat, it was my job to ensure that she got the nutrition that she needed. What a challenge this was! So how did I get her to eat? Read on to find out!
Tip 1: When my patient would refuse to eat based on her faulty thinking that she was not hungry, I would use the guilt tactic. This may sound unprofessional, but drastic times call for drastic measures! I would tell this patient that I made the food especially for her and that it would hurt my feelings if she did not eat at least a little bit of it. This usually worked and I would be able to get her to eat at least 50% of her meal.
Tip 2: If the guilt tactic failed, I would ask her to taste the food for me to see if I “got it right”. She would take a bite, tell me what I was missing and I would go back and pretend to add the ingredient. I would then have her taste it again. By the time I “got it right” she had eaten over half of her meal!
As you can see, getting an Alzheimer’s patient to eat can sometimes take creativity and it is all in a day’s work for a CNA!
For typical elderly patients who do not want to eat, there are some things you can do to get them the nutrition they need. Many elderly patients enjoy the taste of Ensure. In my experience, it is quite easy to convince a patient to drink one of these tasty shakes; easier than convincing them to eat what is on their meal tray! Getting them to eat anything is better than having them eat nothing. It is my view that the nursing staff at most nursing homes focus too heavily on the types of food the patients eat. These are elderly people who have lived long and productive lives. They have done for everyone else in their world and should not be able to eat the things that they want to, and refuse the things that they do not. After working in several nursing homes, I have come to the conclusion that getting my patients to eat or drink the things that they want to is sometimes the best we can do. Short of forcing the food into their mouths (which should obviously NEVER be done), trying to get someone to eat who does not wish to is a losing battle. The best you can do is the best you can do.
Expert Contribution by Tanya Glover, CNA
She writes candidly about the things she encounters while working as a CNA. Some of her popular articles include Goldilocks and the Three Nursing Assistants and Nursing Home Personalities 101