Catering for residents with dementia

Dementia Action Week Monday 17th May to Sunday 23rd May Dementia Action Week is organised by charity Alzheimer’s Society to raise awareness for the condition.

Catering for residents with dementia in care homes needs careful planning. People with dementia have more complexities which make eating and drinking more difficult independently, so it is essential they are offered food that they not only enjoy eating but also benefits them nutritionally.

Sue Cawthray, National Chair of the National Association of Care Catering (NACC) says “Dementia creates an ever-present barrier to eating well for many reasons – from a person not understanding that it’s breakfast, lunch or dinner time, to not recognising some foods or having difficulties with fine motor skills. It is therefore imperative that chefs and catering teams understand the individual needs of each resident living with dementia and are agile and creative in the approach to food and mealtimes.”

We’ve spoken to Sophie Murray, Nutrition and Hydration Ambassador, NACC and Head of Nutrition & Hydration at Sunrise Senior Living (a group of 45 care homes) who shared with us various elements of their approach to catering for their residents with dementia.

Question Time When a resident with dementia first arrives at a care home, it is vital to glean information from the family about what food they like, as well as asking the resident key questions. Sophie says “Questions can include ‘After you were ill, what was the food you craved, what foods helped nurse you back to health?’.”

Mix up the Menu Most care homes have a weekly menu with key choices which run for three or six months. It is seasonal taking into account residents’ likes and needs. Sophie says “In addition we have what’s called an “always available” menu. If it’s a roast dinner on the set menu, but the resident prefers a salad, they can order it from this menu.”

Popular dishes include cottage pie, beef bourguignon, lamb hotpot, salmon with tomato cream sauce and for vegetarians, ‘shepherdless’ pie with lentils and vegetarian gravy or nut roast. Fruit based sponges are a hit, as well as mousse and ice cream.

Feedback Loop Tasting sessions are a good idea to get residents’ feedback. “There may be residents from four decades from their 60s to 100s so you have to cater for different tastes.”

Feast Your Eyes The key at meal-times is to make the food visual by showing them a plate of food. “Picture menus work as well,” says Sophie. “So at breakfast they can be shown a cooked breakfast or a bowl of cooked porridge and asked to make a choice. Then the server gives them a fresh plate of food.”

Stimulate the Senses Loss of appetite is a common difficulty, so an effective way to encourage residents to eat is to stimulate the sense of smell. Sophie says “Bread machines, toasters, waffle machines, popcorn machines all emit delicious aromas and can be used in front of residents.”

Suitable Setting It’s important the dining area has a relaxed atmosphere with the table laid out properly, pictures on the walls and so on. Crucially, the dining experience needs to be without distractions. “Service needs to be co-ordinated with no washing up going on. You need to find out what each resident prefers- sometimes they don’t want a carer sat next to them and prefer to sit with other residents,” Sophie says.

Eventful Running themed events work well. For example, during Wimbledon Week Sophie’s team serve strawberries and cream.

Involving residents in aspects of cookery keeps them stimulated and interested in food. Baking is a great activity with several steps for people to be involved in. The Alzheimer’s Society is holding its annual fundraising Cupcake Day on Thursday 17th June to encourage baking. To find out more information about the NACC please visit https://www.thenacc.co.uk/

Keeping meal-times flexible

At Heath Lodge residential care home in Harrogate, Yorkshire, run by Harrogate Neighbours, 40% of the 28 residents have dementia.

Stephen Wilkins, Hospitality Manager, Harrogate Neighbours, says “We find out about the person’s background, their history and understand their level of dementia. Every resident has a profile provided by the family or local authority. We complete a food evaluation form with likes, dislikes, allergies and so on. We look at their past life, where they worked, lived, occupation so we build
a picture of the person. We work closely with the care staff and have regular meetings to raise any concerns.”

All food is cooked fresh daily by the catering team. The set times for meals are very flexible and service is not rushed. Stephen’s advice for menus is to make portions small, bite-sized, appetising and accessible, “as anything too big can put the resident off
the meal.”

Pies, roast dinners, sausages, fish and chips, corned beef hash are all popular. “We build
a profile of the nutritional elements to make sure the meal is balanced,” he adds. “We celebrate days such as Shrove Tuesday, National Pie Week and special events during the year associated with food such as VE Day and St Patrick’s Day.”

There are also areas where residents can enjoy snacks such as pâté on toast, cheese and biscuits, small pieces of cake, mini fruit and finger sandwiches.

At meal-times residents are encouraged to sit together where possible with care staff. “We serve food on a tray so they can see the food.”

To help residents recognise which meal they are having and to encourage their appetite, Stephen says they use “prompts” and by that he means verbal prompts, pictures of food
or a trolley laid with appetising dishes.

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