Thursday, March 20, 2008

Alzheimer’s Disease and Hospice Volunteering in Nursing Homes (Video 3:10 mins.)

The following includes an excerpt from my book "Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes.” This chapter titled “Mealtime Gathering” explores Alzheimer’s disease and patients’ mealtime interactions at an inner-city nursing home experiencing a staff shortage. I am seated at a table with several patients, most in varying stages of dementia. Alzheimer's disease is the most common form of dementia. Fictitious names are used.

“Some patients were confused about which utensils to use. They tried to eat soup with a fork if they were not guided to a spoon. For a few, the tray of food was more like a tray of colors that smelled like food. Sometimes with pureed food, they had no idea what they were eating, and neither did I. Fortunately, a menu came with each tray. At another nursing home, I had observed a nurse aide telling a blind patient everything on his plate when she sat his tray in front of him. He grinned with delight the whole time she went down the list of foods. That’s why I started telling my hospice patients what was on their plates. Even those who could see didn’t always know what was there.

I continued talking to Naomi, my hospice patient, and assisting her while monitoring others at the table. I noticed that Petra had not touched anything. Petra was not a very independent eater, but I knew she was physically capable of feeding herself.
“Petra, your food is just sitting there getting cold. You have a whole tray of delicious things to eat. You should eat some and see how good it is. You’re a good eater. Eat your food.”
“Food? What food? I don’t have none.”
“The food on this tray is all for you, Petra. This is your food tray right in front of you. Watch me point to each item. You have coffee, juice, milk, mashed potatoes, fish, broccoli, bread, and fruit. That’s your name spelled P-e-t-r-a.”
“That’s not my name. My name is Petra. That’s somebody else’s name. That’s not my name. I know my name.”
“Well, that is still your food on the tray. You should eat before it gets cold. Go ahead and eat. Give it a try.”
“Eat? Eat what?”
“Your food, Petra, your fish, potatoes, and everything else.”
“Fish? What fish? I don’t have none. Do you see a fish here? I don’t see a fish. I don’t have none.”

From previous experience, I knew that Petra and I could go on roaming forever around this same circle. Luckily, she was sitting next to me. I gave her a taste of the fish because I knew she liked it. Then I placed her fork in her hand and started her off eating. I did this in steps by steering her hand and giving her directions on putting food into her mouth, chewing, and swallowing. Patients with dementia needed tasks broken into simple steps. Usually, she ate for a while by herself, even with her hands, once somebody started her off. Without any help, she sat and looked at the food she said was not there. My other hand continued to assist Naomi.”

© Frances Shani Parker

This video explores stages of Alzheimer’s disease.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog

1 comment:

  1. Thanks for the info. These will really help everyone who read this understand that AD makes it difficult for seniors to convey the whatever physical changes or discomfort they feel. People around older adults, especially those with Alzheimer's disease, should be more sensitive to the changes and needs of these seniors.

    Dementia specialist