“Food? What food?”
As a hospice volunteer in Detroit nursing homes, I had contact often with residents not assigned to me. My hospice
patients were always my primary concern, but most of them shared rooms with up
to three other people. At mealtimes, my patient and I shared a table with six
other residents. In the excerpt below, I am the only one at the dinner table
without dementia. Due to limited staff, I
knew I would have to supervise, encourage, and generally keep an eye on
everybody at the table. A public school principal, I was
used to multi-task management and didn’t mind assisting them at all.
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 by
any means necessary.
“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.”
(Note: Nowadays, I would omit some of the above conversation to keep her calmer and more focused on eating.)
From previous
experience, I knew that Petra and I could go on roaming forever around this
same circle. Luckily, today 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. But without any help getting started, she would sit and look at the food
she said was not there. My other hand continued to assist Naomi.
“Don’t do that! Leave
my food alone! Get your nasty hands off my plate! Help! Can somebody help me?”
screamed a resident at our table as if she were under attack. All the nurse
aides were occupied feeding residents at other tables and experiencing their own
mealtime problems. I was resigned to be the unofficial table captain. I
told Roscoe sternly to leave Charlena’s food alone. He gave me a confused look,
pretended he didn’t know what I was talking about, but betrayed himself with a
silly smirk he thought I didn’t see. I leaned across the table and directed his
attention to his own plate by putting his spoon in his food. He picked up his
spoon and started eating again. Then I reassured Charlena that everything was
okay, and she could finish eating. Charlena smiled with an air of triumph.
Roscoe was in trouble, and she relished knowing she helped to get him there.
Rita had been watching
me help Naomi and Petra eat. Now, she was attempting to feed George, but with
her own used utensils. George had his mouth open obligingly, anything to help
the cause. I interceded before any damage was done. By this time, several residents had spilled food on the table or the floor and had food stains on
their bibs. Petra had to be restarted twice to eat the food she insisted she’d
never received. I had stood to lean across the table two more times to settle
other table disputes involving food and different residents.
Naomi ate right along
during all the interruptions. I had been giving her ongoing praise on how well she was doing. I also praised
others at the table when they did well. They savored the attention, and Naomi
wasn’t the least bit jealous. She had already told the others that I was her
guest and even offered me food, which I declined. I hadn’t gone there to eat and
couldn’t even think about eating if I had. When one resident was praised,
another would often say, “Look at me. I’m eating, too.” This reminded me of
students at my school who said the same thing when someone else was praised. I
laughed, thinking the world was a universal classroom. Maybe the stars in the
sky were created to be placed on billions of people’s foreheads when they did
something praiseworthy.
© Frances Shani Parker, Author, Becoming Dead Right: A
Hospice Volunteer in Urban Nursing Homes
My experience above is consistent with research
findings on factors affecting independent eating among elderly patients with
Alzheimer’s disease. Published in Geriatrics and Gerontology International, this Alzheimer's research study on independent eating is the first to generate objective data
showing that difficulty in beginning a meal is a factor that hinders feeding
independence by older adults with Alzheimer’s disease. The study also concludes
that eliminating environmental interference factors and providing assistance
promoting beginning a meal are necessary to assist older adults with
Alzheimer’s disease.
Frances Shani Parker, Author
