Oxfordshire Skills and Learning Service

Unit 108 (3565) (D!30" #"""$366) %no&ledge 'ork(ook

Understand and )eet the n*tritional re+*ire)ents of individ*als
&ith de)entia
Learner na)e, -./ 0eg1 2o,
Learner signat*re,
Date co)3leted,
0eco))ended /L4S, "6
5ssessor na)e,
This unit is about understanding that individuals may have specific nutritional needs
because of their experience of dementia. Learners will develop their knowledge and
skills in meeting these nutritional requirements and be able to provide evidence of
their competence to enable individuals with dementia to eat and drink well
Learning outcome 3 needs to be assessed in the workplace environment
You must understand your organisations policies and procedures before attempting
to answer the learning outcomes
ead the guidance on the terms used in this workbook before you start.
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Learner 5ssess)ent 0ecord
Unit 2*)(er, 108
Unit 6itle, Understand and )eet the n*tritional re+*ire)ents of individ*als
&ith de)entia
Date 'ork(ook s*()itted, 1st $$$$$$$$$$.. "nd $$$$$$$$$$..
%ssessment
&riteria
%ssessor 'eedback "st
(ubmission
)utcome
!ass*efer
#nd
(ubmission
)utcome
!ass*efer
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Learning outcome 3 must be assessed in a real work environment and your
%ssessor will agree additional methods to cover these- including observation of your
practice
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%ssessor comments to Learner
Target date and action plan for resubmission .if applicable/
)utcome of second submission
0 confirm that this assessment has been completed to the required standard and
meets the requirements for validity- currency- authenticity and sufficiency
%ssessor (ignature1 2ate1
0 confirm that the assignment work to which this result relates- is all my own work
Learner (ignature1 2ate1
0nternal 3erifiers (ignature1 2ate1
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5dditional g*idance
%n individual is someone requiring care or support
!erson4centred approach1
This is a way of working which aims to put the person at the centre of the care
situation taking into account their individuality- wishes and preferences
5eal times1
5eal planning
'ood shopping
'ood preparation
!re4 and post4meal activities
2ining
(nacking
6ell4being1
%ppropriate weight gain*loss
0mproved sleep patterns
educed confusion
0mproved physical health
0mproved emotional state
educed infections
educed constipation
7or )ore detailed infor)ation 3lease research,
www.al7heimers.org.uk
http1**www.scie.org.uk*publications*dementia*index.asp
http1**www.logontocare.org.uk*e4learning8*
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5ssess)ent -riteria 111, ho& cognitive8 f*nctional and e)otional changes
associated &ith de)entia can affect eating8 drinking and n*trition
"
2ementia can greatly affect a person9s relationship to food and eating. The
behavioural- emotional and physical changes that take place as dementia
progresses can all have an impact upon a person9s eating habits and on their intake
of food and drink.
0t is important to do what you can to make sure that the person you are caring for
en:oys their food and eats a healthy- balanced diet. %s dementia progresses eating
can become difficult for some people. ;owever- by making a few changes you can
help keep mealtimes as en:oyable and stress free as possible.
% person with dementia may no longer recognise the food in front of them. They may
struggle to use a knife and fork as co4ordination becomes difficult. The person may
not open their mouths as food approaches and may need reminding to do so. 'ood
may be difficult to chew or swallow or they may not want to accept assistance with
eating.
0f you are supporting a person with dementia at mealtimes it is important to
remember that these reactions are not a deliberate attempt to be 9difficult9- or a
personal attack. The difficulties are likely to be related to changes caused by the
person9s dementia. 6hen supporting a person at mealtimes it can be a challenge to
identify what the problem is- particularly if the person themselves is finding it difficult
to find the words to explain.
5ssess)ent -riteria 11", ho& 3oor n*trition can contri(*te to an individ*al9s
ex3erience of de)entia1
5ssess)ent -riteria 113, ho& other health and e)otional conditions )a: affect
the n*tritional needs of an individ*al &ith de)entia
5ssess)ent -riteria 11#, the i)3ortance of recognising and )eeting an
individ*al9s 3ersonal and c*lt*ral 3references for food and drink
5ssess)ent -riteria 115, &h: it is i)3ortant to incl*de a variet: of food and
drink in the diet of an individ*al &ith de)entia
!eople with dementia need to make sure they eat a healthy balanced diet. %
balanced diet provides all the nutrients the body needs in the right amounts to stay
healthy.
%s dementia progresses- changes in a person9s eating habits and ability to eat often
take place. 2ifficulties swallowing- changes in taste and smell or a poor appetite can
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make it increasingly difficult to ensure that an adequate amount of nutritious food is
eaten.
% healthy diet is only as healthy as the food that is eaten. 0t is therefore important to
take into account the person9s likes and dislikes and their ability to manage certain
foods. &onsider ways of preparing food to stimulate interest- particularly if the
person9s appetite is poor.
emember- eating healthily does not mean that certain foods have to be avoided.
=verything in moderation and a little bit of what you fancy is the key to en:oying food
and staying fit and well.
5any foods provide a range of nutrients and similar foods are often grouped together
into 9food groups9. Listed below are the different food groups and the nutrients they
provide. &hoosing a variety of foods from different food groups is the best way to
ensure a balanced intake of all the different nutrients needed for good health.
!ilk and dair: food
This group includes milk- cheese and yoghurt and foods made with milk- such as
custard- milky drinks or milk puddings.
These foods are a good source of protein- which is needed to build and repair body
tissues. They also provide a rich source of calcium- needed for strong bones and
teeth.
To help the body absorb calcium from food- we need vitamin 2. 3itamin 2 is mainly
formed by the action of sunlight on the skin- but can also be found in foods such as
oily fish- margarine and eggs. ;owever- for older people who are housebound- or
spend little time outdoors- a vitamin 2 supplement may be required. &heck with the
>! or dietician.
!eat8 fish and alternatives
This group includes meat- poultry- fish- offal- eggs- nuts- beans- lentils and soya
products such as tofu.
These foods are a good source of protein and also provide some of the ? group
vitamins .see ?read- cereals and potatoes/.
'oods of animal origin- such as meat- fish- offal and eggs- are good sources of
vitamin ?"#. 3itamin ?"# is needed for a healthy nervous system and the formation
of red blood cells.
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'olate and iron are also needed to keep the blood healthy. Liver is a good source of
folate .see 'ruit and vegetables/ and iron can be found in red meat- oily fish- liver-
kidney- beans and lentils. =ating fruit and vegetables that are rich in vitamin & can
help with the absorption of iron from food .see 'ruit and vegetables/.
)ily fish- such as salmon- mackerel- herring and sardines- is a rich source of
essential fats called omega43 oils. These oils play an important part in maintaining
the health of the heart and the nervous system. =ating oily fish at least once a week
is recommended.
'or those who choose not to eat meat or fish- foods such as pulses .beans- peas
and lentils/ nuts- eggs- cheese and soya can be eaten instead. % variety of these
foods should be eaten to ensure a good range of nutrients. (ome people who avoid
all animal foods 4 meat- fish- eggs and dairy foods 4 will probably need a vitamin ?"#
supplement. &heck with the >! or dietician.
;read8 cereals and 3otatoes
This group of foods provides energy and is a good source of ? group vitamins. %s
well as keeping the blood and nervous system healthy- ? vitamins break food down
to release energy. 'oods in this group include1
?read .wholemeal or white/- including chapatti- nan and pitta breadA crackersA
crumpetsA muffins- and teacakes
!asta- such as spaghetti or macaroniA noodles- and rice
!otatoes- plantain and yam
?reakfast cereals and flour. ?reakfast cereals are fortified with added vitamins
and minerals- such as folate- vitamin ?"# and iron. (erved with milk- they
provide a nourishing snack that can be eaten at any time of the day- not :ust in
the morningB
6holemeal bread- wholemeal pasta and wholegrain breakfast cereals are all good
sources of fibre. =xamples of wholegrain breakfast cereals include porridge oats-
bran flakes and whole wheat biscuits.

7r*it and vegeta(les
This group includes all fruit and vegetables- dried fruit and fruit :uices.
'ruit and vegetables are packed full of fibre and vitamins 4 in particular- the
antioxidant vitamins &- = and beta4carotene. These vitamins help to protect the
healthy cells of the body from damage and support the immune system to fight
infections. ?eta4carotene is found in yellow and orange fruit and vegetables and in
dark green leafy vegetables. )nce in the body- it is converted into vitamin % as
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required. 3itamin % can also be found in animal foods such as liver- eggs- cheese
and butter.
3itamin = is present in green leafy vegetables- vegetable oils- butter and nuts.
3itamin & is needed to keep gums- teeth and skin healthy. 0t also helps the body
absorb iron from food .see 5eat- fish and alternatives/. &itrus fruit- such as oranges-
strawberries and kiwi fruit- and tomatoes and potatoes are good sources of vitamin
&. 'or those who find it difficult to eat or prepare fruit and vegetables- drinking a
glass of orange :uice every day is a good way to ensure an adequate intake of
vitamin &.
>reen leafy vegetables- ?russels sprouts- oranges and other citrus fruit are all good
sources of folate.
% general guide is to try to have five servings of fruit and vegetables a day to ensure
a good range of nutrients for health. ;owever- individual dietary needs can vary-
particularly for people with dementia- and may be influenced by the stage of
dementia- ability to eat certain foods- the person9s medical condition and other
circumstances. This guide may not be appropriate or achievable for all people with
dementia. ;owever- every little helps- so encourage and accept what each person
can manage.
7ats8 oils and other foods
This group includes margarine- butter- ghee and vegetable oils such as sunflower oil
and olive oil.
These foods are concentrated sources of energy- so are not needed in large
amounts. They do provide some vitamins. 5argarine contains vitamins 2 and = and
vegetable oils are a good source of vitamin =.
9)ther foods9 include cakes- pastries- biscuits- confectionery- crisps- and soft and
alcoholic drinks. These foods are not nutrient rich. They mainly provide calories or
energy from fat and*or sugar. They can be included as part of a healthy balanced
diet- but if eaten too frequently they may dampen the appetite for more nutritious
foods. 0t is a question of moderation.
5 &ord a(o*t fi(re
'ibre is important to help prevent constipation. The risk of constipation is greater for
people who are inactive- do not drink enough or eat a low fibre diet. &ertain
medications can also aggravate the problem.
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% good way of preventing constipation is to include foods that are a good source of
fibre in the diet 4 fruit and vegetables- salads- beans- lentils- wholemeal bread or
wholegrain breakfast cereals- for example. ;owever- it is best to introduce high fibre
foods gradually if the person is not used to eating them. Too much fibre in the diet
can be bulky and uncomfortableA small changes are usually sufficient.
0t is not advisable to add raw bran to foods as this can cause bloating and
discomfort. 0t can also make it difficult for the body to absorb nutrients such as
calcium and iron.
To help prevent constipation also try- if possible- to encourage daily activity for those
who are able. % short gentle walk is a good start.
Drink to think
2rinking enough fluid every day is vital for good health. % low intake of fluid is likely
to result in dehydration. This can increase the risk of constipation and affect mood-
resulting in increased irritability and confusion. (ome people with dementia may not
recognise that they are thirsty or may simply forget to drink.
'luids include water- tea and coffee- fruit :uice- milk and other soft drinks. >entle
reminders and prompts to drink may help. )ffering the person the cup rather than
leaving it on the table may prompt a person to drink.
(ome supermarkets offer a delivery service- where orders can be placed by phone
or through the internet. This is a good way of ensuring a regular stock of fresh food
and can help if time is limited or it is difficult to get to the shops. There may be a
charge for this service- so it is best to ask first.
<oor a33etite
There are several reasons why a person with dementia may have a poor appetite or
seem uninterested in eating.
0n the early stages of dementia some people lose interest in food because
they are depressed. 2epression is very common but there are effective drug
treatments available. 0f you suspect this is a problem- consult your >!. 6hen
the depression lifts- the person9s appetite should return.
% sore mouth- badly fitting dentures or sore gums can make eating
uncomfortable. egular dental care is important- so seek the advice of a
dentist.
0f the person is inactive during the day- they may not feel hungry. =ncourage
activity such as walking- if appropriate.
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0n the later stages of dementia- people may no longer understand that the
food in front of them is there to be eaten- even if they are hungry. This is
because the nerve pathways in the brain are damaged and the messages do
not get through. >entle prompts and reminders to eat may be helpful. =ating
in company can act as a useful cue- reminding the person what to do and how
to eat.
5edication can sometimes affect the appetite. (ide4effects such as
constipation- changes in taste or a dry mouth can reduce the desire to eat.
&onstipation can be helped by increasing fibre and fluid intake. Eeeping food
moist by adding sauces or gravy can help the person to eat more easily if their
mouth is dry. (mall sips of water taken while eating may also help.
&hewing and swallowing sometimes becomes a problem as dementia
progresses. !eople may find chewing solid food difficultA they may hold food
in their mouths rather than swallow it- or you may notice that they cough after
swallowing. 0f you have any concerns about chewing and swallowing food- a
speech and language therapist can advise.
(ome people with dementia find eating with a knife and fork difficult because
they have problems with co4ordination. This can be frustrating and they may
feel embarrassed if they drop food or if the task becomes messy. This can be
sufficient to put a person off eating at mealtimes. Try offering finger foods to
boost confidence and maintain independent eating.
!eople with dementia often experience changes in food preferences. This is
thought to be a result of damage to specific areas in the brain or it may be due
to the person simply forgetting which foods or drinks they used to like.
&hanges in taste and smell can all impact on the amount and variety of foods
eaten. 0f food preferences become very limited- the person will probably not
be getting all the nutrients they need to stay healthy and they may lose
weight. % dietician can offer practical advice on how to enrich food and drink
to help with a poor appetite and weight loss. (ome people with dementia may
need food supplements- such as energy4 and protein4enriched drinks. These
are usually prescribed and should be taken under the guidance of a dietician
and >!. (ome supplement drinks can be purchased from chemists and
supermarkets. These often come in a powdered form and can be made into a
drink- usually by adding milk.
Losing weight is not an inevitable part of having dementia. 6ith time- effort and
knowledge of the person- food intake can be increased. 0t is helpful to be aware of
some of the changes that can occur as dementia progresses- such as difficulties
using cutlery and changes in visual perception1 these changes can result in a person
eating and drinking less than they need to stay healthy and well nourished.
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5easuring a persons weight each week can help to indicate any changes that need
attention. This is part of what is called Fnutritional screening- a process of identifying
people who are malnourished or at risk of becoming so.
4o& and &hen to eat
This depends on the individual and how they prefer to eat. % person with a good
appetite may have no problem eating sufficient food at regular mealtimes.
;owever- a person with a small appetite may not respond well to generous servings
of food three times a day. Too much food on the plate can be off4putting to someone
whose appetite is poor. 0n this case- try serving smaller portions at mealtimes and
offer nourishing snacks in between mealtimes to supplement food intake. )ffer
dessert as a separate course an hour or so after the main meal- rather than
presenting both courses at the same time- as this may also help.
%lternatively- you may find the person prefers to eat 9little and often9 4 five smaller
meals spread over the day instead of the usual three- for example. 0t is a matter of
finding out what works best for the individual.
Drinks
=ncourage milky drinks- hot or cold. 5ake malted milk drinks or hot chocolate with
milk.
Snacks
(andwiches with fillings such as egg- tinned fish- meat- cheese or peanut
butter
&heese and biscuits
Toast with cheese- pGtH- peanut butter or yeast extract
?uttered scones- toasted teacakes- buttered crumpets or muffins
'ruit loaf or malt loaf
5ilk pudding- breakfast cereals and milk- yoghurt
'ruit cake or gingerbread1
5voiding over eating
(ome people with dementia may eat too much food. They may forget they have :ust
eaten or they may have a persistent desire for certain foods- such as sweet biscuits
or confectionery- and snack on these throughout the day. )vereating can become a
problem if the person gains too much weight. &arrying extra weight will make it more
difficult to get around and the person will start to feel uncomfortable.
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(nacking frequently on foods such as confectionery or biscuits can reduce a
person9s appetite for more nutritious food at mealtimes- which means they may not
be getting all the nutrients they need to keep them healthy.
Try to limit the availability of these snack foods if they are being eaten too often and
the person is gaining excess weight. !rovide healthier alternatives- such as pieces of
fresh fruit and vegetable. (ome people may eat out of boredom or loneliness- or they
may not be active during the day
/etting hel3
0f you have concerns about a person9s eating or drinking- help is available. Eey
healthcare professionals who can offer advice and guidance include1
2ieticians- who can provide advice on issues such as poor appetite- weight
loss or weight gain- food enrichment and vitamin and food supplements.
(peech and language therapists- who can give advice and guidance on
swallowing difficulties. 0t is important that changes to the texture of food are
only made as necessary and with their professional advice.
)ccupational therapists- who can advise on adapted eating aids- such as
cutlery- cups and plate mats- which help to maintain independent eating.
These professionals can be contacted through their >! or consultant- who will be
able to arrange for a referral. (ome professionals may be able to offer a domiciliary
visit to people who are housebound. )thers may be based at a local health centre-
>! practice or hospital. (ervices vary from area to area.
5ssess)ent -riteria "11, ho& )ealti)e c*lt*res and environ)ents can (e a
(arrier to )eeting the n*tritional needs of an individ*al &ith de)entia
5ssess)ent -riteria "1", ho& )ealti)e environ)ents and food 3resentation
can (e designed to hel3 an individ*al to eat and drink
5ssess)ent -riteria "13, ho& a 3erson centred a33roach can s*33ort an
individ*al8 &ith de)entia at different levels of a(ilit:8 to eat and drink
#
The environment in which a person with dementia eats will have an effect on how
they eat. !eople with dementia will not want to stay and eat in an environment in
which they feel uncomfortable. Inderstanding the impact of the mealtime
environment can help us to improve the eating experience for people with dementia.
0magine you are in a restaurant with a group of friends and there is loud music
playing or a live band playing close to your table. The restaurant is busy and the
conversations around your table are loud. You are trying to make a choice from a
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www.scie.org.uk
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long list of options on the menu as well as keep up with the conversation among the
friends you are with.
The waiter is hovering and you are feeling pressure to choose your meal. 0t may be a
challenge for you to concentrate on the conversation around you while choosing
from the menu- but you will manage to make this choice and continue to converse
with your friends despite everything else going on around you.
'or a person with dementia a noisy environment can be confusing1 it can make it
difficult to concentrate and focus. (o if you had dementia and you were in that noisy
restaurant you may have :ust got up from the table and walked out as the music-
conversation and waiter were all competing for your attention.
6e need to be aware that people with dementia may struggle to concentrate at
mealtimes if there are other distractions. The eating environment needs to be calm
and relaxed. (witch off the television or turn down loud music to avoid distractions.
% person with dementia may not be comfortable eating with other people or in an
unfamiliar environment. They may have difficulty eating food and this can only make
feelings of embarrassment worse if they are sitting with others. %s a result- they may
leave food uneaten.
%llow a person to sit and eat in a place where they feel comfortable- either at a table
or perhaps sitting with a tray on their lap on a comfortable chair.
0t is important to be aware that some people with dementia may experience visual
impairments that make it difficult to see the food in front of them.
2escribe the food you are offering and ensure that the food is presented colourfully
and attractively. 0t should look good enough for anyone to eat.
=nsure the area in which a person with dementia eats is bright and well lit so they
can see the food easily
'ood and images of food can also be used for reminiscing or part of reminiscence
activities. This can help stimulate discussion and interest in food and mealtimes by
helping the person to reconnect with familiar food from their past.
0t is not uncommon to notice a persons likes and dislikes for food and drinks change
as dementia progresses. These may be quite dramatic and very different to the
preferences a person may have held for many years. 0t is wise to expect change and
not make assumptions that everything will stay the same.
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% flexible approach to providing food and supporting the person at mealtimes is vital.
%s with any one of us- the appetite of a person with dementia may vary from day to
day.
6e all have likes and dislikes and eating habits that are particular to us as
individuals. !eople with dementia are no different. 6e need to know what type of
food a person likes to eat- where they like to eat it and when they like to eat.
'or example- a person with dementia may be used to eating their main meal in the
early evening by themselves- sitting in a comfortable chair listening to the radio.
0f this person is suddenly offered their main meal at lunch time and expected to sit at
a dining table with others it would be no surprise if they refuse to eat the meal or
leave it uneaten. This new situation may be confusing and unfamiliar to the person or
they may :ust not be hungry at that time of the day.
%sking people with dementia about their mealtime preferences- when and where
they like to eat and what foods they en:oy is vital to ensure we provide food and
options at mealtimes that are familiar to them. 'amilies and carers can be a valuable
source of information if the person with dementia is struggling to communicate their
eating habits and preferences for food and drinks.
!eople with dementia may struggle to ask for food if they have difficulty finding the
words to express themselves. 'ood and drinks need to be visible and available
throughout the day so that people can eat and drink whenever they feel hungry or
thirsty.
=nsure that snacks and drinks are easy to access and see so that people with
dementia can take a drink or eat without having to wait for it to be offered.
Look at this website and view the video clip about nutritional care for older people
http1**www.scie.org.uk*socialcaretv*video4player.aspJguidK3e,,CC,f4#"D84+d<e4
Cc",48D8cf,c@e<Ce
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%ssessment &riteria "."1 =xplain how cognitive- functional and emotional changes
associated with dementia can affect eating- drinking and nutrition
Think about an individual you support who has dementia and complete the chart
below
;ow it affects their
eating
;ow it affects their
drinking
;ow it affects their
overall nutrition
&ognitive
changes Dementia means
a decline in a
persons
cognition
because of
changes in the
brain. For
example: A
person may sit in
front of a lunch
plate and start
eating only when
another person
initiates the
process for her;
she may appear
lethargic or
uninterested.
Patients with
Dementia may
forget to drink or
ne!er technically
feel "thirsty". #!en if
you lea!e a glass of
water on the table
in front of them
they will not know
how to drink. $his
can lead to
dehydration%
&educed 'uid
intakes ad!ersely
a(ect the o!erall
nutrition and can
lead to
dehydration%
3
'unctiona
l changes Patients with
Dementia may
ha!e problems
with the actual
process of eating
and drinking )
may not open
their mouth and
then not chew
and spit out the
food. As a carers
we ha!e to gently
*e all need to drink
between six and
eight glass of water
a day. Patients with
dementia may also
ha!e problems with
drinking. +f they
dont want to open
their mouth means
that they maybe
en,oy drinking
through a straw. +t
$he problem with
chewing and
swallowing food and
drinks a(ects the
o!erall nutrition. All
this leads to
excessi!e weight
loss and bringing
the body to the
dehydration.
3
6hat they can do
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remind them how
to eat so they
feel that they are
in control and are
making a choice.
is important that
patients with
dementia always be
o(ered 'uids to
a!oid dehydration%
=motional
changes
-ome emotional
symptoms are
common in
dementia and
can be ma,or
sources of stress
to patients and
their careers.
.ne of the most
common
emotional
changes
associated with
dementia is
eating disorder /
changes in
weight 0gain or
loss1 changes in
appetite changes
in appropriate
eating beha!ior
preferences for
only certain types
of foods.
Drinking enough
'uids e!ery day is
important for good
health. A lack of
'uids in the body
can result in
dehydration
constipation
confusion changing
mood. +f a person is
not willing enough
to drink water it
would be desirable
to make a cup of
tea and talk
together. 2aybe
that person feels
lonely and sad and
need our company.
#motional changes
a(ect the 3uality of
life. *hen we are
sad or depressed
the last thing we
want is food or
be!erages.
#motional downs
lead to poor
nutrition.
%ssessment &riteria ".#1 =xplain how 3oor n*trition can contribute to an
individuals experience of dementia. .5inimum ,8 words/
$he reason why dementia patients su(er from poor nutrition is the
inability to properly feed themsel!es. -ome of them ha!e a poor appetite
and little interest in food because their sense of taste and smell often
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does not work or they may ha!e di4culty chewing and swallowing.
Poor nutrition can make the symptoms of dementia worse for people
unfortunate enough to ha!e this condition. Poor nutrition not only worsens
the symptoms of dementia but increases the chance of needing
hospitali5ation or institutionali5ation.
Patients with dementia should ha!e a recommendation from nutritionist
for daily necessary amount of each group of food.
A consultation with a nutritionist to make sure theyre getting ade3uate
amounts of each food group. 2any dementia patients are malnourished
and need additional amounts of proteins and calories. $hey also need
dentures that 6t well and do not create discomfort. Any issues with
constipation and swallowing should be addressed by a doctor.
%ssessment &riteria ".31 2escribe how other health and emotional conditions may
affect the nutritional needs of an individual with dementia .5inimum ,8 words/
-ometimes a person with dementia loses their appetite. $here may be
se!eral reasons for this:
/ $hey may be depressed. Depression may lead the person to lose interest
in food.
/ -ometimes it actually hurts to eat like sore gums non/comfortable
dentures.
/ 7ack of exercise may mean that the person is not using enough energy
to feel hungry ) more walks on fresh air%
/ As the dementia progresses the person may no longer understand what
food is for. *e need to remind them by putting food on a spoon and
gently guiding it to their mouth.
/ +f swallowing becomes a problem ) professional help from speech
therapist is necessary%
%ssessment &riteria ".+1 2escribe the importance of recognising and meeting an
individuals personal and cultural preferences for food and drink .5inimum ,8 words/
For e!ery patient who is admitted to our home is especially important to
6nd out his likes and dislikes his normal diet and any speci6c needs he
may ha!e. $his will help us to pro!ide an en!ironment that promotes
choice and demonstrates respect for his personal beliefs and preferences.
+n our nursing home we ha!e residents who had !egetarian and !egan
food residents who had li3uidised food or residents who has ne!er eaten
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certain food 0like !egetables or certain type of meat1. *e also respect
when some of our residents re3uires their meat to be cooked in a certain
way because of religious needs.
%ssessment &riteria ".,1 =xplain why it is important to include a variety of food and
drink in the diet of an individual with dementia
.5inimum ,8 words/
8$he ,oy of mealtimes belongs to all ages rich and poor in all countries
and at all times. $he happiness at the table can be combined with other
,oys and remains to the end a comfort for the regrets about what we
lost%9 0:.-ar!ing #l!ing ;<=< p.>?<1
$his 3uotation from a :rillat -ar!in ) famous French gourmet explains how
essential and meaningful food and the mealtimes are for people in
general particularly important as a comfort for people who are elderly
and ill and who no longer ha!e so many pleasure in their life%
$he eating and nutrition of people with Dementia can impact on their
health. *eight loss nutritional de6ciencies and inade3uate 'uid intake
can all ha!e dangerous results. A healthy balanced diet pro!ides all the
nutrients the body needs. #ating a nutritious balanced diet and
maintaining a healthy body weight +ts important for people with
dementia.
%ssessment &riteria #."1 =xplain how mealtime cultures and environments can be a
barrier to meeting the nutritional needs of an individual with dementia L describe at
least three for each that are common to the type of work you do
6hat
environmental
barriers there
may be to good
nutrition
;ow 0 can reduce these
barriers
6hat cultural barriers
there may be to good
nutrition- including
organisational
cultures as well as
the individuals
;ow 0 can reduce
these barriers
Privacy
during
mealtimes
Pro!ide the person
with dementia with a
comfortable place to
sit and eat. $he habit
to be alone during
mealtimes must be
respected because
Having strict
meal times?!
People with
dementia do not
ha!e routine. $he
care they recei!e
should be person
centred and to 6t
in with what the
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6hat
environmental
barriers there
may be to good
nutrition
;ow 0 can reduce these
barriers
6hat cultural barriers
there may be to good
nutrition- including
organisational
cultures as well as
the individuals
;ow 0 can reduce
these barriers
the presence of other
people can be !ery
stressful.
indi!idual needs
this should also be
true with the
meals the person
recei!es.
Very noisy
environment
A noisy en!ironment
can be confusing for
people with dementia
because they are
struggling to
concentrate and focus
at mealtimes. $hey
need calm and
relaxed en!ironment.
+n our nursing home
the tele!ision in the
dining room is always
switch o( and we are
trying to create an
en,oyable
atmosphere.
Having certain
number of
courses and in a
certain order?!
This routine may not fits
to the needs of a person
with dementia. Their
tastes may have
changed and they dont
want to eat in a
particular traditional
order. 3ery often they do
not want to eat at the
same time the same
amounts of food.
Unfamiliar
environment
$he dining room in a
nursing home is !ery
di(erent from the
ones we ha!e at
home. For all new
residents is especially
important to adapt.
As they fail to adapt
to their rooms and as
they create social
contacts with other
residents the meals
in the dining room
Lack of appetite
or something is
missing
*e need to set the
table as we would
for our own family
at home. $he food
that is ser!ed
should whet ones
appetite. *e need
to put on the room
lights ) older
people need more
light than younger
people do. *e also
need to make sure
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6hat
environmental
barriers there
may be to good
nutrition
;ow 0 can reduce these
barriers
6hat cultural barriers
there may be to good
nutrition- including
organisational
cultures as well as
the individuals
;ow 0 can reduce
these barriers
become a pleasure. that the residents
sit well and close
enough to the
table.
%ssessment &riteria #.#1 how mealtime environments and food presentation can be
designed to help an individual to eat and drink
Food appeals to many senses. +t can be attracti!e to look at we can smell
it and it has a taste. $he sight and smell of food help people to decide if
they are full or hungry. $he way food is ser!ed where is ser!ed how it
smells and its appearance will in'uence the feelings and associations
that are being stimulated. All these things are important for the people
with dementia. $he smell of newly made tea and co(ee freshly baked
biscuits or cakes soft music and warm light stimulates associations with
the past expectations of an en,oyable experience.

%ssessment &riteria #.31 how a person centred approach can support an individual-
with dementia at different levels of ability- to eat and drink
Look at this website and view the video clip about nutritional care for older people
http1**www.scie.org.uk*socialcaretv*video4player.aspJguidK3e,,CC,f4#"D84+d<e4
Cc",48D8cf,c@e<Ce
Think about an individual you support who has dementia. 2escribe how you support
that person to eat and drink that de)onstrates a person centred approach and
ensuring all factors of this approach are taken into account. .5inimum #88 words/
2ealtimes are !ery important times in the day when our residents not
only consume food but can ,oin others for con!ersation. -ome of our
residents are able to eat with cutlery but some simply forgotten how to
use it. 2rs. 2.7. can no longer use a knife and fork properly and makes a
dreadful mess. For me it is important for her sense of independence and
self/esteem to encourage her to continue to feed herself for as long as
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possible. 2rs 2.7 found this frustrating at times. + am trying always to be
'exible and tolerant as possible and + am trying to make mealtimes as
relaxed as possible. :ecause 2rs 2.7 cant cope with a table napkin + am
encouraging her to wear an easily washable apron when she eats.
-ometimes + am encouraging her to use spoon rather than a knife and
fork but 6rst + am cutting up her food well. *hen she ha!e some 6nger
food for lunch she feel much comfortable and its easier for her to pick up
food with her 6ngers. 2rs. 2.7 is less confused when + am ser!ing her one
portion of food at a time ) 6rst main meal than dessert. + ha!e feeling now
that 2rs. 2.7 is not getting upset about the mess and she is en,oying her
food more than before.
)nce complete please make sure that your details are on the front of the workbook
and then return it to your assessor1
)xfordshire (kills and Learning (ervice
Inipart ;ouse
>arsington Lane
&owley
)M+ #>N
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