Expert: Mary Gordon - 11/4/2011

Question
Hi,
My name is Sha. I am a graduate student from Academy of art University. I am developing an eating set to help people with Alzheimer's to have a better eating experience.

I am doing research and design at the same time.
Would you like to share some experience with me?


When I volunteer in an institute, I found people with Alzheimer's do not know where there body is in relation to other objects, which is why it is common for them to knock things over and spill food or drinks. also they may have bad appetite, confused about how to use utensils then have a messy eating environment.

Is there anything you think I should know when designing an eating set for them?

I want to make a eating set including a tray, a special design bowl, plate, water bottle, and a spoon for them. Hope the eating set can help them eat by themselves better to alleviate caring burden and frustration from caregivers.

Would you like to share your experience with me?

Have a good day! =)

Answer
Hi Sha, here is a good article for you to read about the experience of Alzheimer's.
http://alzheimer.guelph.org/downloads/12%20pt%20Understanding%20the%20Dementia%2

You will see, they have a complex of issues that make eating a challenge, including coordination, perception, distractibility, agnosia(inability to recognize objects), loss of their sense of smell, dysphagia etc. etc. It is very hard to get your mind around just how impaired they are, and on how many fronts.

There are some assistive and adaptive products out there designed to make it easier for them to self feed, such as plates with suction cups and high rims, anti-tip cups, utensils with special grips. Here is a site with examples - there are lots out there. You will also see high contrast tableware here - many people with AD have trouble seeing items on a similarly colored background (i.e. white rice on a white plate). On the other hand a black plate on a white background might look like a hole to them. They have depth perception problems.
http://www.maxiaids.com/categories/386/Eating.html
Here's more http://www.wrightstuff.biz/cuglandst.html

They often do not necessarily seem to feel hunger or thirst like a healthy person - or if they feel the sensations, they cannot interpret them as their body signally a need that can be met by eating or drinking. They also have NO short term memory.

My mother in law was extremely distractible. She could not be fed in a busy dining hall, as she would stop eating because she was paying attention to other things, even if she should have been very hungry. Staff would ask her if she was finished. She would not necessarily understand what was being said to her, or recall that she was in the middle of a meal, but would respond to their tone and inflection, often by saying yes - which did not mean yes - it was really more of a reflexive response to any question. The plate would be prematurely taken away.  

She did much better eating in a very quiet location away from other noise and bustle. She also needed a LOT of time to eat. Yes, she made a mess. That did not bother us at all. We also let her get food into herself anyway she wanted. Finger foods were fine when she could still handle solid textures, but keep in mind, if she would allow it, we did hand feeding as well, even when she would self feed. Sometimes we could get quite a bit more into her if we provided some direct assistance and prompts. It helped a huge amount if someone ate with her. Seeing someone else eating can stimulate them to take in more and stick with the activity.

I do recall her having major problems when in hospital for an injury from a fall. They would put food in her room with a tray cover on it, and not put it directly in front of her. She would not realize that there was food under the tray cover, much less what to do to get it (i.e. she would not be able to figure out how to get a lid off due to her cognitive impairments and agnosia). It had to be put directly in front of her, uncovered, or she wouldn't eat. There would be many things on the tray, which were hard for her to understand or interpret what to do with, including condiments.

Usually small portions are best, preferably one or two things at a time (i.e. several choices or things on the plate can be visually confusing or overwhelming). Things need to be very simple and focussed. A lot of the strategies have more to do with what you feed them and how often, the setting, and the assistance offered, rather than the specifics of the tableware.

The fewer distractions on the table, the better. No patterns on the surfaces, no table decorations, no extra cutlery, no salt and pepper shakers or condiments or napkin holders. No patterns on the dinnerware.

I'm not sure if this has helped. Good luck with your project.

Mary