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Time saving mealtime tips for carers

Time saving mealtime tips for carers

Time saving mealtime tips for carers 

I’m hugely passionate about the health and welfare of older people and continue to provide training to care homes and carers about the importance of nutrition.  This passion extends to the heath of carers and whilst I know there’s always so much going on when it comes to caring for older people, you should never overlook the importance of diet and nutrition.  This applies to yourself as well as those you care for.

Food has the power to do so much more than just nourish the body

Aside from the physical benefits of eating well, mealtimes are often the only opportunity many older people get to interact with someone and is a way for those with dementia to navigate their day. Food has a unique way of stimulating thoughts of the past and certain dishes/foods have the wonderful ability of conjuring up an association with occasions during the year such as strawberries for Wimbledon, pumpkins for Halloween, mithai for Diwali and sprouts for Christmas.  Amidst the current wellness landscape, I hope we never lose these associations between culture and food as they’re so much more important than the latest protein powder or green juice!

Carers in the UK

My hat goes off to carers in the UK and so should yours.  Aside from the huge commitment and impact it has on their health and wellbeing the economic contribution is estimated at £132 billion each year according to research carried out by the charity organisation Carers UK.

There’s no carer stereotype, but it can be defined as anyone (child or adult) who looks after a family member, partner or friend because they need help as a result of illness, frailty, disability, mental health problem or an addiction, and is not paid for their work.  There are around 7 million carers in the UK equating to one in ten people and this figure is predicted to rise by 3.4 million people over the next 15 years (1).

I’m focusing on those that care for older people and the majority of these carers in the UK are women, many of whom are considered to be part of the ‘sandwich generation’ caring for children and older parents at the same time (2).

I will write another blog on the impact of caring on health and the little attention they pay to their own self-care, which puts them at risk of both physical and mental health issues.

Financing the cost of care

The impact of caring can take its toll on those that still have to work at the same time, which is estimated to be one in eight carers.  Many carers have to sacrifice employment to fulfil their caring responsibilities, which can add to stress and financial commitments with surveys showing that 53% of carers have had to borrow money as a result of their caring role with 61% borrowing from friends or relatives and 41% having to use overdrafts.  It’s also been shown that 60% of carers have had to use all of their savings, whilst 23% have had to re-mortgage their homes or downsize to smaller properties to cover the costs (3).

The older carer

Another group of carers often not considered by those with little knowledge of this environment are those who are older themselves.  Research shows that 65% of carers aged 60-94 years themselves have long-term health problems and that 68% of such carers say that their caring role has had an adverse effect on their health with a third saying they have cancelled treatment or an operation because of their responsibilities (4).

Why is diet so important for older people being cared for?

The food we eat provides the energy and nutrients that the body needs to maintain good health.  Good nutrition is particularly important as we get older as it helps to support the immune system (which protects against infection) and offers nutrients that help with many other areas of health.

Nutrient deficiencies are not common in the general population but can occur in this age group and can lead to fatigue and low mood, and many other symptoms that can impact on day-to-day wellness.  Malnutrition is common in older people, especially those with dementia and this can not only make life more difficult for those that you care for but also for carers that have the added burden of dealing with the symptoms as a result.

We absorb nutrients less efficiently as we age and medication as well as lifestyle can also impact on this. There are also many other things that carers may have to consider when helping older people to eat well such as dentition or the changes brought about by dementia that affect all of the senses and the desire to eat.

Mealtimes are just one of the responsibilities of carers and aside from cooking food can be a lengthy process if they have to put time into helping someone to eat.  For those also supporting a family, it doesn’t take a maths genius to see how much time needs to be committed to mealtimes, especially if the person your caring for needs a lot of support.

Time management is essential and even more so to insure carers are taking time out for themselves, which many fails to do.  Mealtimes don’t have to feel like a burden and there are shortcuts that you can take to reduce the time spent in the kitchen without having to sacrifice good nutrition.

Get the basics right first

To insure every meal counts nutritionally you just need to get the basics right.  Meals should include a good source of protein (meat, fish, Quorn, tofu, beans, pulses, cheese), source of carbohydrates (pasta, bread, potatoes, rice or other grain) and plenty of vegetables, whilst bursting with flavour to encourage appetite.  This doesn’t need to be expensive or complicated as you can create some very simple meals using this principle, whilst making the most of time-saving preparation techniques and quick-fix foods.

Useful tips

I have put together this list of tips but there are probably many more that you already use and I would love to hear from you to share these ideas.

Breakfast smoothies 

Smoothies are a great way to provide a very quick breakfast or snack if you’re feeling rushed for time.  Use any milk as a base and throw in fruits (frozen or fresh), spinach and oats then sweeten with a little honey.  You can also prepare single smoothie packs in individual sandwich bags and keep them in the freezer to save a little more time. This is a great option if you’re trying to deal with malnutrition as you can easily whack up the calories by adding other ingredients such as oils, tofu or protein powders.

Batch cooking 

Cooking in batches once or twice a week is a great time saver.  Dishes such as stews, curries, casseroles, hearty soups and other one-pot dishes are perfectly suited to this and can be packaged individually and stored in the freezer.  Try adding in plenty of veggies to your dishes (frozen is fine) or pulses (canned) to maximise the nutritional content.  You can also add foods such as chicken livers to batch cooked meals to boost their nutritional content.  You can buy ready cooked grains in ambient pouches that can be microwaved to save time boiling grains.

Lunch platters

Mealtimes can be made up of lots of small food items, which can be taken straight from the fridge to create a lunch or supper platter.  Dips, vegetable sticks, chopped fruits, pitta breads, cooked meats, samosas, dim sum, sushi, scotch eggs, hard boiled eggs, cheese and biscuits are just a few examples and if stocked up can offer a meal in minutes.

Healthy ready meals 

You don’t have to be a slave to the stove when preparing meals and there are plenty of healthy ready-meals available that can be microwaved in minutes to provide a quick meal option. Foods such as fish pie, cottage pie or beef stew always go down well and can be teamed with a serving or two of frozen veggies such as carrots or peas to help boost the nutritional content of the meal.

Learn a repertoire of simple five-minute-meals 

Creating a quick repertoire of nutritious quick meals can be a great standby when you’re struggling with what to cook.  Eggs are perfect (omelettes or scrambled) as is wholemeal toast topped with canned fish or baked beans, pasta with canned tuna tomato sauce, soup with wholemeal toast and grilled salmon fillet with ready-made mashed potato.  Try teaming each dish with vegetables by either serving them as a side or adding them into the dish.

Nourishing soups 

Soups are a great way to cook up a meal in a flash and when served with wholemeal bread provide a good balanced meal.  Try and boost their nutrition potential by adding in canned pulses, lentils or other frozen vegetables before cooking.  Soups can be low in calories so try drizzling with a little olive oil after cooking or topping with parmesan shavings.

Make use of canned and jarred foods 

There’s nothing wrong with canned and jarred foods as they can be hugely nutritious and essential time-savers.  Canned tuna is a great protein booster and jarred sauces can be a life saver and reduce the time required to batch cook.  You can add fresh or frozen vegetables to these foods to boost their nutritional content.  A simple Bolognese sauce takes little more than mince, tomato sauce and some chopped vegetables to create a nutritionally balanced meal.

Create a list of weekly essentials

Take some time to get a grip on the foods that you use on a weekly basis to create healthy meals. If you have the essentials in stock, then you will never get caught short.

Keep snacks in stock

There will be times when you need snacks, which may be needed to help someone in your care to gain weight or for those moments when someone’s appetite is not strong enough to face a whole meal.  Foods such as cold meats, yoghurts and cheese are useful to keep in the fridge as are sweeter foods such as custard and fruits like bananas.

Don’t waste the left-overs

It’s amazing what you can create from leftovers and these can save a lot of time the following day when preparing meals.  Sunday roast leftovers can easily be whipped up into a nutritious hash the following day and spaghetti bolognese tastes great when re-fried.

Find ways to make sweet foods more healthy

In some instances the person your caring for may develop a sweet tooth, which is common in those with dementia.  If something sweet is the only way to get someone to eat then think of ways to add a little extra nutrition to the food your preparing.  Chopped fruit is good on custard and ice-cream, whilst fruit-based puddings made using fresh fruit such as pies and crumbles contain the benefits of the fruit and switching traditional crumble for something oat-based is good.

There are no hard and fast rules when it comes to helping an older person in your care to eat well.  Providing those in your care with a healthy nutritious diet is important but you also have to do the best you can within the moment in time.  Don’t make mealtimes stressful and try to use the tips above to take the strain off this area of your responsibilities. It goes without saying to figure out the foods that the person your caring for likes to eat as this can be a game-changer when their appetite is compromised.

My only final note is that carers don’t forget the importance of self-care and this means taking time out for yourself to eat and live well.  It can be difficult to see the woods for the trees with such responsibility but I for one think you are all amazing.

x

References

  1. http://webarchive.nationalarchives.gov.uk/20160109213406/http://www.ons.gov.uk/ons/dcp171766_300039.pdf
  2. https://www.carersuk.org/for-professionals/policy/expert-comment/4604-sandwich-generation-concern-is-growing
  3. https://www.carersuk.org/for-professionals/policy/policy-library/caring-family-finances-inquiry
  4. https://www.carersuk.org/for-professionals/policy/policy-library/in-sickness-and-in-health

 

Dementia – tips to help care for loved ones at home

Dementia – tips to help care for loved ones at home

 

Guide to help loved ones with dementia to eat well  (download PDF here  Guide to help loved ones with dementia to eat well  Guide to help loved ones with dementia to eat well )

Having trained in public health I take a particular interest in dementia care and have worked closely with the NHS and care home groups delivering expert advice on how to help older people with dementia to eat well.   I hope to share a little insight and a few tips to keep your loved ones with dementia properly nourished

 

What is dementia?

Dementia is a word used to describe a group of symptoms that occur when brain cells stop working properly.  This happens to specific areas of the brain, which affect how you think, remember and communicate.

The condition has a huge impact on the lives of someone with the condition and those around them.  Dementia is now the biggest killer of women and third biggest killer of men in the UK.

 


“Dementia is a word used to describe a group of symptoms that occur when brain cells stop working properly”


 

Dementia statistics  

  • 850K people living with dementia in the UK and is expected to increase to over 1 million by 2025
  • 24% of males and 35% of females born in 2015 will develop dementia in their lifetime
  • A person’s risk of developing dementia increases from one in 14 over the age of 65 and to one in six over the age of 80
  • Over 42K people under 65 years old have dementia in the UK

 

Why do older people with dementia need to eat well?

The purpose of a good diet is that someone receives the right amount of energy and nutrients they need to maintain bodily processes and protect against ill health.  There is plenty of evidence to support the fact that a poor diet will increase the chances of illness and many other health conditions as well as lowering someone’s quality of life.  Eating a wide variety of foods regularly will ensure someone’s dietary needs are met although in the case if dementia there are often many challenges that must be overcome to achieve this.

 


“The purpose of a good diet is that someone receives the right amount of energy and nutrients they need to maintain bodily processes and protect against ill health”


 

How the ageing body changes

Ageing can render the immune system less efficient, which makes older people with dementia more vulnerable to illness and infection.  A slower digestive system make constipation more common and a loss of muscle and bone strength increases the risk of falls and fractures.  Understanding thirst can also occur as less efficient kidneys make urine less concentrated and this can make dehydration more common.

 

Why are older people more likely to become malnourished?

A good diet is important for everyone but even more so for people with dementia who are at greater risk of becoming malnourished.   Not eating an adequate diet can lead to someone becoming under-nourished and this will impact on the greater chance of getting ill, skin problems, muscle weakness, tiredness, confusion and irritability.  There are many reasons why this this may be more common in older people with dementia: 

  • Smaller appetites and eating too little food
  • Chronic disease
  • Increased need for energy and nutrients due to illness or wound healing
  • Chewing and swallowing problems impact no food choices
  • Medicines may contribute to change in appetite, abnormal eating or eating disorders
  • Changes to the senses of sight, hearing, taste and smell make meals less enjoyable
  • Reduced communication skills make it difficult to explain your food preferences or that the temperature of your food is too hot or cold or that you may still be hungry

 


“A good diet is important for everyone but even more so for people with dementia who are at greater risk of becoming malnourished”


 

Informal dementia carers in the UK

There are currently 700K informal carers for the 850K people living with dementia in the UK.  Looking after someone with dementia is challenging and often impacts on family relationships and physical and psychological health but at the same time it can be rewarding and strengthen family bonds through the intimate relationship.  Caring for someone at home can allow loved ones to catch glimpses of past personality such as the occasional smile, laugh or a few words that allow an emotional connection to stay alive and that may be missed in residential care.

 


“There are currently 700K informal carers for the 850K people living with dementia in the UK”


 

Whether you’re a sibling, child or family friend, the effects of possible sleep deprivation and carrying out all the household chores, extra cleaning and laundry as well as moving and lifting their loved one can be exhausting and this is even more relevant as 44% of carers have a long-standing illness or disability according to research carried out by NHS digital.

Providing adequate food can be a challenge for home carers.  Budget constraints, lack of food knowledge or cooking skills, managing difficult eating behaviours anda exhaustion means that cooking home-prepared meals from scratch three times a day is often not a reality.  Understanding how to make mealtimes more manageable and quick healthy food fixes can lessen the burden whilst keeping your loved ones with dementia healthy.

 

A few tips to help people with dementia to eat well

Dementia is a fluid condition and every case is different but I hope these tips can offer a little insight and advice to help manage mealtimes.

 

Stimulate the appetite!

If you’re struggling to get someone to eat then try whetting their appetite.  Any increase in activity can help instigate hunger so a short walk or chair-based activity may help (this also helps relieve constipation).  Don’t fill stomachs with excess fluids before mealtimes as this will blunt the appetite. Prepare very flavoursome meals by adding spices or strong flavoured foods such as mature cheese, mustard or tomato puree.  Food should also look appealing and eye-catching with bright colours as we often, ‘eat with our eyes’. 

Try and use simple food cues to help older people with dementia orientate themselves with mealtimes.  The smell of toast or coffee in the morning, the clanking of pans or sight of someone cooking may all help someone with dementia to understand that it’s time to eat.

Mealtimes can be flexible and it may be easier to focus on the times of the day when someone usually has a bigger appetite, whether this is at breakfast, lunch or evening meal.  You should also offer small portions of food if someone has a small appetite as too much can be off-putting.

 


Create a calm eating environment

  • Avoid noise from the television or radio at mealtimes
  • Make sure plates are clearly visible on the table opting for red or blue colours or ones with a coloured ring around the edge (you could also try a white plate with coloured placemat)
  • Don’t clutter the table as this can be very distracting
  • Allow plenty of time to eat
  • Eat together

 

Take account of food preferences

Understanding someone’s food likes and dislikes can make a difference at mealtimes.  Be adventurous with new flavours but not to the point that someone refuses food.  Think about food occasions that the person your caring for may have been familiar with as it may even trigger a memory and connection with that particular food.  A Sunday roast, Christmas dinner, Strawberries during Wimbledon, seasonal foods, Birthday cake or hot cross buns at Easter are all good examples.

Taste and smell diminishes with age and more so with dementia so food preferences may change day-by-day.  It’s not uncommon for people with dementia to prefer sweet foods so try adding a little honey to savoury quiches, pies and omelettes or serve main meals with apple or cranberry sauce.  Fruit chutneys are also great to serve with cheese or cold meats, which also work as finger foods.  You can also add honey to roast vegetables and apples or dried fruit work well in stews, casseroles, curries and other one-pot dishes that can be cooked in batches and frozen.

 


“Understanding someone’s food likes and dislikes can make a difference at mealtimes”


 

Be aware that someone may not remember when they last ate and this may cause reluctance to meals.  Listen to what they are saying or trying to communicate and try and work around this with the food you offer. For example, if the person you’re caring for keeps asking about breakfast then you could consider several breakfasts across that day to encourage them to eat.

 

Maintain independence

It’s important that someone with dementia is given the opportunity to feed themselves as this helps retain a sense of independence and dignity.  Don’t worry about neatness as it’s more important that someone is eating independently. This may mean being patient and mealtimes could be lengthy and often require gentle encouragement along the way as well as appropriate supervision to reduce any risks of choking.

As dementia progresses someone may become less dexterous and lose the ability to use cutlery.  You can find specially adapted cutlery, cups with handles and non-slip placemats to make things easier.  If cutlery becomes difficult to use then provide finger foods.  A finger food diet can be just as nutritious and served hot or cold.  Pizza slices, chopped vegetables, fruit, meat pies, boiled eggs, potato wedges, sandwiches, fruit loaf are all good examples.

 


Recognising weight loss

There are many reasons why someone with dementia may lose their appetite such as suffering with constipation, swallowing issues, depression, mouth ulcers or painful teeth.  It’s important to be aware of weight loss in people with dementia and act immediately to help regain a healthy appetite and reduce the risk of malnutrition.

  • Bones visible under the skin
  • Loose clothing
  • Loose rings
  • Loose fitting dentures
  • Leaving food on the plate

 

Fortify foods 

If someone is losing weight then you may need to consider fortifying foods as it’s important to get as much nutrition as possible into a small serving of food, especially calories and protein.  Full fat milk, cream, cheese, oils, butter, mayonnaise, crème fraiche, milk powder, coconut milk, avocado, nut butters and pureed tofu are a few ideas of foods you can use. 

Nourishing smoothies can also help to top up someone’s calorie and protein intake.  There’s no end to the different combinations you can use and the best base is full fat milk.  

 


Planning meals

When you’re trying to think about what food to prepare each day it’s worth paying thought to a few factors that may make mealtimes more enjoyable for people with dementia.

  • Combine colours on the plate to help meals become more visible. Choosing three or four is a good target such as steamed fish with carrots and peas
  • Combine textures to make food more appealing. Mix up crisp, crunchy, chewy, soft and smooth foods (unless someone is having difficulty swallowing)
  • Vary taste but don’t add too many favours to any one meal
  • Have a buffet day with finger foods such as quiche, scotch eggs, vegetable sticks, cocktail sausages and yoghurts

 

Quick fixes 

If you don’t have the time to prepare something from scratch or are just too exhausted then there is nothing wrong with turning to good quality ready meals as a quick option.  Dishes such as lasagna, cottage pie, fish pie, macaroni cheese and risotto all provide a good soft food option.  Canned foods can also save time and offer a quick nourishing meal.  Canned fruit, fish (watch out for bones that pose a choking risk) or even baked beans are good examples and can be partnered with other ingredients.  Eggs are also a quick food option and can be scrambled with soft vegetables such as tomatoes and mushrooms or made into a simple omelette.

Pre-prepared foods can be used to make an interesting buffet meal that is also suitable for people that require a finger food diet.  You can also cook foods in batches and keep individual portions in the freezer to help save time. 

 


Food textures

Some older people with dementia may need the texture of their food altered.

  • Difficulty using cutlery or with a tremor may need finger foods
  • Difficulty chewing and poor teeth may need softer foods (mash, tender meats and fish, soft vegetables)
  • Difficulty swallowing may require a pureed diet (you must seek professional advice to assess someone’s potential swallowing problem before pureeing their diet) 

 

Hydration

Dehydration is common among older people with dementia as they may not recognise they are thirsty, may forget to drink, may be unable to communicate that they are thirsty, or may refuse to drink because they are worried about incontinence.

Dehydration can cause headaches, confusion, irritability and constipation which can contribute to urinary tract infections.  Older people who are incontinent need to drink more, not less, to encourage the bladder to empty regularly to prevent infection and to exercise the bladder muscles.

 


“Dehydration can cause headaches, confusion, irritability and constipation which can contribute to urinary tract infections”


 

We get some of our fluids from food, particularly foods such as soup, stews, fruits and vegetables, jelly, sauces, ice Lolli’s and yoghurt.  All drinks help us to remain hydrated, including tea, coffee, water, milk, fruit teas and fruit juices.

Caring for someone with dementia is a full time job and mealtimes present a whole new set of challenges however, maintaining a well-nourished body will help someone with dementia achieve a better quality of life and help to deter the onset of other illnesses that may make caring for them even more challenging.

 

More information

Dementia UK

Caroline Walker trust

Alzheimer’s research UK 

Age UK

 

Download PDF here Guide to help loved ones with dementia to eat well