In November of 2016, my sister and I were told our Mum wouldn’t survive Christmas.
These are the words no one ever wants to hear about their loved one, but my Mum’s GP warned us that Mum had given up on life and was ready to die.
There was no denying that Mum was really poorly, living at home with vascular dementia aged 95, she had suffered 3 falls, several urinary and chest infections and had no appetite or interest in eating or drinking resulting in dramatic weight loss and dehydration. She would not pick up a knife or fork to eat and if you tried to assist her with a meal she would turn away from you.
However, my Mum was an incredibly strong, and stubborn, lady and we weren’t prepared to just accept what the care professionals said, so we set to work to do whatever we could to help her recover.
With my, then, 26 years experience from working in the care sector, and having some knowledge of nutrition and hydration for our elders, I decided to take charge of Mum’s mealtimes and began to observe her mealtime behaviours to see what I could do to improve her dining experience and ultimately her nutrition levels.
I learned that getting people with dementia to eat can be challenging, and that complex interaction with the mealtime environment, plus many eating difficulties can prevent their nutritional intake.
Following research, I found an online mealtime assessment tool and started to observe Mum’s mealtime behaviours, to identify, find solutions and create a care plan to help overcome her mealtime eating difficulties with the goal of bringing enjoyment for her at mealtimes, giving her back her mealtime independence, preventing malnutrition and improving her quality of life.
The assessment tool provided me with a list of suggested interventions of which I chose several to trial with Mum including:
- Decluttering the mealtime environment to reduce confusion levels.
- Reducing noise levels resulting in a calmer setting which improved her nutrition
- Introducing adapted crockery and cutlery to help her regain eating independence
- Eating with her to make mealtimes more social occasions
Mum’s transformation was miraculous! Within weeks, Mum was back to eating completely independently, enjoying her meals and gaining weight.
The care professionals couldn’t believe her transformation and her end-of-life care nurse, Sally, stopped her visits saying ‘you don’t need my help anymore!’
Having seen Mum’s transformation, I wanted to share my learnings with others, who were caring for people with dementia, to enable them to also experience more positive and dignified mealtimes and improved nutrition.
And so Mum provided me with the inspiration to write my guide, as a free resource, with one aim – to help people with dementia achieve the most dignified, independent and delicious dining experience possible.
I had walked a mile in the shoes of those who care for people with dementia. I had faced their challenges, and I had been able to overcome them and I wanted to share the strategies which had worked for us.
I wanted to empower care managers and their teams and family members caring for people living with dementia to understand they CAN make a big difference in the way they support their people to lead to improved engagement and enjoyment at mealtimes.
I wanted them to really think about how their dining experience made their residents feel by putting themselves in their shoes.
Would their dining experience pass the ‘Mum’ test – would it be good enough for their loved ones? And if not why should it be good enough for anyone else?
My guide is designed for busy care managers and anyone who ‘s role involves supporting nutritional health. It is packed with best practice guidance and combines solutions to mealtime challenges, tips to improve the dementia mealtime experience and ideas of product solutions that are enabling for people with dementia.
My guide launched in 2017 and was requested and distributed to many different care professionals and types of organisations, more than I could have imagined: OT’s, care home managers, local authorities, care trainers, CQC inspectors, SALT teams, dieticians, care quality consultants, care catering specialists, end of life nurses and home care companies to name just some of the people who have had copies and have fed back what a valuable resource it has been.
Following feedback from a senior dietician within the BDA, who highly rated it and helped me to improve it, I updated it in 2018 and very much see it as an evolving resource as I learn more, and more research is done.
In 2018, I delivered ‘The Dementia Mealtime Challenge’, an interactive workshop I created based on my guide, at the National Association of Care Catering annual training and development forum. Several people who were present, have since come back to say ‘thank you we have implemented all the suggestions from your workshop!’
This is now available as a workshop for teams in care homes who are serious about looking at ways to improve their mealtime experience.
2019 saw me start my first consultancy project after an outstanding care provider approached me to work with them on a project to further improve their already excellent mealtime experience. This led to me developing a range of services to offer care homes including:
- Mealtime observational audits
- Enabling independence at mealtimes assessments for individuals
- Creating enabling dining environment audits for people living with dementia
- Mealtime equipment audit
- Partnership working with care teams on improvement plans and implementation.
- Retained support to measure continuous improvement.
I am passionate about helping people and sharing my knowledge, and with my own experience and care sector background would love to work with more care homes to help them too.
I was thrilled to speak in the Dementia Theatre at the Care and Dementia show, and to launch our new video celebrating dining in care made in collaboration with Ian Donaghy; ‘Made with Love’.
by Jo Bonser
Download your own copy of my Dignified Dining Solution Guide using this link: https://hcsuk.co.uk/dignified-dining
You can visit Jo’s website here: www.hcsuk.co.uk.