One of the issues which has emerged from previous Talking Mats and dementia projects is that many people with dementia experience difficulties with mealtimes and that it can affect people at any stage of dementia.
Mealtimes involve two of our most fundamental human needs, the basic physiological requirements for food and drink and interpersonal involvement. Mealtimes are particularly important for people with dementia as they may develop difficulties both with eating as a source of nourishment and with the social aspects of mealtimes.
In 2015 Joan Murphy and James McKillop carried out a project, funded by the Miss EC Hendry Charitable Trust, to gather information from the first-hand experience of people with dementia about their views about mealtimes. We ran three focus groups and used the Talking Mats Eating and Drinking Resource to allow participants to reflect, express and share their views.
The people who took part in this study felt that there were significant changes in their eating and drinking since their diagnosis of dementia. For some, their experience of mealtimes had changed and several said that they now skip breakfast and sometimes lunch. For some this seemed to be related to forgetting to eat and drink, for others it related to changes in taste whereas for others these meals seemed to be simply less important. Forgetting to eat was particularly noted by the participants with dementia and confirmed by their spouses.
The social aspect of eating and drinking also changed for many of the participants and, given the importance of social engagement for quality of life it is important to be aware of the effects of changes in eating and drinking on mealtime dynamics. For some it may be that they are now less interested in the social aspect of eating with others at home. Others found it hard to eat out because of distractions and lack of familiarity while some felt embarrassed about eating out in front of strangers. Others still really enjoyed going out for meals but added that they preferred to go somewhere well-known to them. The shared mealtime may be a particularly crucial opportunity for social engagement as it plays a central role in our daily lives. Social relationships are central for not only enhancing quality of life, but also for preventing ill health and decreasing mortality (Maher, 2013).
Almost all the participants talked about how their taste had changed both for food and drink which in turn affected their appetite. Some families had overcome the problem of lack of taste by going for more strongly flavoured food. When asked specifically about drinking, thirst was noted as a significant change since diagnosis
Their feelings about the texture of food did not appear to have changed significantly and was simply a matter of preference.
Three additional health issues which the participants felt were connected with eating and drinking were poorer energy levels than before their diagnosis, reduction in ability to concentrate and changes in sleep patterns.
We are delighted to announce the release of Version 2 of the Talking Mats App
This app has a number of great new features which many of you have been asking for.
There are two new resources – Eating and Drinking – which has 3 main topic sets -Meals, Impact on Health and Things that might help.
The second new resource is Social Care which includes the topics Activities, Where you live and You.
There is an amazing new feature which many people have been asking for. Version 2 allows you to add your own images from your camera roll. This means that you can add you own personalised pictures to any of the topics.
Watch out for next week’s blog when Lois will tell you about her holiday using this new feature!
You can now also reset your password, use the Back button to navigate through the app, delete individual sessions and use the updated report page.
If you have already purchased the gold version of the Talking Mats app you will get all these new features for free.
If you wish to purchase the app please click here or for further information call our office 01786 479511
Recently we delivered two Talking Mats specialist seminars in London:
Talking Mats and the Eating and Drinking resource
Talking Mats and Capacity
Both seminars were very well attended with lots of discussion from a wide range of professionals.
During the Eating and Drinking seminar, we provided background on how and why the resource was developed and showed some DVD examples of people using the resource. This really brought things to life and showed how important it is to give people (with and without speech) the opportunity to consider and talk about different aspects of eating and drinking. We also gave people hands-on practice in using the symbols from each topic. Each participant received a copy of the full resource, including symbols, a mat, and explanatory booklet.
During the Capacity seminar we discussed the fundamental principles the Capacity Act and participants had a chance to consider how Talking Mats can help people to:
weigh up information
communicate their views/wishes and feelings.
They were also given the opportunity to work through some practical examples and think about options to help people understand issues and make decisions.
Whilst developing the eating and drinking resource, we tried it out with people with a range of eating and drinking difficulties. I talked to Ellie, who had swallowing difficulties following a stroke. She found it really helpful to use the mats to think about different aspects of meals (mealtimes, where you eat and the process of eating). Ellie had very good insight into her eating and drinking difficulties and had developed clear strategies to help manage them. She found breakfast and snacks the most difficult meals to manage. She was also very clear that pureed and soft moist foods were the safest and easiest for her. After we had done the mat, Ellie reflected on her eating and drinking, saying that it was limiting but that she could see that things had improved. One of the most difficult things for her was the impact of her swallowing difficulties on some of the social aspects of eating. She really misses going out for a meal with family and friends, something that we often take for granted.
Doing the ‘meals’ mat helped Ellie to see that although she still has many difficulties, mealtimes have become less stressful. For example, although eating and drinking is still a long, slow process, Ellie and her family have adapted to this and now manage ok, especially if they plan ahead. Some useful action points were also identified for the professionals working with Ellie – it would be good for her to have suggestions about a greater range of breakfast options as well as a variety of snacks which she could eat between meals.
Using the mats really helped to clarify the progress that Ellie has made with her eating and drinking since her stroke.