Dining Out:
An Experience for the Person with Alzheimer’s Disease
 Enjoying a meal at any occasion can become stressful for many of those affected by Alzheimer’s disease. From in-home meals to family occasions and restaurant dining, ensuring that the environment is one that encourages meal consumption and is pleasant for all can be challenging.
For the caregiver and the person with dementia (PWD),
the act of dining anywhere is not only for nutrient intake
but also because of the pleasure and enjoyment that results
from dining out.
Ensuring a positive mealtime experience for persons
with Alzheimer’s disease will depend on many factors,
such as the stage of the disease, the dining environment,
and experience of the caregiver.1 During the early stage
of the disease, only minor eating problems may be exhibited. 2 This may be the most appropriate time to take the
Alzheimer’s patient to dine away from home.
As the disease progresses, the person with Alzheimer’s
disease may have increasing difficulty maintaining normal
behaviors that are appropriate for social situations. For
family caregivers of the person with Alzheimer’s disease,
it may be even more difficult to manage because of limited
knowledge, limited skills and coping mechanisms
and guilt.3 It is therefore important for the caregiver
who is contemplating taking a family member out to
dine to get some information so that the experience is
less stressful. Most behavioral problems will require the
caregiver to modify the environment and change communication
styles.4
Helpful tips when taking the person with AD out to
dine:
- Find a few special restaurants to visit regularly. A
familiar environment will help make dining out more
enjoyable.5
- Select restaurants where the staff are sympathetic to
the elderly and are willing to make adjustments. Make
sure that they are aware of the disease so they won't be
startled by an odd comment or question.5 The NYC
Chapter provides cards that can be given to staff, saying “Please be patient, the person with me has Alzheimer’s
disease, and may require a few extra moments.”
- Go early before the hectic dinner crowd arrives.5
- Choose restaurants
with soft,
soothing music
and a quiet dining
room. Dining
room environment such as color, light, sound,
aroma, and touch are significant environmental factors
that affect physical and emotional health and well
being of the person with Alzheimer’s disease. Loud
music or ambient noise can disorient and upset someone
with mid- or late-stage Alzheimer’s disease.5
- If the restaurant offers a busy buffet, go on off nights
and always accompany your family member to the
buffet so he/she won't get lost or confused.5
- Allow them to order for themselves if able, but be ready
to make suggestions from the menu if necessary. One
solution is to order for the entire table. This ensures
that the person is not put on the spot to remember.5
- Avoid introducing new dishes or ethnic foods unless
it is a special request.5
- Assist with food set-up such as cutting meat or adding
condiments and provide familiar feeding utensils
if necessary. An unfamiliar setting combined with
preparing food can cause increased confusion.5
- Keep the conversation flowing to avoid distractions.
Discuss appropriate topics of conversation that the
person can be included in. Reminiscing is always a
good conversation starter.5
- If the person becomes agitated or upset at something
he/she sees or hears while dining out, quickly distract
them with a question or comment that draws the conversation
back to the present. If the problem persists,
ask your server to move you to a quieter part of the
restaurant. Noise and glare significantly impact comfort
levels. This should be a relaxed, environment.5
- End the meal at a reasonable hour. Fatigue can exacerbate
some Alzheimer-related personality changes.5
Learning eating behavior management techniques may help to minimize the effects of problem behaviors. This will allow caregivers to better understand how to respond when the person with Alzheimer’s reacts. Learning
how to deal with the behavior of the PWD will also
improve the caregiver’s quality of life and decrease their
overall stress level.
This is the second in a series of articles on the nutritional
and feeding needs of persons with AD. If you
have specific nutritional questions, please submit them
to Patricia Slinger-Harvey at Pslinger@GLWD.org or Jlevine@alznyc.org.
—Patricia Slinger-Harvey, MPH, RD, CDN &
Sonia Grant, MA, RD, CDN of God’s Love We Deliver
1 McDaniel et al. American Journal of Alzheimer’s disease and Other Dementias. Sept/Oct 2001. 16(5): 297-302.
2 Tully et al. The Journal of Nutrition, Health & Aging. 1998. 2(2);119-121.
3 Riviere et al. The Journal of Nutrition, Health & Aging. 2001. 5(4):295-299.
4 Russell et al. Alzheimer’s Care. March 2006. http:www.healthguide.org/elder/alzheimers_behavior
5 Lavoie-vaughan et al. July 2004. http:www.moaa.org/todaysofficer/
God’s Love We Deliver, (GLWD), a non-profit agency in NYC, provides meals to men, women & children affected by HIV/AIDS, Cancer, AD and many other serious illnesses who are unable to shop or prepare meals for themselves. The agency’s team of experienced nutritionists also provides nutrition education, information and counseling in individual & group sessions to clients, their caregivers & other service providers.
Patricia Slinger-Harvey is the Director of Nutrition Services at GLWD and Sonia Grant is a staff Nutritionist. For individualized nutrition information, the nutrition department of GLWD can be reached at 212.284.8103/800.747.2023 or by visiting www.godslovewedeliver.org.
— Amanda Leis
Manager, Care Consultation
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