There’s breakfast, lunch and dinner—those are the mealtime standards. Then there are the more unconventional options—brunch, tea time, midnight snacks and more. With all the choices we have about what to eat, when to eat and who to eat with, it’s no surprise that it gets confusing at times, even for our own digestive systems! However, when someone with dementia starts getting confused about what meals to eat, starts skipping standard mealtimes, or seems disoriented at the dinner table—it’s a signal that the symptoms of their condition may be at play. It’s also a red flag to caregivers to dig a little deeper in trying to uncover the causes for their mealtime confusion. 

As I always advise, digging deeper starts by asking the key question- ‘Why?’  In the case of a gentleman named “George”, who had dementia, this simple question posed by his wife “Anne” led to a solution to his mealtime challenges. Before Anne cracked the code, George had been confused about what meals to order at the retirement home. Whenever lunch or dinner time came around, he would ask his wife what she was ordering, relying on her to dictate his choice of food. Anne was worried about why George seemed so anxious when it came to deciding what to eat. ‘Is he having trouble with his eyesight?’ she wondered, ‘Or is he unable to comprehend what he’s reading on the menu due to a deterioration in his cognitive abilities?’  

By asking questions and observing George’s behaviour, she soon discovered that his confusion stemmed from his inability to discern whether it was lunch or dinner. Even if he could read the menu and understand it, he didn’t know whether to order the lunch items or the dinner items. Anne also realized that George was embarrassed about asking his table mates for help. 

Armed with a better understanding, Anne took action. Anne started to reminded George about what meal they would be having as they left their room, but due to George’s short-term memory loss, using cues at the dining table proved the more effective tactic.  She started using cues at the dining table to send subtle hints to George about what meal it was. For example, at dinner time she would say “Hmmm, what do I want for dinner?” or “Honey, what do you feel like having for dinner tonight?” Non-verbal cues, such as pointing to the dinner side of the menu, also helped.  

By understanding that there is always a reason behind a challenging dementia-related behaviour, Anne found a way of helping her husband, while still supporting his sense of confidence and respecting his independence. Moving forward, mealtime for George and Anne was no longer a time to fear embarrassment or feel confused, but rather a time to enjoy a meal, an interesting conversation and each other’s company.