HealthInfo Canterbury
Easy eating with thinking or memory difficulties (cognitive impairment)
Te kainga ngāwari me ngā raru ā-roro
Cognitive impairment means a person has trouble remembering, learning new things, concentrating or making decisions. It can range from mild to serious, and often happens after a stroke or brain injury or with dementia.
If you care for someone who has these difficulties, the following strategies might make mealtimes easier.
If their swallowing problems are not due to cognitive impairment, see Safe eating and drinking.
Helping someone eat and drink safely
Offer meals at regular times of the day. The person may find it easier with five or six small meals rather than three larger ones. Let them eat when they are hungry.
Try to prepare familiar foods in familiar ways, especially their favourite foods.
Set up the table so they are looking at someone else eating, as this may remind them to eat and swallow.
Make sure:
- they are seated upright
- they are not sleepy or tired
- any distractions are removed (turn off the radio or TV, limit visitors, close the door)
- they can see the food and drink
- they have their special cup or cutlery
- you present one food item at a time – main, then dessert, then a drink
- you encourage them to feed themselves whenever possible. You can help by putting your hand over theirs
- you remind them to follow any guidelines given by the speech-language therapist.
If the person you are helping holds food in their mouth for too long, try serving foods that may help to prompt them to swallow. These may include sweet, sour, spicy, hot or cold foods. Be careful with hot food, though.
If they are eating too quickly, remind them to slow down. Encourage them to put their spoon or fork down on the plate between mouthfuls. Offering them smaller cutlery, such as a teaspoon can help to reduce the size of each mouthful.
Feeding someone safely
If you need to feed the person, first follow the advice above.
When you are feeding them:
- sit in front of them (rather than to the side)
- if they cannot see the food or liquid, describe what they are eating or drinking, ask "Are you ready?" and tell them when you are giving them another mouthful
- make sure they have swallowed each mouthful before offering another. You can watch to see if their Adam's apple has risen and fallen or check that the food has gone from their mouth
- allow time for them to swallow more than once
- use a teaspoon if they can only have small mouthfuls
- stop feeding them if they become tired, sleepy or have any difficulties, such as coughing or being unable to clear their mouth
- make sure their mouth is clear and clean after meals. You may need to clean their teeth and mouth.
There are many different strategies to make eating and drinking safer. Talk to your speech-language therapist if you have any questions or concerns.
You may also want to access private specialist help.
Written by speech-language therapists, Te Whatu Ora – Health New Zealand Waitaha Canterbury. Adapted by HealthInfo clinical advisers. Last reviewed July 2023.
SourcesReview key: HISWD-121957
