
Easy eating with cognitive problems
Cognition refers to how a person processes and uses information. 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 cognitive impairment, the following strategies might help to make mealtimes easier.
If their swallowing problems are caused by something other than 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 to six small meals rather than three larger ones. Let them eat when they're 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 – they may find it easier with smaller cutlery to decrease the size of each mouthful
- 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're helping holds food in their mouth for too long, try serving foods that may help prompt them to swallow, such as sweet, sour or spicy, or 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, and offer smaller cutlery, such as a teaspoon, 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 can't 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 that 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 being unable to clear their mouth or coughing
- 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. Please talk to your speech-language therapist if you have any questions or concerns.
You may also want to access private specialist help.
Written by community speech-language therapists. Adapted by HealthInfo clinical advisers. Last reviewed October 2020.
Sources
The information in this section comes from the following sources, some of which may be clinically complex or not available to the general public
Canterbury DHB Speech-language Therapy – Allied Health:
Aphasia: patient information. Strategies for you (the person with aphasia), Ref 2980, January 2011
Aphasia: strategies for communication partners; Ref 2979, January 2011
Apraxia of Speech: Strategies for you and your communication partners; Ref 2982, January 2011
Oral hygiene & saliva management; Ref: 2987, January 2011
Safe Feeding Practices: Information for caregivers; Ref 2988, January 2011
What is aphasia? (a-fay-zee-a), Ref 2981, January 2011
What is Apraxia of Speech?; Ref 2983, January 2011
What is dysarthria? Ref 2984, January 2011
What is dysarthria? Patient information, Ref 2978, January 2011
Page reference: 121982
Review key: HISWD-121957