What is an effective way to adequately provide nourishment to a patient with moderate dementia?

When a parent, partner, or someone else you love gets diagnosed with dementia, you want to do everything possible to help them, including their memory, thinking skills, mood, and behavior.

It’s a lot to take in. But there are steps that can help.

These include working with their doctor to treat their dementia symptoms and any other conditions they may have. There are also other kinds of therapies that may help with their daily life. And everyday habits also matter, such as exercise, good nutrition, staying social, doing things that challenge their mind, and getting good sleep.

Medications

No medication can cure dementia. But some may help with some of the symptoms for a time. And doctors may prescribe other meds to treat problems brought on by dementia, such as depression, trouble sleeping, or irritability.

Cholinesterase inhibitors such as donepezil (Aricept), galantamine (Razadyne, Reminyl), and rivastigmine (Exelon) slow the breakdown of a brain chemical involved in memory and judgment.

Memantine (Namenda) helps control a different brain chemical needed for learning and memory. Sometimes doctors prescribe memantine along with donepezil in a combination drug (Namzaric) for moderate to severe dementia.

Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), can improve low mood and irritability.

Anxiolytics such as lorazepam (Ativan) or oxazepam (Serax) can ease anxiety or restlessness.

Antipsychotic medicines such as aripiprazole (Abilify), haloperidol (Haldol), olanzapine (Zyprexa), and risperidone (Risperdal) can help control feelings and behaviors such as aggression, agitation, delusions, or hallucinations.

Therapies

These approaches might help jog your loved one’s memory and thinking skills -- or at least give them pleasure and brighten their day. Make sure anything they try helps their quality of life and doesn’t make them feel frustrated or overwhelmed.

Reminiscence therapy might include things like talking with your loved one about their hometown, school days, work life, or favorite hobbies. It can be done one-on-one or in groups as part of an organized therapy. The person leading the session might use music from your loved one’s past, or things like photos or treasured items, to help.

Cognitive stimulation therapy (CST) is a structured program for groups of people with mild to moderate dementia. At meetings, the group does mentally engaging activities, like talking about current events, singing, playing word games, or cooking from a recipe.

Reality orientation training goes over basic things like the person’s name, and the date and time. They might have signs with that information placed around their home. Some people find this to be too much or even patronizing. If it’s not working for your loved one, drop it.

Lifestyle Changes

Even when someone has dementia, their daily habits can affect how they feel. The same things that are good for their heart and the rest of their body are also going to help their mind -- and their mood.

Stay active. Whether it’s a fitness class for seniors or other physical activity such as walking, dancing, and gardening, it counts. Of course, you’ll want to make sure their workouts are safe for them to do, and their abilities might be different depending on whether they are in the early, middle, or later stages of dementia (and what other conditions they may have). Research shows that exercise may slow down dementia symptoms such as thinking problems, and ease anxiety or depression.

Prioritize good sleep. For many people with dementia, symptoms can be worse later in the day. So encourage a calm routine. It helps for your loved one to avoid caffeinated tea and coffee, especially in the evening, and to limit daytime naps. Keep the end of the day quiet, without a blaring TV.

Focus on foods. What your loved one eats will affect their health, including their brain. Good habits may even have the power to slow dementia. You may have heard of the MIND diet. It combines the traditional Mediterranean diet and the DASH diet (which seeks to lower high blood pressure). It’s being studied as a way to cut the chance of getting dementia. More research is being done to check on that, and whether it curbs dementia that’s already started. But in general, it’s a healthy way of eating that’s in line with communities where dementia tends to be rare.

Researchers say the MIND diet includes:

• Vegetables, especially leafy greens (think of spinach, kale, and other greens)
• Nuts
• Berries
• Beans
• Whole grains
• Fish
• Poultry
• Olive oil
• Wine

The plan limits red meat, butter and stick margarine, cheese, sweets, and fried foods.

Keep in mind that eating isn’t just about nutrients and calories. It’s also social and personal, and a source of enjoyment. If your loved one is able to cook, let them join in. And make sure they are involved in what they eat.

Challenge the brain. This doesn’t have to include doing crossword puzzles or sudoku, unless your loved one enjoys those things and can still do them without getting frustrated. Instead, it might mean revisiting a hobby that person has always loved and is still able to do, like enjoying music, playing the piano, or going to services if they had a longtime place of worship. If these things help them stay social, that’s even better.

Stay organized. Keep a calendar and other easy-to-see reminders around their home to help remember upcoming events and plans.

Rethink the home. You may want to remove items that create clutter and noise (such as extra TVs or radios) and hide things that can be dangerous, such as knives or car keys.

Check Hearing and Vision

Seeing and hearing properly are especially important for someone with dementia. Trouble seeing can make it harder to recognize familiar people or things. Vision or hearing problems can also make dementia symptoms like confusion worse as well as make your loved one feel more alone.

Schedule a vision checkup with your loved one’s eye doctor to see if they need a new eyeglass prescription. Also, ask their primary doctor to refer you to a doctor who can do a hearing test to give them a new hearing aid, if needed.

Counseling and Support

A dementia diagnosis is stressful. If your loved one needs help coming to terms with it, ask the doctor treating their dementia to refer you to a trained mental health professional. (You might also want to do this for yourself, if you’d like help adjusting to their condition.) This might include an individual or family therapist, social worker, psychologist, or psychiatrist. Joining a local or online support group for people with dementia can also be comforting.

At your loved one’s first visit with a counselor, they’ll talk about their symptoms (emotional, mental, and physical) and why they want counseling. You might take a survey with these questions. Your answers will give the counselor a better idea of the best ways to help.