Thank you for your question, those caring for aging loved ones feel your frustration and helplessness and also have struggled with this question as have I as a dietitian in long term care.
It is not uncommon as dementia progresses for adults to stop using utensils for eating.
Because your aunt is in a facility where she is being cared for by skilled staff members, there are a variety of things that can be done by the staff as well as the family. If they are not already doing some of these interventions, then you can suggest that they are attempted.
- Allow her to eat all she wants using her hands, don’t try to change her actions that will only frustrate her. Instead give her more appropriate foods that she can pick up easily without leaving more on herself or the floor. Things such as hard boiled eggs instead of scrambled, wraps, sandwiches, French toast sticks, cooked vegetables such as carrot coins, whole green beans, corn on the cob, apple wedges, orange wedges, bananas, fruit chunks, hamburger patty, hot dog, sausage link, biscuit, muffin, soup from a cup, potato pancake, etc. You get the idea.
- While she is eating her pick up foods, a staff member can be spooning in other foods to complete her nutrition. If she is occupied with feeding herself she will be less likely to fight being fed.
- You as a family member can be the one to help with meal time feedings. You can also bring her foods during your visits that she will enjoy that might not be available from the facility such as soft granola bars/breakfast bars, fresh fruits, etc. You might also want to bring carnation instant breakfast for her when you visit if you are worried about weight loss. Ice cream bars and frozen fruit bars would be a treat too.
- Control distractions during meal times to maintain her focus on her eating skills and bring a clothing protector to keep her clean in case mealtimes become messy. You may also give verbal cues or directions during mealtimes to help your aunt ‘remember’ what to do while eating but this takes time and the staff might be resistant to this approach. Encourage that the dining atmosphere be calm with soothing music playing.
One of the things that dementia does to our loved ones as they age is not only forgetting you but also daily personal care activities such as feeding themselves. Your aunt is probably forgetting what a utensil is, how to hold it and how to bring it to her mouth. You can find alternate ways to get nutrition into her or help her remember how to do it. It is also not uncommon as things progress that she begins forgetting how to swallow too. This is when the disease begins to progress rapidly.
Good luck to you and your family!