Dennis and Christine

Christine Robinson and Dennis Nosko of Boston’s A Fresh Endeavor Personal Chef Service have long focused on creating healthy meals for their Massachusetts clients. That includes working with families living with dementia. As the population ages and diseases like Alzheimer’s, Lewy Body dementia, Vascular dementia, and others are on the rise, personal chefs like Christine and Dennis can provide a foundation for enabling patients to stay healthy and stay home longer, while also helping caregivers, who live with the stress and anxiety of constantly caring for a declining spouse or parent, with nutritious meals and one less responsibility.

We asked Christine and Dennis to share their experience of serving clients with dementia and their advice is spot on.

Over the years we have had several clients with memory impairment. One of the main concerns of the family is generally how to keep a loved one in their own home for as long as possible, as long as the care level is up to par. 

Food and proper nutrition is a huge component in a dementia patient’s quality of life. Balanced meals can allow physical and emotional health to improve. That’s where personal chefs come in. But it is NOT an easy task and it may not be for you. However, for those who feel up to the challenge, you can make a huge difference in the life of a family dealing with dementia. 

When clients contact us to work with their family members with dementia, it is usually the children, hoping to keep their parents in their own home. Many times they’re out of state and this can pose some logistical questions. You need to figure out who is the “point” person and make one source of contact so that there is less confusion. We find that there is usually a family member who has good information about the physical health of the actual client and that is generally the person with whom you want to deal.

We always try to make the food all about the client recipient, following any dietary restrictions but making food they seem to enjoy. Keeping them fed is most important.

Not every job works out. You can have a spouse who does not want the service, or the person with dementia does not want other people around. In these cases, you have to evaluate if you are doing more harm than good. While there is no clear cut answer for every case, you want to err on the side of what will keep the client the happiest, even if it means ending the cooking relationship, recommending someone else, or even cooking at a close relative’s home for them to deliver.

Here’s what we recommend when taking on a family with a member who has dementia:

1) Establish whether another person coming into the home is going to be a benefit or a distraction. In-home meal service can either be a huge help or a stranger in the house can cause the family member with dementia extra stress…find out how they would respond. Many times a new person in the mix doing something different can be a welcome thing…but don’t be afraid to ask up front. Also test the waters to make sure how the other family members living in the house, usually a spouse, are going to feel about more help…the dignity and wishes of both parties are equally important.

2) Conduct a thorough client assessment, hopefully in person, and with a caregiver or family member other than the spouse present. Learn what type of dementia the loved one has–it could be Alzheimer’s, but it could also be any number of other types of dementia, which have different symptoms and progression. You can learn more about them on the Alzheimer’s Association website. Find out about medications and other health conditions that can be helped or exacerbated by certain foods. Cranberry juice, leafy greens, and flaxseed, for instance, do not go well with coumadin and other blood thinners. Make sure that any family members seeking your service are provided with copies of the assessment. Seeds, nuts, gassy vegetables, onions, and acidic foods should be explored on paper and in reality. Repeat favorites and get rid of textures that are not working. As the disease progresses and medications change, you will have to revisit this to make adjustments. 

3) Pay close attention to textures and tastes. Something as simple as a blueberry skin can be a distraction and texture issue for a patient. Have any caregivers/family members keep track of favorite items, but especially items that are not being eaten. Sometimes a switch from a ground meat to a solid piece can make all the difference. Sometimes, as the disease progresses swallowing becomes more difficult and textures become crucial so patients don’t aspirate food. But each person is different. Keep notes and be amenable to changes. This is not a time to be the creative chef, but to listen closely to a client’s needs.

4) Pay attention to the spouse and his/her likes and dislikes. Many times the person without dementia is the lesser focus. They are going through a difficult time seeing the love of their life slip into unknown territory. Ask about their favorites. Make a treat just for them. Talk to them. So much conversation is focused on the patient that the other person can feel left out, especially if the kids are spearheading the need for the personal chef. Everyone counts and should be part of the experience.

5) Expect that these cook dates will probably take extra time. Plan for it and expect to talk. Take advantage of the moments of lucidity and talk to the client about stories and what they may suddenly be remembering. Be prepared for the opposite as well, when they ask the same question repeatedly or talk to you as if you were a family member no longer with them. Ask their caregiver the best way to respond. Often, it’s just to go along with them and their conversation without correcting them.

6) Don’t try to become the savior. At the stage you are entering their lives, there is rarely a turnaround and no special meatloaf or spice combo is going to be the cure all. Enhance for nutrients where you can, and ask the family if there are any holistic things they want to try, such as cooking with coconut oil, or grassfed meats. As long as it does no harm, take their lead.

7) Expect that you will cry after more than one cook date.

8) Expect that you will get some great, funny, wonderful stories when they talk to you.

9) Don’t be offended by anything that the client may say to you. Dementia works in odd ways and people who would never use coarse language can come up with some doozies. It is part of the condition and please realize it is NOT directed at you.

10) Be flexible and compassionate. Anticipate that things can change on a daily basis and you may be making more or less food as needs fluctuate.

This is a hard job, not for everyone. But cooking for these families can be the most rewarding job. You really can make a difference but don’t enter into it without realizing that a part of your heart will forever hold these families as very dear.

Have you been cooking for clients with dementia? What has your experience been?

Not an APPCA member? Now’s the perfect time to join! Go to personalchef.com to learn about all the benefits that come with membership.

And if you are a member and have a special talent to share on this blog, let us know so we can feature you!

Be Sociable, Share!
Caron Golden

About 

Founder of premier organization of personal chefs inspires students to follow their dreams of culinary entrepreneurship.

Candy Wallace, executive director of the American Personal & Private Chef Association (APPCA), today was recognized by Sullivan University’s National Center for Hospitality Studies as its 33rd Distinguished Guest Chef.

2 Comments »

  1. Christine has covered the subject thoroughly. It can be a very rewarding job. The process can be tedious at times, but the results are usually very much appreciated by the caregivers. I cooked for a 90+ couple where the wife’s dementia was very advanced. There were full-time aides on the staff. I would have to unload my kit and groceries to the front door before going in for two reasons. She would become very agitated whenever anyone would arrive at the front door. The aide would take her into her bedroom and close the door, as she was always a flight risk! The house was located in a secluded, woodsy area overlooking Long Island Sound.
    She could be heard saying she didn’t want anyone in the house, she didn’t care who or why, etc. Once I was set up in the kitchen they’d bring her out to the living area. When the aide would make her lunch the client would sit at the kitchen table and rave about what a great job I was doing preparing their meals. And always left the room saying she hoped to see me again, but of course didn’t remember me the next time I was there. After a year of cooking for them she became physically violent to the husband and the aides and was placed in a Nursing Home. The aide who took him to work in the Diamond Industry every day cooked for him until he became too ill to stay at home.

    Comment by Chef Jim — December 6, 2016 @ 11:05 am

  2. Caron Golden

    It can be so heartbreaking to witness dementia patients deteriorate. Those of you who participate in their care through providing meals are very special. Thanks for sharing your experience, Jim!

    Comment by Caron Golden — December 9, 2016 @ 4:37 pm

RSS feed for comments on this post. TrackBack URL

Leave a comment