Healthy nutrition for the patient

This is Number 18 in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years.

Even though the patient has Alzheimer’s we as caregivers cannot neglect their diet and food intake. Proper nutrition can help to prevent other medical and health issues. In this article we shall discuss how we have tried to keep Barbara healthy from a nutrition point of view.

Prior to Barbara becoming caught up in this disease we used to eat out frequently. Barbara enjoyed seafood such as lobsters, fried clams, French fries, fried onion rings, fish and chips, fried calamari, and many kinds of fish cooked in different ways, be they fried, broiled, or baked. Much of this was restaurant food and generally salty, greasy, and not always cooked with good health in mind. In November of 2002 I required prostate surgery and I weighed two hundred and two pounds. This was about the time that Barbara started to show strong signs of her dementia, so-called at that time, and she weighed about one hundred forty pounds. Her married weight in 1957 was one hundred eight pounds and mine was one hundred fifty-five pounds. The bright light went off in my head saying this is crazy for both of us so I decided it was time to stop going out to eat during the week and on weekends and start cooking at home. We stopped all fried and greasy foods completely. Over the period of the next couple of years I lost forty-two pounds and Barbara lost twenty pounds. I believe that the bulk of that weight we lost was from the fried foods. Barbara starting walking at the walk path at Memorial Beach in Webster and I began riding a stationary bike at home each day for four miles, which I’m sure also helped.

We stopped eating all beef products and turned more to chicken, turkey, pork, fish, and ham occasionally for the holidays. Primarily we have meatloaf, stuffed peppers, shepherds pie, spaghetti and meatballs, fish, scallops, and soups made at home from chicken or turkey bones. All of the ground meat is turkey burger which is 93/7 for fat content, for any of the main dishes. We also on occasion have buffalo meat in the form of a roast, stew meat, or burgers. The meat is lean and has less fat content. Fish can be a variety of salmon, halibut, fluke, striper, cod, or flounder. The meals are prepared either on the stove-top, in the oven, microwave, or crock pot. Side dishes consist of vegetables such as carrots, beans, peas, broccoli, cauliflower, corn, potatoes, rice, or squash.

I try to buy as many of the vegetables, if canned, with no added salt. I do not use any salt in any of the cooking I do at the house nor do we salt any of the food we eat. It’s my opinion that there is enough natural salt in all the other products that we eat.

When I cook anything requiring oil, which is not too frequent, I use the Smart Balance brand. I also use that brand of light butter, peanut butter, mayonnaise, and spray oil. For cheese I use the Smart Beat brand which is fat, cholesterol, and lactose free. I continually watch for fat free and low cholesterol products. When I buy Town House crackers, Wheat Thins, or Triscuits for myself, and Barbara her Vienna Fingers, they are all reduced-fat. I also purchase reduced-fat grated cheese for use on spaghetti or other foods.

With all of the above said, two of Barbara’s meals are the same every day. She used to eat this way prior to her disease and I’ve just kept the same schedule that she had. Her breakfast consists of a cup of Cheerios with Lactose milk, a cup of tea, and a half cup of cranberry juice. Prior to Barbara waking up I put milk into the bowl of Cheerios to soften the cereal for her. She is able to chew it easier in this manner. The juice is used as an aid to help as a preventative for a UTI (Urinary Tract Infection).

Her lunch consists of two graham crackers with marshmallow and peanut butter pre-mixed with applesauce. The applesauce is to give the peanut butter a looser consistency. She then has one Vienna Fingers cookie. I break up the graham crackers into small pieces and Barbara takes two or three bites out of that piece. This way she is able to chew it slowly and not gag. After each small piece, which is about an inch square, I give Barbara some milk to help “wash it down.” In this manner she will consume one or two glasses of her Lactose milk.

The dinner meal, which we both share, can consist of any of the items I mention six paragraphs above. The dinner meal for Barbara has been blended since May of 2009. In the early stages of Barbara’s disease I used to cut her meats and other food up into small pieces, but it got to a point where she would chew her food into a round ball and pocket it into her left cheek. I had a fear that if she swallowed that ball of food it would choke her. No matter what the main meal is, it goes into the blender with the vegetables or other side dish that is prepared, and I also add a slice of wheat bread as well. I use water as a liquid for ease in blending all of the food to a pasty consistency. I feed Barbara about a half teaspoon at a time and each meal takes about forty minutes to feed her. She has a glass or two of the Lactose milk and usually a half cup of yogurt, which is another aid to help counteract a UTI, or I give her some other after dinner foods such as jell-o, chocolate pudding, peaches, angel cake in a bowl with milk to make it soft, or a little applesauce.

Prior to going to bed each night Barbara has a half cup of a smoothie which I make for her. It may consist of apples, pears, peaches, plums, bananas, grapes, melons, strawberries, blueberries, or yogurt. For a liquid I use cranberry juice or orange juice. All of the ingredients are very healthy for Barbara. The smoothie also helps to keep Barbara’s digestive system working properly so that she does not get constipated. In her state of mind now and not being able to speak, she cannot tell me if she’s constipated and ask for a laxative to help move her bowels. The process that I am using now takes care of this issue.

Protein is an important factor for the patient’s well-being. For a 2000 calorie diet one should have about 50 to 60 grams of protein per day. Other vitamins are essential and the patient or caregiver should consult with the doctor for the needs of each individual.

(The Alzheimer’s Caregivers Support Group meets every second Monday of the month from 6:15 p.m. To 7:45 p.m., at the Accord Adult Daycare Center, 10 Cudworth Road, Webster.)