Did you know that as Alzheimer’s disease progresses, a person often loses fine motor skills before they lose strength in their hands? Combine that with the return of the palmar reflex—a reflex we’re born with but typically outgrow—and mealtimes can become a challenging experience for both the individual and their caregiver.

In this blog, we’ll explore two critical changes in touch caused by dementia and share four practical strategies to make mealtimes more manageable and meaningful.

Changes in Touch That Impact Mealtimes

1. The Return of the Palmar Reflex:
Have you ever shaken hands with someone living with advanced dementia and noticed their strong grip? This is due to the palmar reflex—a natural reflex in infants that reappears in late-stage dementia. This can make interactions like handshakes and using utensils tricky.

2. Loss of Fine Motor Skills:
Dementia impacts a person’s ability to use their “skill fingers” (thumb, index, and middle finger) needed for holding utensils. This loss can lead to dropped food, difficulty gripping a fork or spoon, and missed bites.

Four Strategies to Improve Mealtimes

1. The Overhand Technique:
For individuals who can still use utensils but need guidance, gently place your hand over theirs to help guide the utensil from the plate to their mouth. This method allows them to stay engaged in feeding themselves while receiving needed support.

2. Switch to Finger Foods:
If utensils become too challenging, switch to foods that are easy to pick up with the hands. Think small sandwiches, vegetable sticks, cheese cubes, or other bite-sized items. However, this approach works only if the individual can still use their “skill fingers.”

3. Spill-Proof Cups with Handles:
For those struggling to hold a cup, consider spill-proof cups with handles. These are easy to grip and reduce the effort required to drink independently. Cups with handles on both sides can be especially helpful.

4. The Underhand Technique:
This is a game-changer for caregivers and individuals alike. Instead of a traditional handshake or grip, use an underhand approach to guide their movements. This method prevents the caregiver from getting hurt while compensating for the individual’s loss of fine motor skills. Using your “skill fingers,” you can hold the utensil while guiding their hand toward their mouth, keeping them actively involved in eating.

Why These Techniques Matter

Sensory changes in dementia, like those impacting touch, can increase the risk of malnutrition, weight loss, and stress during meals. By using tools like adaptive utensils, finger foods, and techniques like overhand or underhand feeding, we can create a more positive and supportive dining experience. Mealtimes can transform from frustrating to moments of connection and care.

If you’d like to dive deeper into managing mealtime challenges for loved ones with dementia, check out my new course, Managing Meals and Eating Challenges. You can also grab the accompanying ebook for quick, accessible solutions. Visit melissabphd.com/courses to learn more.