In Part 1 we looked at foods to eat. In Part 2 we discussed foods to avoid. And in Part 3 we discussed nutrients and supplements. There are specific issues for people with Parkinson’s that affect the ability to eat and drink at all which we will cover in this section.
People with Parkinson’s tend to demonstrate a kind of withering or dehydration which we refer to in Chinese medicine as yin deficiency. Yet acquiring adequate nutrition in the form of soups, or congees for instance, which would help replenish liquids can be difficult because tremors can cause the food to spill. The effort involved in getting food into one’s mouth can reduce consumption while interfering with socialization and the enjoyment of food.
In early stages of Parkinson’s heavy cutlery will engage the muscles sufficiently so that the resting tremor does not manifest. Normal cutlery will suffice at first while weighted or angled cutlery may be necessary if the hand clenches. Knork knife/forks reduce utensil changes. Rocker knives help with cutting. Spoon shields or covered spoon bowls can reduce spills but can also be embarrassing in public. In later stages other strategies are necessary.
One manufacturer, Lift Labs, has created a spoon that provides computerized movements that counter 70% of the tremor so that it is easier to eat and does not require so much attention. Fork attachments are due to be released.
Heavy dishes or those that tend to grip the table can prevent dishes falling off the table. A silicone or Dycem placemat can also reduce spills. A lip on at least one side of a low bowl can compensate for an inability to scoop properly. Normal family dishes can convert with a clear acrylic plate bumper. And there is no need to resort to plastic disability bowls: an attractive but heavy handmade ceramic bowl or a durable carved wooden flat bowl can provide this functionality while protecting the dignity of the eater.
A study done on Alzheimers patients showed 24% increases in food and 80% increases in drinking with red or blue colored utensils. (Apparently the food tended to be white or light colored and was difficult to discern- eating with a full-colored palate of foods might also help.) If undue weight loss is occurring using adaptive Redware or finding other red or blue dishes might be worth a try. Or use red tablecloths, flowers or accessories to enliven the environment.
Drinking can be accomplished through a cup with a drinking lid or a lid and straw once heavy glasses do not suffice. Starbucks has a steady stream of attractive cups with sippy lids that will allow drinking without spills. Look for heft, a good fit on the lid, preferably screw-on or latching, and a handle if that makes it easier or an ergonomic hand hold. If needed, silicone can be added to the base to enhance stability. Since dysphaghia will eventually limit swallowing large amounts at a time it is good to have one that will not require large gulps (say to load a wide straw.)
Smoothies can be an effective way to get fluids and nutrition into a person with Parkinson’s. They liquify vegetables, fruits and are good carriers of coconut oil, trace mineral concentrate, superfood powders, cooked pumpkin, chlorella, hydrolyzed gelatin, spirulina, incan berry powder, goji powder, and cocoa. Don’t forget yin nourishing foods like cooked okra, eggplant, ophiogon tubers or lily bulbs (the last two available through Kamwo Herbs or Chinese herbal or grocery stores.) Smoothies spill less than thin fluids and can often be sipped without undue attention so that the person can enjoy socializing during meals.
It is important not to infantilize the person with Parkinson’s just because they have reduced abilities to do what for the rest of us are easier activities of daily living. Pay attention to aesthetics. Microfiber dining scarves can substitute for bibs. Choose silverware that looks as normal as possible. In a family setting try to match colors or style so the Parkinson’s member does not feel singled out. Cook food that does not require cutting at the table. Slow cooked meats in liquid are more tender than barbecue and ground meat is easier to cut. Mix some turkey into the stuffing to normalize Thanksgiving or other holiday meals. Pureed soups can be given in a cup. Soft background music at a beat that resonates with the person is less distracting than television and can enhance consumption. Try not to do for them what they can do by themselves, but unobtrusively make sure they are eating enough if the process is slow.