How to get Mom to focus on eating her own meal?

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Mom is obsessed with making sure everyone else eats. She often refuses to eat unless someone else is sitting at the table eating with her.This isn't a problem when there are people around to eat with her, although mom can drive people nuts by obsessing over what or how much or how little they are eating. Not a big deal. The first thing mom will ask someone is whether they've eaten, and often will repeat the question dozens of times. But when no one is around, it's a real problem for her caregivers. The caregivers don't always want to eat at the same time with mom, and when it's near the end of their time with mom, they want to go home and eat with their own families, so eating twice isn't an option. Mom gets angry, refuses to eat her meal, sulks, often goes to her room without eating and her mood goes straight to crap. She gets argumentative and angry when people don't stop what they are doing and eat. Sometimes she will still refuse to eat her own food, keeping watch on everyone else to make sure they eat. Some background: Mom is 88 and has dementia. She still recognizes some people, but suffers from typical confusion, short term memory loss, etc. She is living in her own home and has 24/7 caregivers attending to her needs. Mom has always served others and has trouble being served and she is rarely gracious about it. For as long as I can remember, she spent most family meals hovering over the dinner table and rarely took a seat and ate with us. Her job was to make sure everyone ate, and ate well. She worked as a hospital cafeteria manager for over 30 years, so the "making sure people eat thing" is engrained into both her "home" and "work" personas. She is a Nazi concentration camp survivor and knew starvation all too well -- before, during and after the war. She cannot stand to see these other women cooking in "her" kitchen, but she does realize they are helping her out. She often makes rude remarks to the caregivers, who don't always cook in ways that she likes, and that compounds the situation. I know these situations are rarely unique and someone out there must have encountered this or a similar behavior. I am running out of ways to get her to eat alone, and both caregivers find this the most challenging aspect of caring for mom. Any suggestions or ideas about what we can do, if anything to solve this, and short of a solution. Are we just stuck having to pay for a hired meal companion? At this point, since it's disrupting every single day, that doesn't sound like an unreasonable solution to me. Any thoughts, suggestions, ideas will be greatly appreciated.

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Has your mom ever been to a geriatric psychiatrist for evaluation? It sounds as though the dementia is complicated by some long standing mental issues that MIGHT be ameliorated with an SSRI or SSNI.

I know that there are a great many caregivers from the Phillipines currently in Israel careing to the elderly. I'm wondering if there is any information on line from Israeli websites that address the different cooking styles (grasping at straws here--something like "Easter European Cookery for Caregivers from Manila"). Is there a particular herb or spice that you remember from your childhood that "says" this is mom's cooking to you? I'd get a big supply and ask the caregiver/cooks to sprinkle some into every dish they cook.
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Yes to both. Dietary supplementation is on the agenda for her next appointment. The more immediate problem is the arguing and mood changes that result when people don't immediately respond to her demands to eat. She gets into a serious funk and it takes her a long time to recover from these bouts. Of course, she does not comprehend that people that ate 30 minutes ago don't want to eat again or that people that have plans to eat later, don't want to eat now. If it was just an annoyance, I wouldn't give any of this much thought, but it disrupts her in bad ways, and really turns the household upside down. We may lose both caregivers over this, and it took me so long to get them finally here!
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Is she losing weight? Is her lack of focusing on eating her own food a health issue?
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Thanks, Jeanne, for your post. We have tried your first suggestion about having the caregivers eat a light snack or appetizer with her, but mom was smart enough to see through that one and insisted she eat a full meal. The second suggestions about getting her to talk about her food experiences did work for a while, too. But then she goes right back to "you need to eat". I like your suggestions about the cooking "lessons" for addressing the rudeness and comments about the way the food is being prepared. Mom really enjoyed training new chefs and cafeteria workers, so that might help. I also think if they get her involved in the kitchen, supervising her while handling simple tasks that we know she still can manage, she might be more inclined to sit and eat when it's ready. One of the problems is that she sits nearby in the dining room and watches over them while they prepare her meals, and it's never the way she would do it for herself. Food Service was her profession, and she was really good at it, and she still know good cooking when she sees, smells and tastes it. I've spent a lot of time trying to train the caregivers to prepare her meals the way mom likes them, but there's a cultural barrier that no one wants to address here, too, and it is reflected in the style and manner of cooking the caregivers use (they are from the South Pacific). They are frankly, not very good cooks. If the caregivers weren't so good at everything else, we'd replace them, but that would start an entirely new problem for mom -- getting used to a group of new women "fooling around" in her kitchen...
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Well, it is easy to see where the obsession comes from, isn't it?

I wonder if it would work if the caregiver joined her and ate a small appetizer and talked in detail about what she was going to eat with her own family. Mom wants to know that no one is starving and maybe that would be reassuring. Maybe they could talk recipes. "I'm making macaroni and cheese for my family tonight. When you made that, did you put a bread crumb topping on it? What vegetable do you think is best with mac and cheese?" Etc. If she is conversational, perhaps they could get her to talk about her cooking history. Outside of the hospital, what is the most people she ever cooked for? What did she make? What were usual breakfasts for her family? Just anything at all to get her talking about her past and her obsession.

While they are cooking for her, is it possible they could take some of her advice? Probably not all of it, but if they could honor one thing and then thank her and point out how well that turned out and tell her they are glad to have learned something new from her. I think I would be pretty irritated if someone with dementia was criticizing my cooking skills, but they are getting paid to do this and if they could treat her as a "teacher" with many years of experience, that might lessen the rude remarks.

I haven't dealt with this kind of obsession, so I'm just grasping at straws. If you do come up with things that help, please share. We learn from each other.
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