Trends in aging: Senior Gems approach to care based on the Allen Cognitive Disability Theory

By Wendy McHaney
June 13, 2014 at 1:13 a.m.

Today's column continues through the Senior Gems approach to care based on the Allen Cognitive Disability Theory. My previous columns discussed the first four stages - sapphire, diamond, emerald and amber.

This next series of columns will explore mid- to late-stage dementia, also known as the ruby stage. My last column highlighted continence management with a person in the ruby stage, andToday's column addresses address nutrition and health risks for a ruby.

Weight loss is a common occurrence as the disease progresses because of loss in appetite as well as the loss of fine motor skills in the mouth. A ruby may struggle with chewing, which may result in sucking on the item or spitting it back out. Often, they aren't sure what they are supposed to do with the food in their mouth. Swallowing is also more difficult, which can result in choking. It is important to adapt an eating process to meet the ruby's needs:•  Serve smaller-sized bites and softer food.

•  Don't serve liquid and food together because it is difficult to take a bite of food and a swallow of liquid at the same time. A chunky soup can be a choking hazard.

•  Rubies are usually more interested in grazing than they are sitting down to a meal.

•  Since rubies are unable to tell you that they are hungry or thirsty, monitor cues in their behavior.

•  Sense of thirst has diminished, so it is important to make sure a ruby drinks plenty of liquids.

•  Remember that a balanced diet will help prevent weight loss and maintain a healthy immune system.

Health risks become a major concern at this stage. Illnesses, immobility, side effects of medication and lack of proper nutrition can pose risks. It is important to keep a ruby moving and active so as to prevent bed sores, blood clots and infections.Also, be mindful that a ruby's skin has become thin and can easily tear or bruise. The following are ways to help prevent infection:•  Keep teeth and mouth clean.

•  Seek medical attention if you notice any cuts, scrapes or bruises that could lead to infection. Also see a doctor if you notice any pale skin, vomiting, feverish skin or swelling.

•  Look for nonverbal cues, such as wincing, that could indicate pain

Next week's column will begin the series on the final stage of Alzheimer's and dementia, the pearl stage.

Senior Helpers is presenting free workshops and support groups at Copperfield Village, 501 E. Larkspur Drive, from 10:15 to 11:15 a.m. every other Thursday. Call 361-894-8901 for more information about these workshops.

Previous columns on the stages of dementia as well as other trends in aging can be found at

Sources: SH Franchising Senior Gems training materials

Wendy McHaney is a certified senior adviser and the owner and director of operations of Senior Helpers. For more information about Senior Helpers, visit



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