DEMENTIA


is possible that Korsakoff’s syndrome may be underdiagnosed in the UK.


Scientific research has not yet shown how Korsakoff’s syndrome damages the brain, though researchers have found several genetic variations which may increase susceptibility of the syndrome, as well as poor nutrition.


“Whilst removing a type of food might have shown a potential link in slowing down the


decline in one person’s dementia, in another it could trigger memories, give them confidence to talk on a subject from their past and help them feel less alone and confused.”


ADAPTING THE DIET


For Korsakoff’s syndrome patients, it is vital that food plans are continually reviewed due to its associations with poor nutrition and malabsorption. Aligned with expected nutritional difficulties, and while residents are reviewed on a case-by-case basis, it is common for residents to require a liquid or pureed diet.


In many instances, it is not the inability to chew that has led to the recommendations of a liquid or puree diet, but rather the risk of choking due to insufficient chewing.


Physiologically, the muscles and jaw have the capacity to break the food down appropriately, but psychologically the resident may lack capacity to do this in a safe and consistent manner.


The form which food takes is not the only consideration for care staff. With an increased focus on person-centred care from residents, their families and CQC regulators, it is imperative that care staff are continually working to deliver the right menus that also appeal to individual’s tastes and preferences.


There is the balancing act of providing appealing, nutritional food which is presented in the appropriate form for the resident, whilst also acknowledging that the smell, texture and form of the food can evoke memories and emotions for individuals.


The potential for foods to remind a person of previous experiences and moments is intrinsic to that individual, reinforcing the need to adopt a tailored approach for each person, rather than offering a single menu designed for all dementia service users.


Whilst removing a type of food might have shown a potential link in slowing down the decline in one person’s dementia, in another it could trigger memories, give them confidence to talk on a subject from their past and help them feel less alone and confused.


This level of understanding of an individual and their triggers is central to our care and the evolving regulatory environment. Without there being widespread evidence highlighting a


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profound impact in the delay of deterioration in dementia patients, it is unlikely that there will be additional dietary recommendations introduced for dementia patients in the short term.


However, while this may be the case, care staff, community dietitians and speech and language teams will continue to review the nutrition patients require which will support their quality of life.


For people with Korsakoff’s syndrome, this involves providing a menu which is rich in thiamine to help support the management of symptoms caused by a deficiency (while noting that there may be other underlying causes due to there being little understanding of how Korsakoff’s syndrome damages the brain).


In this instance, we would consider menus which feature yeast, cereal grains, beans, nuts and meat at the right levels for the patient in question, considering any food preferences or allergens as appropriate.


However, due to Korsakoff’s syndrome oſten being entwined with - and developing as a response to - other disorders and diseases, the diet and nutritional research surrounding the other comorbidities will also be considered by care staff and community teams when developing their food plans.


The complexity of the variables and considerations made by care teams will, at times, be difficult for families to understand and, as such, it is the responsibility of care home providers to empower their teams to build positive, long-lasting relationships with the families and residents.


The positive relationship between the families and care staff is imperative for residents with degenerative illnesses, such as dementia in particular. The arrival of a resident with no or little capacity can lead to their families feeling increasing pressure to make the right decision on behalf of their family member and, in some cases, feel that they need to challenge the care package being delivered.


“The positive relationship between the families and care staff is imperative for residents with


degenerative illnesses, such as dementia in particular.”


In these instances, it is the empathetic, compassionate approach of care staff, along with appropriate, understandable communication which helps families and care staff alike navigate challenging situations. Only then can they work together to support the care of the person central to their relationship; the resident.


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