Michael was once an epicure, not only enjoying a fine bottle of wine and a sumptuous meal, but also no slouch in the kitchen. When I met him he even had a subscription to a magazine dedicated to fine cuisine. My own cooking style leans toward the staples: casseroles, whole foods, child-friendly meals. His cookbook of choice: "The Playboy Gourmet" (with no reflection on his sexual proclivities). Mine: "Whole Foods for the Whole Family" published by the La Leche League, and "Diet For a Small Planet", the hippie cooking bible of the '70's. Worlds apart, as you can see, but it made for great variety in our early days of eating together, each of us appreciating the other's style...usually.
I'm not sure if this is common in all cases of dementia but with Michael I have seen an enormous change in his tastes. A big part of my job is to ensure he has a nutritious diet that pays special attention to his numerous issues: lots of fibre for the ever-so-sluggish bowels, and careful amounts of fats and salt for his heart condition. There is also a need to pump the fluids, sometimes a challenge with a man whose beverage of choice used to be coke or ginger beer, never water.
Mealtime for Michael is haphazard. Sometimes he is well enough to eat, sometimes not. There are periods of time, during a prolonged episode of mania and psychosis, when he will not eat, at least not very much. Severe bouts of constipation can also interfere with his appetite. This is when I must focus on getting calories alone into him without paying as much attention to quality. At these times he seems to revert to what I call kid food: cans of Chef Boyardee Ravioli, peanut butter sandwiches, small yogurt cups, porridge, hot dogs, pepperoni sticks, pizza, tuna casserole. If I had the energy to create the kind of gourmet meal he used to enjoy, maybe he'd actually eat it. We'll never know. Instead, because of my own recent dietary restrictions, I've been producing a lot of hearty soups and low fat delicacies, none of which are at all appealing to him. And vegetables? The closest he gets to that these days comes in a jar or bottle to go on top of his hot dog. Colour, yes. Nutrition, not so much.
Then there are the days when he forgets how to feed himself. Not frequent - yet - but difficult when it happens. I must step in and spoon-feed him, or, at the very least, cut up his food and demonstrate how to feed himself.
But today there was a new wrinkle. On serving him his scrambled eggs and raisin toast, he pushed himself away from the table. When I asked what he needed, he announced, "Ketchup." Michael has never had ketchup on his scrambled eggs, I quickly reminded him, but he was adamant. Okay, ketchup it is. When he got it into his hands he started to squirt it over everything, including the sweet toast. I don't know why I bothered but I let out a little shriek to stop him (as if it really matters that he wants ketchup on his toast). He looked at me defiantly and articulated as clearly as the Mad Hatter, "But I've always eaten my toast with ketchup."
Hard to argue with that logic. For the record: He ate all his breakfast and even added more ketchup to his toast before he was finished.
* John Tenniel's illustration from Lewis Carroll's, "Alice's Adventures in Wonderland", 1865.