How Dementia Affects One’s Ability to Eat and Caregiver Suggestions to Encourage Eating

Last Updated: August 30, 2018

For people with Alzheimer’s disease or a related dementia, mealtime can become a complicated and even frustrating event, especially as their memories and coordination deteriorate. Meals are important to not only satisfy hunger, but also to provide an opportunity to slow down, be with others, and socialize. Therefore, it is important to understand how you can best help your loved one meet these needs according to his or her current capabilities.


The Stages of Dementia & an Individual’s Capability to Eat

In earlier stages of dementia, your loved one may be able to eat a meal without any problems. However, you may find that he or she needs help with tasks that have multiple steps, such as assembling a sandwich or perhaps making a salad. You can schedule simpler meals or you can simply offer to help your loved one with these more complicated tasks.

Your loved one may eventually become “messy” at meal time, playing with, or picking at, his / her food. Your loved one may also start getting upset when dining out at a restaurant or when staying in. It is important to recognize that these actions are often signs that he or she is feeling frustrated. This may be due to the inability to use utensils or even remember how to eat and drink. You may also find that your loved one does not seem to be interested in the food that is on the plate or that he or she does not appear to be hungry. This may be because he or she is feeling less able to self-feed.

In later stages of dementia, the ability to swallow becomes compromised and care must be used to avoid food or beverages getting into the airway or lungs, which can cause pneumonia. Eventually, you may have to remind your loved one to chew and even to swallow.


Appetite and Dementia

It’s not uncommon for persons with dementia to have a poor appetite, resulting in weight loss, as the disease progresses. If your loved one is not eating a sufficient amount of food, there are several reasons why this might be happening. Dentures that don’t fit correctly can cause pain while eating, and hence, an avoidance of doing so. Certain medications can also cause a decrease in appetite, as can not getting enough exercise. In addition, a person with dementia’s capability to smell and taste food might be diminished, resulting in he / she not feeling the urge to eat.

To encourage eating, prepare foods that are favorites of your loved one, serve frequent small meals, set out snacks in clear view, and encourage physical activity. If multiple meals are too difficult to plan, consider serving high-calorie beverages or breakfast drinks. Also, consider visiting a nutritionist or dietician for help understanding what nutritional needs your loved one might have and for meal suggestions and / or plans. If issues with poor appetite continue, seek advice from a physician.


Suggestions for Caregivers

The following suggestions are all intended to encourage your loved one to eat and to make meal times less stressful, frustrating, and difficult:

Reduce noise in the dining environment
It can be difficult and upsetting for someone with dementia to concentrate on the task of eating if there is a lot of noise or activity going on in the environment.

Suggestions: Try to ensure that meals are provided in settings that are quiet, clean, and simple in terms of their decor. A quiet, calm atmosphere will help ensure that your loved one can enjoy the meal at his/her own pace rather than feel rushed.

Provide simple meal choices
In addition to noise in the environment, having too many food options to choose from can also frustrate and overwhelm individuals with dementia.

Suggestions: Plate small portions, perhaps no more than one or two options on the same plate at once.

Show your loved one how
Often times, your loved one may just be missing that one step or cue to continue on with the meal.

Suggestions: If you are eating with your loved one, get his / her attention and demonstrate what you would like him / her to do, such as using a fork and knife to cut a piece of meat or spreading jam on a piece of toast. By resisting the urge to feed your loved one, you respect his / her individuality and give him or her the chance to do it independently.

Make eating easier
As dementia progresses, it becomes difficult for your loved one to use utensils, such as forks, knives, and spoons.

Suggestions: Cut up food into smaller bite-sized pieces or serve finger foods. Also, use straws and cups with lids for your loved ones so that he / she can more easily drink beverages. Serving meals in bowls rather than on plates can also facilitate eating, as the sides can make it easier for your loved one to pick up food.

Keep your loved one hydrated
Older individuals with dementia are less able to recognize they are thirsty. Signs of dehydration include dry, cottony mouth, sticky saliva, and dark urination.

Suggestions: Make sure that your loved one does not become dehydrated by offering him / her fluids, such as water, milk, or juice, several times throughout the day and not just at meals. Also, offer foods that are known to have water content that is high. Examples include watermelon, cantaloupe, cucumbers, lettuce, soups, yogurt, and cottage cheese.



Special Note on Smoking and Drinking Alcohol

If your loved one drinks or smokes, try to monitor him / her during these activities. Individuals with dementia may not realize they are putting themselves at risk, and they might forget when they last drank or smoked. For drinking, reduce the number of alcohol beverages in the environment or even dilute alcohol, if possible. For smoking, ensure that environments are fire-resistant and have smoke alarms.


Eating in Late Stage Dementia

During late stage dementia, there will come a time when your loved one must be manually fed. If you are doing the feeding, try alternating a solid food with a sip of a liquid. Other tips for feeding in late stage dementia include the following:

  • Do not rush eating. Allow at least an hour for a meal.
  • Keep the person upright and comfortable while eating, as well as for 30 minutes afterwards.
  • Serve soft foods. Bite-sized foods and eventually mashed or pureed foods may be needed.
  • Learn the Heimlich maneuver in case of choking. Classes may be offered at a local hospital or through the Red Cross.
  • Use caution with watery liquids. Thicken liquids using cornstarch or unflavored gelatin. Once swallowing becomes a problem in dementia, the person is more likely to choke on thin liquids.
  • Monitor bowel movements, and if 3 days pass without one, consider adding a natural laxative, such as prunes or bran to the diet.
  • Get a medical evaluation for weight loss.