For someone with Alzheimer’s disease or a related dementia, mealtime can be complicated and frustrating, especially as memory and coordination deteriorate. Meals are important for nutrition and to satisfy hunger, but they also provide an opportunity to slow down, be with others, and socialize.
There are multiple reasons someone with dementia will stop eating:
– Dentures don’t fit correctly, causing pain while eating.
– Medication causes decreased appetite.
– Not getting enough exercise.
– Decreased ability to smell and taste food.
– Memory loss such that food can’t be recognized as food.
– Over-consumption of soda, diet soda and sugary foods diminishes appetite at meal-times
A bad diet can worsen symptoms of dementia. Be sure your loved one eats vegetables, fruits, whole grains, and protein. Foods that are greasy, or have a lot of sugar, can negatively affect mood and health.
In earlier stages of dementia, your loved one may be able to eat a meal without problems. However, preparation with multiple steps, like assembling a sandwich or making a salad, may be too difficult. Simpler meals that don’t require assembling may be best.
As the disease advances into middle stages, your loved one may become “messy” at meal time, playing with or picking at food. Eating out, especially in crowded restaurants, can cause anxiety and may not be a good idea. Using utensils gets harder. Appetite begins to decrease. It’s possible that appetite issues in the middle stages are related to frustration in a person unable to self-feed.
In late stages, the ability to swallow becomes compromised and care must be taken to avoid choking or blocking airways or filling the lungs with food (as this can cause pneumonia). Eventually, you may have to remind your loved one to chew and even to swallow. For more, see below.
The following tips can make eating less stressful for your loved one:
Someone with dementia may need to concentrate harder to accomplish any task, including eating, so make it easier by lowering noise and activity in the environment. Eat in quiet, clean, simple settings. You want your loved one to feel comfortable, without needing to rush.
Keep It Simple
Too many food options can cause frustration and overwhelm someone with dementia. Plate small portions.
Demonstrate the steps, like using a fork and knife to cut a piece of meat or spreading jam on toast. Resist the urge to feed your loved one, who may just be missing that one step or cue to continue with the meal.
Use of utensils becomes more difficult as dementia progresses. Cut food into smaller bite-sized pieces, or serve finger foods.
Serving meals in bowls rather than on plates can facilitate eating, as the sides make it easier to scoop food onto a fork or spoon.
Someone with dementia will probably have an easier time drinking if you provide a straw.
People with dementia are less able to recognize their thirst. Watch for signs of dehydration: dry mouth, sticky saliva, and dark urination. Serve your loved one fluids, like water or juice, several times throughout the day (not just at meals). And offer foods that have high water content, including watermelon, cantaloupe, cucumbers, lettuce, soups, yogurt, and cottage cheese.
On Drinking and Smoking
Pay closer attention if your loved one drinks or smokes. People with dementia may forget when they last imbibed. For drinking, reduce the amount of alcohol in the house, or water it down. For smoking, ensure a fire-resistant environment and working smoke alarms.
During late-stage dementia, your loved one will eventually need to be manually fed. If you are doing the feeding, alternate a solid food with a sip of liquid. Other tips:
– Do not rush. Allow at least an hour for a meal.
– Keep the person upright and comfortable while eating, and for 30 minutes afterward.
– Serve soft foods. Start with bite-sized, until mashed or pureed foods are needed.
– Learn the Heimlich maneuver, in case of choking. Classes may be offered at a local hospital or through the Red Cross.
– Be careful with watery liquids. Thicken liquids with cornstarch or unflavored gelatin, because a person who has difficulty swallowing is more likely to choke on thin liquids.
– Monitor bowel movements. If three days pass without one, consider adding a natural laxative like prunes or bran to the diet.
– For weight loss, see a doctor.
Special dinnerware and utensils may make eating easier for your loved one with dementia, and help maintain independence for longer. Among the products available are forks, spoons and knives with extra-large handles to make gripping easier. Special plate guards, or “food bumpers,” wrap around the edges of plates to prevent spills and simplify scooping up food. There are also “scooper plates” with higher, rounded edges that make eating less messy and simpler. Finally, consider dinnerware with suction cups that prevent moving or sliding.