Difficulty swallowing and a loss of appetite often contribute to eating issues in dementia patients. However, these changes can be subtle, even in the early stages of the condition. Prioritizing comfort, accessibility, and nutritious foods can make a significant difference.
Dementia is a broad term encompassing memory loss and cognitive decline that goes beyond normal aging. Alzheimer’s disease is the most prevalent form, representing up to 80% of dementia diagnoses.
Changes in eating habits are common among dementia patients. Early research from 2015 indicates that as many as 81.4% of individuals with dementia experience eating or swallowing disturbances, and nearly half of these individuals notice changes in appetite even in mild stages of the condition.
For caregivers, understanding how to respond when someone with dementia refuses or struggles to eat is crucial in preventing malnutrition.
Why Might a Dementia Patient Not Want to Eat?
When a person with dementia doesn’t want to eat, it’s usually not due to stubbornness or combativeness. Dementia, as a neurodegenerative condition, alters brain function, and eating involves more than just the sensation of hunger.
A 2020 review on eating behavior in dementia suggests that changes in eating patterns often begin gradually and are connected to memory decline. For example, you might go to the grocery store and forget what you needed to buy or how to prepare a meal properly. This can lead you to opt for low-quality, ready-made foods or simpler meals.
As dementia progresses, memory decline can cause missed meals or overeating, especially if appetite changes are occurring. The brain controls appetite, and as dementia alters its function, you may not feel hungry as frequently or intensely.
Several factors can prevent someone with dementia from eating, including:
- Poor motor control, such as difficulties swallowing or chewing
- General discomfort
- Inactivity
- Depression
- Isolation
- Sleep disturbances
- Changes in the sense of smell and taste
- Altered food cravings
- Comorbid conditions
- Communication impairment
- Medications
What to Do If a Dementia Patient Won’t Eat
While you can’t alter a person’s natural hunger cues, there are effective strategies for encouraging a dementia patient to eat and maximizing their nutritional intake.
Many dementia patients also face dietary restrictions due to medical conditions like diabetes or liver disease, which can complicate feeding efforts. As a caregiver, this added challenge requires careful planning and adaptability.
Ruling Out Causes of Pain
People with dementia may become less aware of their physical condition and can be more prone to injuries or infections. Additionally, they often struggle to articulate their physical discomfort.
If your loved one suddenly loses interest in eating, it could be a sign of pain or discomfort, such as from a urinary tract infection (UTI), stomach upset, a tooth abscess, or even a broken bone.
Consult their doctor to determine if they need an evaluation and whether treatment for an infection or injury is necessary. Often, their appetite will improve once the underlying issue is addressed.
Prioritizing Comfort
At mealtime, being mindful of room temperature, posture, seating support, lighting, and the overall atmosphere can significantly help.
After ensuring physical comfort, focus on mental well-being. Making meals a social experience and allowing ample time to finish can make mealtime a positive experience.
Reducing Distractions
Eating may become easier if it’s the primary focus. You can help maintain this focus by minimizing dual activities, such as eating and watching television simultaneously.
However, take cues from your loved one and observe which setting works best for them. They may eat better when engaged in other activities during meals, or they might prefer quiet, uninterrupted mealtimes.
Using Nutrient-Dense Foods
Sometimes, you need to maximize the nutritional value of what your loved one does eat. You can achieve this by focusing on nutrient-dense options, like meal replacement shakes and soups, or creatively combining foods.
Consider enhancing the flavor of nutrient-rich foods with toppings or sauces that your loved one enjoys.
Being Kind and Patient
It can be frustrating when someone with dementia doesn’t want to eat, but punishing them or holding them accountable for typical meal behaviors won’t help.
Allow them to be messy if needed. You can adapt by using plastic tablecloths and other disposable items for easy cleanup.
If they repeatedly ask for more food because they can’t remember eating, consider offering multiple smaller servings rather than simply saying “no.”
How to Help a Dementia Patient Eat
For someone experiencing cognitive decline, complexity can be overwhelming and may contribute to a lack of desire to eat.
You can keep meals straightforward by:
- Offering a variety of options
- Serving one food at a time to avoid decision overload
- Accommodating abilities, such as using bowls instead of plates
- Choosing foods that are easy to pick up with fingers
- Serving meals on colored plates and bowls that make food more visible
- Preparing foods with easy-to-chew and swallow textures
- Pre-cutting food items into bite-sized pieces
- Using thickening agents to help with swallowing liquids
- Providing straws to maximize fluid intake
- Offering foods at a ready-to-eat temperature
Easy Meals for Dementia Patients to Eat
When preparing meals for someone living with dementia, the Alzheimer’s Association recommends the following guidelines:
- Limit foods high in cholesterol and saturated fat
- Focus on vegetables, fruits, whole grains, lean protein, and low-fat dairy
- Replace refined sugar products with fruit or juice-sweetened baked goods
- Avoid high-sodium foods and use less salt in cooking
Keeping these principles and mealtime strategies in mind, there are many easy meal options available for those caring for someone with dementia.
Soups
Soups are a convenient way to incorporate a variety of nutrient-dense foods into one dish. They can be customized to suit individual tastes, and boiled ingredients are generally softer and easier to eat.
However, soups might not be suitable for everyone. If swallowing is an issue, they may need to be thickened to make them easier to ingest.
Snack Platters
While too many food choices can be overwhelming, snack platters with items like cut-up cheese, meatballs, and fruit offer a way to present small, bite-sized portions that can be eaten by hand.
Smoothies
When you need to maximize nutritional intake without using much volume, smoothies offer an excellent way to condense fruits, vegetables, and protein into a drinkable form.
Compared to juices, smoothies are typically thicker, which makes them easier to swallow as they move more slowly down the throat.
Slow Cooker Meals
Foods prepared in slow cookers are known for their tenderness. Meats and vegetables soften over the course of the day while retaining their flavors, making them easier to eat.
Using a slow cooker also provides the convenience of cooking an entire meal at once, saving you time and effort.
Pasta
Pasta must be cooked carefully to ensure it becomes soft enough for someone living with dementia. Opting for small noodles rather than long strands may be more suitable.
There are also whole grain, gluten-free, and veggie-based pasta options that can add additional nutrients to the meal.
Additionally, pasta sauce offers a great opportunity to puree vegetables that might otherwise be avoided or found unappetizing.
Takeaway
Living with dementia can affect eating in various ways. In addition to mechanical difficulties with eating, appetite may decline, and previously appealing foods may no longer be attractive.
If someone living with dementia isn’t eating, consider addressing any pain or discomfort they may be experiencing. Make mealtime as comfortable as possible, and provide food that is the right size and texture for their needs.