Dementia - how to encourage healthy eating

A person with dementia may find eating difficult. Loss of appetite, loss of memory and problems with judgement can cause problems with food, eating and nutrition. The person may forget how to chew and swallow or may be distracted by their environment.

Mealtimes provide us with an opportunity to spend time with our family and friends, as well as share food together. When caring for someone with dementia, mealtimes can become stressful for the person with dementia and their carers. However, there are ways to make your life as a carer easier and to help the person with dementia maintain a healthy diet.

Loss of appetite
A person with dementia may forget how to chew and swallow. Other reasons for an apparent loss of appetite may include ill-fitting dentures, insufficient physical activity and being embarrassed by difficulties in eating.

Things you can try:

• Check with the doctor to make sure that there are no treatable causes for loss of appetite, such as acute illness or depression.
• Offer meals at regular times each day.
• Allow the person to eat when hungry.
• Encourage physical activity.
• Provide balanced meals to avoid constipation.
• Try a small glass of juice, wine or sherry before the meal – if medications permit – to whet the person’s appetite.
• Offer icecream or milkshakes.
• Try to prepare familiar foods in familiar ways, especially foods that are favourites.
• Encourage the person to eat all or most of one food before moving on to the next – some people can become confused when tastes and textures change.
• Try to make mealtimes simple, relaxed and calm. Be sure to allow enough time for a meal. Assisting an impaired person can take up to an hour.
• Consult a doctor if the person with dementia experiences significant weight loss (such as 2.5kg in six weeks).
• Check with the doctor about vitamin supplements.
• Carers should also make sure their own diet is varied, nutritious and enjoyable.

• Try five to six small meals each day.
• Have low calorie snacks available, such as apples and carrots.
• Consider whether other activities – such as walks or increased socialisation – may help.
• Lock some foods away, if necessary.
• Leave healthy snack foods on the table – this may be enough to satisfy some people.

• Check medications for side effects. Some antidepressant medications cause a craving for sweets.
• Try satisfying the sweet cravings with foods that have some nutritional value such as milkshakes, eggnogs or low calorie icecream.

• Arrange a dental check-up of gums, teeth and dentures.
• Moisten food with gravies and sauces if a dry mouth is causing problems.
• For chewing problems, try light pressure on the lips or under the chin, tell the person when to chew, demonstrate chewing, moisten foods or offer small bites one at a time.
• For swallowing problems, remind the person to swallow with each bite, stroke the throat gently, check mouth to see if food has been swallowed, do not give foods which are hard to swallow, offer smaller bites and moisten food.
• Consult the doctor if choking problems develop.

• Serve one course at a time and remove other distracting items from the table such as cutlery, glasses or table decorations.
• Ensure the crockery is plain and is a contrasting colour to a plain tablecloth.
• Allow plenty of time to eat.
• Keep noise or activity in the environment to a minimum.
• Make sure there is adequate lighting.
• Serve food that is familiar to the person.
• Eat with the person with dementia so that they can follow your lead.
• Serve familiar food.

• Keep eating simple – not all food has to be eaten with cutlery if this is becoming difficult. Finger foods can be a nutritious and easy alternative.
• Keep in mind a person’s past history with food – they may have always had a small appetite, been a voracious eater or had a craving for sweets.
• Watch food temperatures – while warm food is more appetising, some people with dementia have lost the ability to judge when food or drink is too hot. Beware of using styrofoam cups – they hold the heat for a long time and tip over easily.
• Offer support – spoiled food in the refrigerator, hiding food or not eating regularly may all be signs that someone living alone needs more support.
• Offer fluids – regular drinks of water, juice or other fluids are essential to avoid dehydration. Many people with dementia do not get enough fluids because they may forget to drink or may no longer recognise the sensation of thirst.
• Be prepared for changes – many eating problems of dementia are temporary and will change as the person’s abilities deteriorate.

• Your doctor
• Your local community health service
• Your local council
• National Dementia Helpline Tel. 1800 100 500
• Dementia Behaviour Management Advisory Service (DBMAS) Tel. 1800 699 799 – for 24-hour telephone advice for carers and care workers
• Carer Respite Centre Tel. 1800 059 059
• Carer Resource Centres Tel. 1800 242 636
• Aged Care Assessment Services – contact your regional Department of Human Services office
• Aged Care Information Line Tel. 1800 500 853

• A person with dementia may forget how to chew and swallow.
• Check with the doctor for other causes of loss of appetite, such as acute illness or depression.
• Carers should also make sure their own diet is varied, nutritious and enjoyable.

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