At IP Homecare, we understand that eating and drinking can be difficult for those living with dementia. Our dementia eating and drinking guide outlines ways you can support someone, drawing on experience of caring for those dealing with dementia and eating issues. Increasing your knowledge and knowing how to make adaptations means you can enable your loved one to remain at home, eating and drinking well with dementia.
Dementia and weight loss
Those living with dementia may lose weight for a variety of reasons, with the most common being unable to communicate and recognise hunger. Difficulty with chewing and swallowing can also contribute to dementia and weight loss issues, along with poor coordination that can put people off their food. According to the Alzheimer’s Society, 20-40% of those diagnosed with dementia will experience depression, which can also cause loss of appetite.
Dementia and swallowing problems
Various motor and sensory difficulties can affect someone’s ability to eat, with one of the main challenges being difficulties with chewing and swallowing food. For those living with dementia, this can range from struggling to communicate that they have sore gums to ill-fitting dentures that can make it difficult and painful to eat.
As dementia progresses, swallowing difficulties (dysphagia) become more significant. Dementia and swallowing problems can include being unable to hold food in the mouth, issues with continuous chewing and leaving foods that are harder to chew uneaten on the plate.
If you notice that issues with dementia and swallowing are worsening, a referral can be made to a speech and language therapist. Speech and language therapists can provide support through swallowing and speech exercises, dietary advice and changes to medication.
Dementia and loss of appetite
In later stages of dementia, it’s normal for a person’s food preferences to vary. This can affect the amount and variety of food that is eaten. To help support these kinds of dementia and eating issues, you can:
- Offer small portions of food, more frequently throughout the day
- Be flexible with mealtimes. Some people with dementia will have more of an appetite at certain times of the day, whether this is breakfast or teatime
- Make meals look appetising and include a variety of colour such as a bowl of chopped fruit or mixed vegetables
- Try not to overload the plate with too much food
- Leave a gap between the main meal and dessert
- Include foods that are familiar to the person
When it comes to dementia eating and drinking changes, it is also common for people to begin enjoying unusual food combinations, such as mixing sweet and savoury flavours:
- Add sweet sauces (e.g. apple sauce) with a main meal to add sweetness
- Add a teaspoon of sugar or honey to savoury foods such as quiches, pies and omelettes
- Roast vegetables such as carrots and parsnips with honey
I’m worried about leaving a person with dementia alone – what can I do to ensure they’re eating?
Those living alone with dementia may struggle to prepare meals, or food may spoil and be forgotten about. If dementia and eating issues are becoming a significant problem for your loved one, it may be a sign they need more care and support. This need may be met in the form live-in care, where someone is on hand 24 hours a day to support your loved one and ensure nutritious food is being eaten.
Tips to support those living alone with dementia
- Buy ready made meals as they require little preparation
- Consider having their meals delivered. Contact your local council or Alzheimer’s Society to see what’s available in your area. They may be able to have a week’s supply of ready meals delivered directly to their home
- Shop online – a relative or friend can order preferred foods on their behalf
- Simple notes or pictures about where food is may help – eg a picture of a sandwich on the fridge
- Use simple instructions to help them prepare, cook or reheat food for themselves – eg ‘microwave on high for 3 minutes’.
- Consider arranging a homecare package to assist with eating and drinking and meal preparation
What food can I prepare if they have difficulty using cutlery?
Cutlery can make mealtimes challenging and become an obstacle to eating and drinking well with dementia. Finger foods are easy to pick up and can be eaten without using cutlery. These are ideal for people who have difficulty with their co-ordination or for those who like to walk around at mealtimes. Good finger food options include:
- Small finger sandwiches or crackers with soft cheese
- If the person is struggling with a knife and fork, chop up their food so it can be eaten with a spoon
- Hard-boiled egg (quartered)
- Potato wedges or chunky chips
- Cocktail sausages, chicken breast cut into pieces, slices of quiche, fish fingers, meatballs, or sausage rolls
- Slices of fruit cake, tea cakes or scones
- Slices of apples or bananas, seedless grapes or orange segments
You may need to help your loved one by guiding their hand to their mouth to remind them of the process involved. You can also speak to an occupational therapist about specially adapted cutlery, such as lipped (high-sided plates) or spill cups.
The importance of healthy eating and dementia
Studies have shown that a healthy diet is key to living well with dementia. Eating a healthy and balanced diet is important for both physical and mental health, decreasing the risk of problems like dehydration, weight loss, urinary tract infections and constipation. These health issues can increase symptoms of dementia, namely confusion and delirium. Combinations of nutrients such as healthy fats, omega-3 fish oils, vitamins and minerals may help to support healthy brain function. These nutrients can be found in the following foods:
- Plenty of fruit and vegetables including leafy greens
- Twice weekly intakes of oily fish to provide a good intake of fish oil, which is rich in omega-3
- Nuts, seeds and olive oil to provide a variety of healthy fats
- Wholegrain food
What happens if food isn’t enough?
Contact your local GP or pharmacist and ask about medical nutrition. Medical nutrition is a liquid food option that is scientifically formulated to provide energy, protein, vitamins and minerals.There are also options available for specific types of dementia, such as the early stages of Alzheimer’s disease.