Dementia and Nutrition

9 tips to keep your loved one eating well with dementia

When you think about side effects of dementia, eating probably isn’t one of the first issues to come to mind. But for a disease that impacts every area of a person’s life, mealtime definitely takes a hit.

Over time, dementia may cause changes in food habits and preferences, making eating more difficult. It can feel overwhelming for caregivers to manage meals on top of everything else. But there are many simple, practical ways to help your loved one get the nutrition they need.

“Nutritional problems are common in dementia patients,” says Smita Patel, DO, director of the center for brain health at NorthShore University HealthSystem. “Weight loss is a good indicator of calorie and protein malnutrition in the elderly.” And that malnutrition can further impact their health.

Common eating issues with dementia

While each individual faces their own specific issues, people with dementia, as a whole, are at risk for the following:

• Poor appetite. The brain triggers feelings of hunger. As dementia progresses, those hunger signals may weaken. Some medications also decrease appetite.
• Taste changes. A changing sense of taste and smell may make food taste bland and unappealing to a person with dementia, even for foods they previously enjoyed.
• Trouble focusing. Someone with dementia may be easily distracted and have trouble sitting still to eat a meal.
• Lack of coordination. Self-feeding skills may decline over time, including hand/eye coordination and the ability to use utensils.
• Difficulty chewing and swallowing. Loss of motor control for chewing and swallowing may make eating difficult and, at times, unsafe, with a risk of choking.

Ensuring good nutrition with dementia

The brain requires a continuous supply of energy to function. If you’ve ever felt foggy or tired when you’ve gone too long without eating, you know that firsthand.

For individuals with dementia, adequate nutrition is even more critical. Without energy from food, their brain, which is already feeling the effects of cognitive decline, may struggle even more. Malnutrition may affect their brain function, cause compromised immunity, and result in weight loss, among other health issues.

Caregivers should work with their loved one to make sure the person consumes enough calories to maintain a healthy weight and that those calories contain optimal nutrients to prevent deficiencies. Adequate protein is especially important. A recent study found certain amino acids — the building blocks of proteins — help maintain cognitive function in older adults.

On top of their need for enough food, a person with dementia also needs enough of the right kinds of food. Vitamin B-12 and folate deficiencies are common, Patel says.

Vitamin and mineral deficiencies can occur if the diet is monotonous or imbalanced. For example, if someone eats only white bread and cheese, they would miss out on essential vitamins and minerals from a varied diet that also contains fruits, vegetables, nuts, and legumes — each of which brings something different to the table.

“Antioxidants — such as fruits and vegetables rich in vitamins A, C, and E — presumably improve health and have a positive effect on Alzheimer’s disease and other neurodegenerative diseases,” Patel says.

If this information feels daunting, don’t be discouraged. While malnutrition risks are real, once you know just how much nutrition matters, you can take steps to ensure your loved one gets the right nutrients.

Practical mealtime tips for dementia

Meal management — in addition to many other caregiving duties — can overwhelm family members, but some pointers can make mealtime easier and healthier.

Emphasize balanced, nutritious meals for your loved one. “It may be helpful to see a dietitian earlier in the disease process to make sure caregivers can provide adequate nutrition,” Patel says.

Also, try not to make mealtime overwhelming. “The number one tip for caregivers would be to offer food to [people with dementia] in small portions,” says registered dietitian nutritionist Rachael Costello, owner of Fox Valley Nutrition Consulting in Algonquin. “This prevents the meal from feeling overwhelming and will often increase the amount of food the person will end up eating.”

Other ideas for helping someone with dementia eat well include:

1. Offer bite-sized finger foods that don’t require utensils.
2. Eat meals at a table with other family members to help the person focus.
3. Avoid brightly colored or patterned plates, which may be distracting.
4. Turn off the TV during mealtime.
5. Provide verbal encouragement and reminders to eat without being forceful.
6. Boost fluid intake by offering iced or flavored water.
7. Encourage fruits and vegetables, especially those high in water, such as citrus, cucumbers, peppers, melon, and tomatoes.
8. Modify food textures, to make chewing and swallowing easier.
9. Consider meal supplements such as Boost or Ensure for a concentrated source of nutrition.

As a caregiver, you know your loved one best. Your commitment to your loved one’s well-being is their best protection from malnutrition.

If you’re concerned about how your loved one with dementia is eating, talk to their doctor. A physician or dietitian will provide an individualized plan to target the specific issues that your loved one faces.