Eating/Nutrition and Dementia

General tips to help with eating:

• Consider the person’s past eating habits. Did they have a small or large appetite? Did they eat snacks at certain times of the day? Did they often crave certain foods (i.e. sweets, salty snacks)?
• Involve the person living with dementia in meal preparation as much as possible.
• Give options and ask what they would like to have (i.e. would you like a sandwich or soup?). It allows some control over their meal choices.
• Give them enough time to eat during meals.
• Minimize distractions during mealtime (i.e. turn off the TV, keep conversation to a minimum). Clutter on the table or busy patterns on linens or dishes can also be distracting and make it difficult for the person to see and eat their food.
• Make sure the temperature of the room is comfortable; not too hot or too cold.
• Make sure seating is comfortable and the person is well-supported to be able to sit in an upright position.

Tips to improve cognitive and physical reasons of eating challenges:

• If a person wears glasses, ensure they are wearing them while eating. This allows them to see the food in front of them.
• Consider using plates and cups in a contrasting colour to the table to help with visual perceptual changes.
• Schedule an appointment with the dentist- continual denial could be due to dental pain.
• Schedule a medical evaluation to rule out the possibility of acute health issues (i.e. infection, constipation, dehydration etc.).
• Ensure they use the bathroom before eating. Needing to use the toilet can cause distractions during mealtime.
• Try to soften meals. Sometimes hard or dry foods can be difficult to eat.
• Moistening food with sauces or gravies can also help with dry mouth.
• If the challenge continues for a long time, consult a nutritionist or speech pathologist who can help make swallowing easier and prevent choking.
• Try using larger handled utensils if regular utensils become hard to hold or offer finger foods at mealtime.
• If the person has a tremor, consider weighted utensils- heavier weight can help reduce handshaking. For example, a cup with a lid can also be a good strategy for people with hand tremors to reduce spillage.
• Make sure water and non-caffeinated beverages are available and within reach
  throughout the day to maintain hydration.
• A person in the later stages of dementia may need cueing throughout the meal.
• Caregivers should be seated in the field of vision when eating with the person living with dementia- this can be helpful to copy movement if they forget how to eat or chew.
• If the person is alone during mealtimes, consider assistive technology like a smart speaker to set reminders for eating. Some people in the early stages of dementia also find it helpful to keep a binder in the kitchen and write down what they eat throughout the day.

Tips that may help when the person living with dementia is eating too little:

• Reach out to a doctor to make sure that there are no treatable causes for loss of appetite (acute illness or depression).
• Consult with a doctor about supplements.
• It is best to consult with a doctor if the person with dementia experiences significant weight loss (e.g. 5lbs in six weeks).
• Offer balanced meals at regular times each day. Serve smaller portions as large meals can be overwhelming or unappealing to people living with dementia.
• Let the person eat when they are hungry if the current routine mealtime is not working.
• Encourage physical activity- The person might feel hungry.
• Try to prepare familiar foods in familiar ways, especially foods that are favourites.

Tips to manage overeating:

• Try serving five to six small meals each day.
• Include healthy, low-calorie snacks that are available throughout the day- this may be enough to satisfy cravings for some people.
• Assess whether the person is doing enough activities that make them feel hungry or if they are eating out of boredom. Increase socialization and try to include different activities throughout the day.
• Increase exercise (i.e. chair exercises, going for walks etc.).
• Lock some foods away, if necessary.

Tips to manage sweet cravings:

• Check medications for side effects– some antidepressant medications cause a craving for sweets.
• Try to fulfill sweet cravings with foods that have some nutritional value, such as milkshakes/smoothies, eggnogs or low-calorie ice cream.

Keep in mind: A person with dementia may begin to develop changes in how
they experience flavours. They may start to enjoy some flavours they didn’t like before or dislike foods they always liked. Sometimes people with dementia make food choices that don’t match their usual choices or preferences.