Mealtimes + Dementia: Pro Tips for Family Caregivers
Alzheimer’s disease and other dementias affect memory and cognition, but they also impact your loved one’s ability to eat and drink. For some people, these conditions trigger overeating; But for others, they reduce appetite.
Regardless of your loved one’s symptoms, it’s important to know how to take action. With the right strategies, you can provide optimal nutrition and reduce the risk of common problems, like choking. This guide provides simple tips and tricks to make mealtimes easier. It includes proven strategies, ingredient recommendations, and more.
How Does Dementia Affect Appetite and Eating?
Neurodegenerative diseases, like Alzheimer’s and dementia, affect appetite and eating habits in several ways.
“One study found that of 220 participants with Alzheimer’s disease, 80% had eating and swallowing difficulties and about 50% showed changes in food preferences,” says Carmelita Lombera, RDN, a registered dietitian with Consumer Health Digest. “Depending on the brain region that’s affected, caregivers can anticipate specific changes.”
For example, people with vascular dementia and pseudobulbar palsy are more likely to have swallowing difficulties and aspiration pneumonia. While those with Lewy body dementia (LBD) tend to experience a loss of appetite. Alternatively, those with frontotemporal and semantic dementia often experience an increase in appetite and want to eat the same foods all the time. “I had one patient with frontotemporal dementia who insisted on eating a cheeseburger every day,” Lombera says.
By taking the time to research and understand your loved one’s diagnosis, you can reduce the risk of choking and other accidents and take the stress out of mealtimes.
How Can I Make Mealtimes Easier If I Care for Someone with Alzheimer’s Disease or Another Type of Dementia?
Lombera says that there are several things you can do to make mealtimes easier if you care for someone with Alzheimer’s disease or another type of dementia, including:
Create a Meal Schedule
“Offer meals and snacks at consistent times,” Lombera explains. “Creating more structure around snacks and meal times can help ensure your loved one gets enough calories throughout the day.”
A schedule also supports independence. For instance, If your loved one knows that lunch is always at 12 p.m. it becomes part of their routine. And, a routine can help them maintain their independence, especially in the early stages of the disease.
“It’s common for patients with Alzheimer’s disease and other dementias to wander and/or get easily distracted,” Lombera says. “Turn off the television or radio to create a more relaxing and calm eating environment.”
Likewise, set a spot at the table and make sure the dining room is tidy and clutter-free. Piles of books, paperwork, or other objects can be overwhelming for someone with a neurodegenerative condition. Ensuring their eating area is clean and organized prevents overstimulation so they can focus on what’s important –– eating.
Offer Food in Small, “Snackable” Portions
As Alzheimer’s disease and other types of dementia progress, they may affect your loved one’s ability to recognize and use certain objects. Case in point: cutlery. Unfortunately, if your loved one forgets how to use a fork and knife, they may avoid food altogether.
“Preparing finger foods can help increase food intake,” Lombera says. “Meals such as sandwiches, wraps, and chicken strips are excellent options. Snacks, such as cut-up fruits and vegetables can also be very beneficial.”
Finger foods don’t just make mealtimes easier. They also support your loved one’s nutrition. One study found that 70% of dementia patients who ate finger foods improved their food intake and gained weight. Another found that dementia patients who ate finger foods gained a sense of independence and rediscovered the joy of eating on their own.
Serve Snacks and Meals with Sauce or Gravy
Alzheimer’s disease and dementia affect how your loved one sees and experiences food. Changing the texture with sauces or gravies can make all the difference.
“Adding sauces or gravies helps give food more flavor and softens it, so it's easier to chew and swallow,” Lombera explains. “These sides can also support hydration and make foods a smoother, more appealing texture.”
Neurocognitive illnesses like Alzheimer’s disease increase the risk of dehydration for various reasons. Some patients don’t know they’re thirsty, while others have difficulty swallowing or worry about choking.
Encourage your loved one to drink water by offering it to them throughout the day. Products like thickened water and Thick-It instant food and beverage thickener can support hydration if they have dysphagia or another medical condition that makes it difficult to swallow.
Support Caloric Intake with Healthy Fats
30%-40% of all dementia patients experience significant weight loss. “Since these individuals often need more calories to maintain weight, I recommend adding healthy fats, such as olive oil, avocado, and nut butter to foods,” Lombera says.
There are also high-calorie meal replacement shakes, like Ensure Plus, specifically formulated to support weight gain.
Should People with Alzheimer’s Disease or Other Dementias Include Specific Foods In Their Diet?
“Consuming specific food items can help prevent and slow down the progression of diseases like dementia,” Lombera says. “A balanced diet, like The Mediterranean diet is an excellent choice because it’s rich in Omega-3 fatty acids, like DHA (a nutrient found in certain fish, like salmon). DHA protects the brain and improves nerve function.”
Other food choices and drinks to consider include:
Antioxidant-rich beverages, like coffee and tea
Low glycemic fruits, like berries, which have higher amounts of polyphenols (healing plant compounds)
Potassium-rich fruits like oranges, tomatoes, and avocados can preserve muscle mass and support muscle strength
Nuts, seeds, and beans
Fatty fish, like Salmon, mackerel, and tuna
Are There Any Professionals Who Can Make Mealtimes Easier for Family Caregivers?
If your loved one has Alzheimer’s disease or another type of dementia, supporting their nutritional needs can be challenging.
“If you need more support, a registered dietitian can be a great resource,” Lombera says. “RDs are nutrition experts who can provide you with a meal plan and modifications to ensure your patient or loved one is getting enough calories, nutrients, and flavor.”
“I also recommend working with a speech-language pathologist to help with swallowing function and to monitor cognitive abilities,” Lombera adds. “They may also benefit from working with a physical therapist to regain any lost muscle mass and improve their ability to complete daily tasks, such as showering and self-care.”
As these diseases progress, you may need to consider tube feeding or texture-altered foods with thickening products, especially if your loved one has a low appetite or difficulty swallowing.
Mealtimes + Dementia: The Bottom Line
Alzheimer’s disease and other dementias can make mealtimes challenging. But with the right approach and a professional support network, you can reduce headaches and ensure your loved one has everything they need to maintain good nutrition.
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Chad Birt is a freelance medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.