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Food, Eating and Alzheimer's
Regular, nutritious meals may become a challenge for people with dementia. As a person's cognitive function declines, he or she may become overwhelmed with too many food choices, forget to eat or have difficulty with eating utensils.
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Proper nutrition is important to keep the body strong and healthy. For a person with Alzheimer's or dementia, poor nutrition may increase behavioral symptoms and cause weight loss.
The basic nutrition tips below can help boost the person with dementia's health and your health as a caregiver, too.
- Provide a balanced diet with a variety of foods.
Offer vegetables, fruits, whole grains, low-fat dairy products and lean protein foods.
- Limit foods with high saturated fat and cholesterol.
Some fat is essential for health — but not all fats are equal. Go light on fats that are bad for heart health, such as butter, solid shortening, lard and fatty cuts of meats.
- Cut down on refined sugars.
Often found in processed foods, refined sugars contain calories but lack vitamins, minerals and fiber. You can tame a sweet tooth with healthier options like fruit or juice-sweetened baked goods. But note that in the later-stages of Alzheimer's, if loss of appetite is a problem, adding sugar to foods may encourage eating.
- Limit foods with high sodium and use less salt.
Most people in the United States consume too much sodium, which affects blood pressure. Cut down by using spices or herbs to season food as an alternative.
People with Alzheimer's or dementia do not need a special diet. As with anyone, eating a well-balanced, nutritious diet is important for overall health.
As the disease progresses, loss of appetite and weight loss may become concerns. In such cases, the doctor may suggest supplements between meals to add calories.
Staying hydrated may be a problem as well. Encourage fluids by offering small cups of water or other liquids throughout the day or foods with high water content, such as fruit, soups, milkshakes and smoothies.
Possible Causes of Poor Appetite
- Not recognizing food. The person may no longer recognize the foods you put on his or her plate.
- Poor fitting dentures. Eating may be painful, but the person may not be able to tell you this. Make sure dentures fit and visit the dentist regularly.
- Medications. New medications or a dosage change may affect appetite. If you notice a change, call the doctor.
- Not enough exercise. Lack of physical activity will decrease appetite. Encourage simple exercise, such as going for a walk, gardening or washing dishes.
- Decreased sense of smell and taste. The person with dementia may not eat because food may not smell or taste as good as it once did.
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During the middle and late stages of Alzheimer's, distractions, too many choices, and changes in perception, taste and smell can make eating more difficult. The following tips can help:
- Limit distractions.
Serve meals in quiet surroundings, away from the television and other distractions.
- Keep the table setting simple.
Avoid placing items on the table — such as table arrangements or plastic fruit — that might distract or confuse the person. Use only the utensils needed for the meal.
- Distinguish food from the plate.
Changes in visual and spatial abilities may make it tough for someone with dementia to distinguish food from the plate or the plate from the table. It can help to use white plates or bowls with a contrasting color placemat. Avoid patterned dishes, tablecloths and placemats.
- Check the food temperature.
A person with dementia might not be able to tell if something is too hot to eat or drink. Always test the temperature of foods and beverages before serving.
- Serve only one or two foods at a time.
Too many foods at once may be overwhelming. Simplify by serving one dish at a time. For example, mashed potatoes followed by meat.
- Be flexible to food preferences.
Keep long-standing personal preferences in mind when preparing food, and be aware that a person with dementia may suddenly develop new food preferences or reject foods that were liked in the past.
- Give the person plenty of time to eat.
Remind him or her to chew and swallow carefully. Keep in mind that it may take an hour or longer to finish eating.
- Eat together.
Make meals an enjoyable social event so everyone looks forward to the experience. Research suggests that people eat better when they are in the company of others.
- Keep in mind the person may not remember when or if he or she ate.
If the person continues to ask about eating breakfast, consider serving several breakfasts — juice, followed by toast, followed by cereal.
Map out a plan to approach Alzheimer's
During the middle and late stages of Alzheimer's, allow the person with dementia to be as independent as possible during meals. Be ready to help, when needed.
- Make the most of the person's abilities.
Adapt serving dishes and utensils to make eating easier. You might serve food in a bowl instead of a plate, or try using a plate with rims or protective edges. A spoon with a large handle may be less difficult to handle than a fork, or even let the person use his or her hands if it's easier.
- Serve finger foods.
Try bite-sized foods that are easy to pick up, such as chicken nuggets, fish sticks, tuna sandwiches, orange segments, steamed broccoli or cauliflower pieces.
- Use a "watch me" technique.
For example, hold a spoon and show the person how to eat a bowl of cereal.
- Don't worry about neatness.
Let the person feed himself of herself as much as possible. Consider getting plates with suction cups and no-spill glasses.
In the middle and late stages of Alzheimer's, swallowing problems can lead to choking and weight loss. Be aware of safety concerns and try these tips:
- Prepare foods so they aren't hard to chew or swallow.
Grind foods, cut them into bite-size pieces or serve soft foods (applesauce, cottage cheese scrambled eggs).
- Be alert for signs of choking.
Avoid foods that are difficult to chew thoroughly, like raw carrots. Encourage the person to sit up straight with his or her head slightly forward. If the person's head tilts backward, move it to a forward position. At the end of the meal, check the person's mouth to make sure food has been swallowed. Learn the Heimlich maneuver in case of an emergency.
- Address a decreased appetite.
If the person has a decreased appetite, try preparing favorite foods, increase physical activity, or plan for several small meals rather than three large ones. If the person's appetite does not increase and/or he or she is losing weight, consult with the doctor. Keep in mind, as the person's activity level decreases, he or she may not need as many calories.
- Only use vitamin supplements on the recommendation of a physician.
Help Is Available
Alzheimer's Association Message Boards. Exchange tips with other caregivers who are experiencing eating and mealtime challenges with a loved one with dementia.
My Plate for Older Adults. Read information from Tufts University about the unique nutritional and physical activity needs associated with age.
Eating. Get strategies from the Leonard Davis School of Gerontology for meeting the nutritional needs of people with Alzheimer's.
Swallowing Problems in Adults. Learn about swallowing problems from the American Speech-Language-Hearing Association.
Meals on Wheels. Find out about free, home-delivered meal services for seniors.