Good nutrition

Good nutrition helps us all keep healthy, which helps us maintain a better quality of life. People who don’t eat well get sick more often and recover from injury and illness more slowly.

It can be challenging for someone with dementia to keep eating well. They may:

  • not feel hungry
  • forget to eat and drink
  • forget how to chew or swallow
  • have a dry or uncomfortable mouth
  • crave sweet food
  • not be able to recognise the food or drink they are given.

It can also be challenging to share meal times with someone with dementia as their loss of memory and lack of judgment can cause difficulties for others at the table.

But there are ways to improve the situation.

 daily nutritional balance

The nutritional requirements – or how much food we need to eat each day – of someone with dementia will be similar to other people their age. However, some people with dementia use up a lot of energy doing things such as pacing, and that means they need to eat more to stay a healthy weight.  

The Ministry of Health dietary guidelines for older New Zealanders recommend:

  • eating a wide variety of nutritious foods
  • eating at least three meals a day
  • drinking plenty of water (five to eight glasses a day)
  • eating plenty of vegetables and fruit
  • eating plenty of cereals, breads and pasta
  • eating a diet that’s low in saturated fats
  • choosing low-salt foods and using salt sparingly
  • include high-calcium foods
  • adding sugar in moderation.

 common eating challenges

Challenge

What to try


Forgetting to eat

 

  • An alarm clock or a phone call may be a useful reminder at mealtimes.
  • Snacks that are easy to eat and don’t need to be refrigerated can be left out where they will be seen easily.


Unable to prepare meals for themselves

 

  • Family/whānau and friends helping to prepare meals and/or eat together.
  • Delivered meals, such as Meals on Wheels.
  • Home support to assist with meal preparation, serving, and discretely prompting eating.
  • Pre-prepared meals from the supermarket or cafés, etc.
  • Prepare large qualities of food, then put meal-sized amounts into their freezer.
  • Eat out – but first check the person is comfortable going to a restaurant.
  • Stock up on healthy snacks, such a yoghurt, cheese or dried fruit that do not need any preparation or cooking.


Drinking too much alcohol

 

  • Make sure the person is well nourished.
  • Discourage them from drinking on a empty stomach – encourage them to eat as they drink.
  • If they want a drink, offer something other than alcohol.
  • Water alcohol down.


Difficulty using cutlery

 

  • Offer food that’s easy to eat with fingers.
  • Don’t use lots of different cutlery, crockery, glasses, foods and drinks together.
  • Allow time for their memory to respond.
  • Eat together so they can copy you.
  • Serve only one plate of food at a time.
  • Make sure they can see their food easily – put the food on a flat plate with no pattern so the food can be seen easily, and make sure the plate is in easy reaching distance.


Loss of appetite

 

  • Rule out any any treatable causes, such as illness or depression (constipation can also be common – see the next chapter for tips to deal with constipation).
  • Make sure the person’s meals are nutritionally balanced, with plenty of fibre to avoid constipation.
  • Continue to offer meals at regular times each day to tempt their appetite.
  • Allow them to eat when hungry, even if it’s not at what you would think of as a meal time.
  • Encourage some physical exercise or activity to work up an appetite.
  • Try to prepare familiar foods in familiar ways, especially favourite foods.
  • Encourage eating all or most of one food before moving onto the next as some people can become confused when the tastes and textures change.
  • Their ability to taste and smell food can change so cooking tasty, strong flavoured food might help.
  • Offer ice cream or milkshakes if they won’t eat a meal.
  • Try to make mealtimes simple, relaxed and calm – and make sure you give them enough time to eat, as it can take up to an hour to help someone with advanced dementia eat a meal.
  • If they are losing weight, see their doctor – ask about vitamin supplements.


Overeating/increased appetite

 

  • If they aren’t putting on weight, leave snack foods that don’t need any preparation out within easy reach.
  • Try five to six small meals each day.
  • If they are putting on weight, have low-calorie snacks – such as apples and carrots – available.
  • If the person is still able to get out and about, encourage physical activity or exercise.
  • Social contact might help – lots of people, whether they have dementia or not, over-eat out of boredom.
  • Lock some foods in cupboards, if necessary.


Sweet cravings

 

  • Check medications for side effects – some antidepressants can cause a craving for sweet things.
  • Try milkshakes, custards, or low-calorie ice cream.


Mouth, chewing and swallowing problems

 

  • Have a dental check-up of gums, teeth and dentures.
  • Serve food with gravies and sauces if a dry mouth is causing problems while eating.
  • For chewing problems:
    • try pressing lightly on their lips or under their chin to prompt chewing
    • tell them when to chew
    • demonstrate chewing
    • make sure their food is moist
    • offer small bites, one at a time.
  • For swallowing problems:
    • remind them to swallow with each bite,
    • stroke their throat gently
    • check the mouth to see if food has been swallowed
    • don’t give foods that are hard to swallow
    • offer smaller bites
    • moisten food
    • See a doctor if their problems are causing choking issues.


Confusion at the table
(pouring a glass of juice into a bowl of soup, buttering the serviette or eating dessert with a knife, etc)

 

 

  • Serve one course at a time.
  • Take away anything that can be distracting, such as extra cutlery, glasses or table decorations.
  • Make sure the plates, tablecloth and food are all different colours so they are easily see.n
  • Serve up finger food if using knives and forks is getting too difficult.
  • Eat with them so they can copy you.
  • Give them plenty of time to eat and don’t rush them.
  • Make sure where they eat is quiet, calm and well lit.
  • Serve familiar food so they have more chance of remembering how to eat it.

 

There is help available for you as you care for someone with dementia, contact your local Alzheimers organisation for more information.