Meals

When caring for someone with dementia, mealtime can sometimes become stressful and frustrating. The impact of Alzheimer’s disease and other dementias on the brain may cause the person to experience an altered sense of taste or smell, as well as the inability to interpret bodily sensations associated with eating, such as hunger, thirst, or fullness. Changes in appetite can vary from person to person.

There are a lot of things to consider with regards to mealtimes for the person with dementia. Making sure that the person with dementia gets a well-balanced diet and is properly hydrated is very important. Caregiving at mealtimes also involves a balance of encouraging independence and offering assistance when it is needed.

Some general things to consider include making meals as simple as possible and trying to maintain daily routines.

How Dementia Can Impact Eating

Learning to assess the eating habits of the person with dementia could help resolve some of the mealtime issues that you encounter. Here are some possible reasons why people with dementia may refuse to eat:

  • They have a dry mouth or other discomfort in their mouth (dentures do not fit)
  • Motor skills have diminished and they cannot use utensils
  • Illness causing them to lose appetite (for example, pneumonia, urinary infection)
  • A condition such as constipation or depression causing a lack of appetite
  • Sensory skills have diminished (cannot taste or smell food)
  • Poor lighting
  • Food looks unappetizing
  • Too many distractions (new environment, too much noise, too much on their plate)
  • They no longer understand how to eat
  • Side effects of certain medications can include decreased appetite
  • The person with dementia sense the caregiver’s impatience when it comes to meals
  • Fear or anxiety

Tips for Improving Mealtime

Atmosphere

  • Minimize distractions (for example, turn off the television or radio)
  • Make sure that the lighting is adequate
  • Ensure that there are no loud noises or abrupt noises
  • Keep in mind the number of people who will be dining with you
  • Encourage meals with other family members
  • Consider using soft, relaxing music
  • Try hanging pictures of food on the wall of the dining room to cue appetite

Table settings

  • Only provide the necessary utensils and condiments for the meal
  • Provide sharp colour contrasts between the table, place mats, and plates
  • Ensure that plates are stable and will not slip, consider a damp cloth under the plate to prevent it from slipping
  • Avoid sharp utensils such as knives, consider using plastic cups
  • Use plain coloured bowls, plates, place mats, etc.

Food

  • Whenever possible, try to involve the person with dementia in the food preparation
  • Try to stick to food favourites that the person with dementia will enjoy
  • Provide food that is colourful and contrasts with other foods
  • Cut food into manageable bite-sizes
  • Make sure that the food is not too hot or too cold
  • Avoid foods that may be hard to chew such as nuts, raw carrots, popcorn
  • If the person with dementia has difficulty swallowing, make sure that the food is soft (examples eggs, casseroles, soups)
  • Provide finger food whenever possible
  • Use mugs or cups for soup
  • Consider smoothies or other liquid food supplements that could sometimes replace a meal
  • Limit the number of choices, consider providing 5-6 small meals rather than 3 large meals.
  • Consider using vitamin supplements as recommended by a doctor

Giving Instructions

  • Use simple one-stop instructions, break it into small steps
  • Speak with a soothing and calm tone
  • Cue the person with words or actions (encourage the person to follow your motions for eating)
  • If necessary, use hand-on-hand guidance to help initiate eating
  • Tell the person with dementia what food you are giving them
  • Avoid commenting on spilled food that could cause embarrassment
  • Do not rush the person with dementia
 

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