A common experience of dementia and taste changes
A few weeks ago I spoke with Sara* whose father had just arrived at our long term care facility. “Is there anything your dad really likes to eat?” I asked her. Sara looked at me sadly and told me that they didn’t know any more – it was like he’d stopped enjoying the things he used to like to eat. This was an upsetting thing for Sara to have to tell us, but it is not unusual. I find that people with dementia and taste changes or changed food preference can be a common issue. At our facility we gave him our usual variety of meals and snacks and observed what he would and would not eat.
People with dementia may like different flavors
Many people with loved ones with Alzheimer’s notice that their loved one’s tastes seem to have changed. They often want to know why their loved one doesn’t seem to like their favorite foods anymore, or seem to only like sweet foods. This is something that we notice in long term care as well. I will often find that some folks will just want desserts. If we offer them a meal, they pick at it and eat very little, but once we give them dessert, they eat the entire thing. People also often really like nutrition shakes that taste sweet.
We also know that sometimes people with dementia will only eat very particular things. I had a client who would drink nothing but cranberry juice, and though it wasn’t something she preferred when she was younger, it certainly kept her hydrated.
Not everybody with dementia wants sweet foods. Sometimes people want spicier foods. I have had more than one client who was used to eating spicier food at home when they were younger. These clients can find the food in long term care a bit bland. This would be even more true if the person comes from a culture where spicier food is more common. I can remember a client from Southeast Asia whose family had to bring a spice mixture that we would shake on to his meals. He enjoyed his food a lot more once it had more flavor to it. Was that because our food tends to be more western and less spicy than he was used to? Was it because his dementia made it harder for him to taste flavors? It would not be possible to know, but adding spices to his meals certainly worked for him!
Why does taste appear to change in Alzheimer’s?
People often wonder if Alzheimer’s really affects people’s ability to taste things. There’s even a word for it – dementia taste buds. The truth is, Alzheimer’s can affect multiple parts of the brain, and these effects can be seen in various ways. What things taste like is no exception.
What does the research say?
These changes are known but not very well understood.
There has been some research that actually tests how well people with Alzheimer’s dementia are able to taste when compared to people who do not have any kind of dementia. Generally, people at a moderate stage of Alzheimer’s dementia are less able to recognize flavors than people without Alzheimer’s, and this worsens with dementia severity. The food really does taste that bland to them because they can’t actually taste the flavor very well. We do know that the problem is not actually from the taste buds, but is in the brain.
This might help explain why your loved one is eating odd things or wanting to put chocolate on all of their food. Their perception of flavor and taste is now different, and so this may be one of the few ways that they can still enjoy their food.
Other reasons that foods may taste different
There are other issues that can make it harder for people with dementia to enjoy the flavor of their food. There are some medications that can cause things to taste different, and can cause less saliva, which in itself will make things taste less good. You can speak to your doctor if you think a change in medication has caused a change in taste or enjoyment of food for your loved one
What can you do to help?
When we have somebody who comes to long term care and their family tells us that they no longer like the things they used to like, we observe what they will eat and what they will not eat, and we try different things.
Perhaps they really like sweet things, which is very common in dementia. Perhaps they like certain flavors, and we will do our best to make sure that they have these at their meals. As long as your loved one is safe and not eating something that’s going to hurt them, there’s no reason why you shouldn’t let them have unusual food combinations. I have certainly had clients who needed the staff in long term cate to add a sprinkle of sugar onto everything before they would eat it. This was helpful for them to eat better even if the food was something that wouldn’t usually be sweet, like mashed potatoes.
If they really only like desserts, you can give them desserts that are meant to be meal replacements, or supplement drinks like boost or ensure, that taste sweet and can replace a meal. You can also try my High Protein Chocolate Smoothie, Pumpkin Pie Protein Smoothie, and High Protein Lemon Pudding!
Enjoying food is the goal
Remember to keep in mind that the goal is eating enough and eating safely. If their food looks a little different than it used to, it is ok. Enjoying their food now and getting enough nutrition is more important than them eating the things they used to like in the past!
*Sara is not a real name and this story is not based on any particular client.
References
Contri-Degiovanni, P.V., Degiovanni, G.C., Ferrioli, E. et al. Impact of the severity of dementia due to Alzheimer’s disease on the gustatory sensitivity of older persons. Aging Clin Exp Res 32, 2303–2309 (2020). https://doi.org/10.1007/s40520-019-01442-w
Kouzuki, M., Ichikawa, J., Shirasagi, D. et al. Detection and recognition thresholds for five basic tastes in patients with mild cognitive impairment and Alzheimer’s disease dementia. BMC Neurol 20, 110 (2020). https://doi.org/10.1186/s12883-020-01691-7
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