If you have been taking care of your mom, dad, spouse, or grandparent with dementia for any time, you will probably notice that they are not eating the way they used to. One of the more common concerns I hear when I talk with people who have loved ones with dementia is that their loved one is not eating enough. People always want to know why they are not eating well and what can be done about it.
Why do people with dementia eat less?
- Different kinds of dementia affect various parts of the brain in unique ways. The way this affects what, how, and how much a person eats is not always the same, but not eating enough is pretty common, and often gets worse as the dementia progresses.
- We do not know exactly what happens in the brain in different dementias that causes changes in eating, but there are some commonalities that can result in people with dementia eating less.
Loss of appetite
In some dementias, particularly Alzheimer’s and Lewy Body Dementia, a person’s appetite can decrease and lead to weight loss. They may eat very little or be less interested in meals.
- What can we do about it? If someone isn’t eating much, you want to make sure every bite counts. You can make sure the food they do eat is extra nutritious, with extra calories and protein so that they are less likely to lose weight even if they eat less.
- For instance, use full-fat versions of foods they like, and offer protein bars as small snacks between meals.
- Add more nutrition to your loved one’s meals with my guide on adding calories and protein
- Try high calorie, high protein snacks like
Difficulty making decisions
Decision-making can become much more difficult for someone with dementia. I have seen folks have a bowl of soup placed in front of them along with a plate of food, a cup of juice and a cup of tea, and a dessert, and with all of this food in front of them, they just don’t know what to do. Someone with dementia in that situation can become too overwhelmed to choose what they want to eat.
- What can we do about it? I find that for someone who is getting more confused and overwhelmed at meals, providing fewer options can be very helpful. I might remove everything from the table and just put a bowl of soup and a spoon in front of the person and ask them to have some soup. That’s much less confusing!
Changes in how things taste
I cannot tell you the number of times I have had folks ask me how to help their loved one eat more when they don’t even want their old favorites. This can be really confusing and frustrating for you as a family member, as you might try to make your loved one’s favorite food, only to discover that they don’t like it anymore. People with Vascular Dementia and Frontotemporal Dementia are more likely to experience this. People with Parkinson’s also can experience taste changes that make old favorites taste strange and unappealing. It’s also really common for people with dementia to simply just want sweet things.
- What can we do about it? This is an issue where you may have to learn more about the changes that your loved one is experiencing. You may have to try new flavors, blander foods, or sweet foods. I’ve had more than one client who wanted to add a bit of salt to everything. See my post on taste changes in dementia for more information and try different things with them and see what works!
Confusion around how to eat
Dementia affects cognitive functions, which can make eating more confusing. A person with dementia might forget what certain foods are, or how to use utensils. For instance, they might try to eat soup with a knife. This confusion can make meals frustrating, and they may be less likely to eat much.
- What can we do about it? When I have clients who are more confused around eating, it can be helpful to remind them of what to do. Some folks just need you to help them to get started by putting a fork in their hand and reminding them of the foods that are in front of them. Some others might need a bit more help and reminding all throughout the meal. It can also help to remove distractions, like turning off the television so that your loved one only has the meal to focus on.
Chewing or Swallowing Issues
In some dementias, including Alzheimer’s and Vascular Dementia, you might notice your loved one is having difficulty with chewing and swallowing. This can be scary, especially if you start to notice that your loved one is getting food stuck or food is going the wrong way when they try to swallow. This can cause them to not want to eat, or it may be frightening for you when you try to help them eat.
- What can we do about it? This is an issue that may need a professional in your area who can meet with you and your loved one. With my clients I usually find adjusting the food helps. For instance, they may find it easier to swallow softer foods, and so I make sure that they only get foods that are soft, moist, and easy to chew and swallow.
Understanding why your loved one with dementia might be eating less is the first step in figuring out how to help them. When you are able to recognize these changes in their eating, you can use these strategies to support them!
A quick guide to why your loved one might be eating less (and what you can do about it)
Download this easy-to-follow handout on reasons people with dementia eat less, and for each reason, practical tips to help you help them get better nutrition.
Referrals
Kai K, Hashimoto M, Amano K, et al. Relationship between eating disturbance and dementia severity in patients with Alzheimer’s disease. Plos one. 2015;10(8):e0133666. DOI: 10.1371/journal.pone.0133666.
Cipriani G, Carlesi C, Lucetti C, Danti S, Nuti A. Eating Behaviors and Dietary Changes in Patients With Dementia. Am J Alzheimers Dis Other Demen. 2016 Dec;31(8):706-716. doi: 10.1177/1533317516673155. Epub 2016 Oct 21.