Is your loved one with dementia not eating their meals? There is no one reason that a dementia patient refuses to eat, but one important possibility is the fact that dementia causes confusion and affects decision making. I have seen folks with dementia who need help with starting a meal, who need someone to tell them what is on their plate, or who need a person to show them how to use their fork before they will start eating.
Dementia affects cognitive functions, which can make eating more confusing. This can get worse as the person’s dementia gets worse. A person with dementia can struggle with
- Recognizing foods
- Using utensils
- Deciding what to eat and how to eat it
- Being easily overwhelmed at mealtimes
What does this look like?
Not Recognizing Foods
Difficulties with vision
People with dementia are more likely to have visual difficulties, and have issue understanding what they can see. Serving foods on a plate that creates more visual contrast between the table, the plate and the food can help your loved one with dementia to see what is on the plate. You’ve probably heard of using brightly colored plates for this reason! Research shows that a bright red or a bright blue plate will help with seeing food on the plate.
Understanding what food is on the plate
People with dementia may also struggle with understanding what foods are on their plate, even if they can see them well. I definitely had one client in the past who did not like foods that were “mixed together”, like casseroles, or stews, because she was not sure what the food was. She did much better if there was a clear difference between her veggies, starches and meat. She also needed someone to tell her exactly what was on her plate, which really helped her enjoyment of it.
Difficulty using utensils
People with dementia can sometimes have real difficulty with using utensils. This can simply be because of arthritis in their hands making it difficult to use or hold a fork, or the poor motor control that can sometimes come with dementia. If they’re having difficulty holding their utensils, you may need to place a spoon or a cup in their hand. You can also adapt utensils to make them easier for your loved on to use. A common solution for a person having difficulty holding a spoon or fork is adding some foam tubing over the handle of the utensil. This makes the handle larger, softer, and the utensil easier to hold.
Finger foods
If your loved one cannot use utensils at all, it may be easier to give them finger foods. These are foods that you can pick up with your hands. Generally these are items that are the right size to pick up between two fingers, and are not messy or saucy so they do not make their hands dirty. Some examples might be sandwiches, cut up vegetables, or cut up meats like chicken strips.
Being overwhelmed at meals
Sometimes people with dementia can become easily overwhelmed or distracted. This makes it harder for them to focus on the meal and on eating.
Reduce distractions
It can be helpful to remove distractions at meal time. Turn off the television so that your loved one only has the meal to focus on. If having many items on the plate or on the table makes it hard for them to decide what to do next, try giving them one thing at a time. You can give just a salad first, and then a sandwich.
Remind them of what to do
Some people with dementia have a difficult time at the beginning of the meal because they’re not sure when or how to start. I have found that it is helpful to start a person off by telling them what is on their plate and putting the utensil in their hand and encouraging them to eat. I’ve definitely had at least one client who would eat very well, but you had to tell him to do it.
Why this is important
When a person with dementia does not eat well, this can cause malnutrition, dehydration, unintended weight loss and loss of muscle mass. That in itself can cause loss of strength and increased risk of falling. When a dementia patient refuses to eat, they may not be refusing at all; there may be some other issue. Helping your loved one with their confusion at meals will help them to eat better, and get better nutrition!
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