Dementia - eating

A person with dementia may find eating difficult. Loss of appetite, loss of memory and problems with judgement can all cause difficulties with food and eating. The person may forget how to chew and swallow, or may be easily distracted by their surroundings.

Meal times are a chance to spend time with family and friends and to share food together. For a person with dementia, and for those caring for them, meal times can also become stressful. There are ways to make life as a carer easier and to help the person with dementia maintain a healthy diet.

Loss of appetite#

A person with dementia may forget how to chew and swallow. Other reasons for an apparent loss of appetite can include ill-fitting dentures, too little physical activity and feeling embarrassed by difficulties with eating. Things that might help include:

• Check with the doctor to make sure there are no treatable causes for the loss of appetite, such as an acute illness or depression.
• Offer meals at regular times each day.
• Allow the person to eat when they are hungry.
• Provide balanced meals to help avoid constipation.
• Encourage some physical activity.

Try to prepare familiar foods in familiar ways, especially favourite foods. Offer ice cream or milkshakes if appetite is low. Encourage the person to eat all or most of one food before moving on to the next, as some people become confused when tastes and textures change.

Try to keep meal times simple, relaxed and calm, and allow enough time, as helping the person to eat can take up to an hour. Talk to the doctor if the person experiences significant weight loss, and ask whether vitamin supplements may be helpful.

Carers should also make sure their own diet is varied, nutritious and enjoyable.

Overeating or an insatiable appetite#

Dementia can cause some people to overeat or to develop an insatiable (unstoppable) appetite. Things that might help include:

• Offer five to six small meals each day.
• Keep low-calorie snacks available, such as apples and carrots.
• Leave healthy snack foods on the table, which may be enough to satisfy some people.
• Consider whether other activities, such as walks or more social contact, may help.
• Lock some foods away if necessary.

Cravings for sweet foods#

Some people with dementia crave sweet foods. Things you can try include:

• Check medications for side effects, as some can cause a craving for sweets.
• Satisfy sweet cravings with foods that also have some nutritional value, such as milkshakes, eggnogs or low-calorie ice cream.

Mouth, chewing and swallowing problems#

Some eating difficulties relate to the physical condition of the mouth. A dry mouth, or discomfort from gum disease or ill-fitting dentures, is common. Things that might help include:

• Arrange a dental check-up of the gums and dentures.
• Moisten food with gravies or sauces if a dry mouth is a problem.

For chewing problems, try light pressure on the lips or under the chin, tell the person when to chew, demonstrate chewing, moisten foods, or offer small bites one at a time.

For swallowing problems, remind the person to swallow with each bite, stroke the throat gently, and check the mouth to see whether food has been swallowed. Avoid foods that are hard to swallow; instead offer smaller bites and moisten food. Consult the doctor if choking problems develop.

Eating at the table#

Behaviour such as pouring a glass of juice into a bowl of soup, or eating dessert with a knife, can be a sign that a person with dementia is finding the dinner table difficult. Things that might help include:

• Serve one course at a time, and remove distracting items such as extra cutlery, glasses or table decorations.
• Use plain crockery in a colour that contrasts with a plain tablecloth and with the food.
• Make sure there is adequate lighting.
• Keep noise and activity in the surroundings to a minimum.
• If using cutlery is too difficult, serve finger food.
• Eat with the person so they can follow your lead.
• Allow plenty of time to eat.

Other meal-time strategies#

• Keep eating simple. Not all food has to be eaten with cutlery if this is becoming difficult, and finger foods can be a nutritious, easy alternative.
• Keep in mind the person’s past history with food. They may have always had a small appetite, been a big eater, or had a craving for sweets.
• Watch food temperatures. Warm food is more appetising, but some people with dementia lose the ability to judge when food or drink is too hot. Take care with foam cups, which hold heat for a long time and tip over easily.
• Offer support. Spoiled food in the refrigerator, hiding food or not eating regularly may all be signs that someone living alone needs more help.
• Offer fluids. Regular drinks of water, juice or other fluids are essential to avoid dehydration. Many people with dementia do not drink enough because they forget, or no longer recognise the sensation of thirst.
• Be prepared for changes. Many eating problems in dementia are temporary and will change as the person’s abilities change over time.

Caring for a person with dementia can be challenging. If you would like further support, speak to the person’s doctor or a local carer support service.

Key points#

• Loss of appetite, loss of memory and problems with judgement can cause difficulties with food and eating.
• There are ways to make life as a carer easier and to help the person with dementia maintain a healthy diet.
• Dementia may cause some people to overeat or even develop an insatiable (unstoppable) appetite.
• A dry mouth or discomfort from gum disease or ill-fitting dentures is a common problem.
• Regular drinks of water, juice or other fluids are essential to avoid dehydration.

Where to get help#