Weight Gain In People With Dementia
In contrast and less common some people with dementia experience weight gain due to decreased mobility due to lack of exercise or an increased appetite. Frontotemporal dementia patients may be particularly attracted to sweet and starchy foods.
If you are concerned that the person is overeating or gaining weight, you should implement portion control when serving food or provide four or five small meals throughout the day rather than three large ones. If they feel the need to snack, replace high-calorie food items with low-calorie items such as fruit or crudites and dips. Keeping foods locked away or out of sight, so they are not encouraged to eat is also a good idea.
Increased activity will also help depending on their mobility, they should be encouraged to go for walks, but exercises in a chair can also help if they cannot walk.
Eating And Drinking Difficulties In People With Dementia
Eating and drinking difficulties are a major source of ill health and stress for people living with dementia and their carers. As dementia progresses, the cognitive, behavioural, and physical changes that occur can make eating and drinking increasingly challenging . These pathological changes are linked with hypermetabolism, reduced energy intake and greater physical activity, leading to malnutrition. The mechanisms underlying weight loss in dementia are complex, multifactorial, and only partly understood.7
What Are The Main Types Of Dementia
Alzheimers disease is the most common cause of dementia, accounting for around 2 out of every 3 of cases in older people. Vascular dementia is another common form, while dementia with Lewy bodies and frontotemporal dementia are less common.
It is possible to have more than one type of dementia at the same time. Alzheimers is sometimes seen with vascular dementia or dementia with Lewy bodies. You might hear this called mixed dementia.
The symptoms of dementia vary depending on the disease, or diseases, causing it. You can read more about the symptoms associated with different types of dementia on the Alzheimers Society website .
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Lack Of Physical Activity
If your loved one isn’t very active physically during the day, they may simply not be hungry. Encouraging them to participate in appropriate physical activities can help increase their appetite as well as improve their overall wellbeing. The Long Island Alzheimer’s and Dementia Center offers stage-specific day programs that includes appropriate physical activities on a daily-basis.
My Loved One With Dementia Won’t Eat What Should I Do
David Heitz is a writer who spent 13 years looking after and advocating for his father with Pick’s Disease, who died last year. David is a member of the American Society of Journalists and Authors.
Nothing breaks a caregiver’s heart like when their loved one stops eating. It’s then that we find ourselves asking: is this the end of the road?
There are relatively simple ways to determine whether a refusal to eat is only temporary or may be indicative of end of life. One of the best, most successful ways to get a person to start eating again is to give your loved one a favorite food, often a sweet. My dad’s last meal was three bites of coconut cream pie from Village Inn that I spoon-fed him.
Other times, the solution is as simple as making the food easier for your loved one to eat puree meals, served in rooms without any distractions to keep the task of eating front and center.
But generally, when a loved one stops eating, it’s because that conventional hand to mouth method has stopped working.
As one nurse told me toward the end of dad’s journey, Their refusal to eat is their last shred of dignity the last thing they can control.” I found that sentiment rang true for dad, who always used to sneer, You gotta eat to survive!” Dad, who lived with behavioral-variant frontotemporal degeneration, or Pick’s, for many years, always said no food tasted good to him. But for years he forced himself to eat anyway.
Are feeding tubes ever appropriate?
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Tips To Encourage A Person With Dementia To Eat More
As we have discovered, reduced interest in food for people with dementia could be due to many factors like changes in taste and smell as well as difficulty chewing food. Whatever the cause might be, there are some things you can do that will hopefully stimulate them into eating more.
Preparation for Mealtime
Choose the best time – There are often times when the person with dementia has more energy or is more hungry than usual try to schedule mealtimes during these times whenever possible.
Understand their preferences – You should consider if they enjoy the social aspect of eating and want you to share mealtimes with them or if maybe they feel self-conscious and prefer to eat alone.
Explore different food types and textures – Experiment with different recipes, spices, and textures to see what appeals. You could also try finger foods or cutting food into bite-sized pieces to make it easier for them to eat.
Prepare moist foods – Adding sauces or gravy to a meal will make it easier to swallow, especially if a dry mouth is an issue.
Thicken liquids – If you serve thin liquids to a dementia patient, they can easily lead to aspiration choking and coughing as they make their way down the throat. You can thicken them with pureed fruit or commercial thickeners.
Mealtime Best Practices
Remove distractions – Turn off the TV or radio at mealtimes to ensure they are focused on their eating. You could play some gentle and familiar music in the background.
But Will They Die From Starvation Or Thirst
In the end stages of dementia, when this phase typically develops, the need for food and fluid intake gradually declines over time and the body has already started to adjust. Activity has typically also decreased, so the person does not need to take in as many calories. Understanding this and observing activity levels can help the caregiver see why not as much food or drink is needed. A medical professional can make observations and reassure the carer that dehydration is not a factor or take steps to help.
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Swallowing Difficulties: What To Look Out For
If a person with dementia has difficulties swallowing they may not be able to tell you, however you may notice some of the following:
- repeated coughing and/or throat clearing after swallowing food or drinks
- choking when eating and drinking
- a wet sounding voice after swallowing
- a reluctance to eat and drink
- food and drinks are not swallowed but are held in the mouth.
How To Connect With The Person
Communicating with a person with late-stage Alzheimers disease can take effort and patience. Though that persons ability to respond may be limited, it is important to continue to interact:
- Continue to visit with the person even if responses are limited.
- Try to speak calmly and slowly be aware of the tone and volume of your voice.
- Consider sharing familiar stories with the person.
- Make eye contact, say the persons name and smile.
- Use other methods of communication besides speaking, such as gentle touching or massage.
- Have the person listen to music or calming nature sounds.
Learn more about how to communicate with a person who has Alzheimer’s disease.
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Problems Eating At The Table For People With Dementia
- Serve one course at a time and remove other distracting items from the table, such as extra cutlery, glasses or table decorations.
- Make sure the crockery is plain and that its colour contrasts with a plain tablecloth and with the food being served.
- If the use of cutlery is too difficult, serve finger food.
- Allow plenty of time to eat.
- Keep noise or activity in the environment to a minimum.
- Make sure there is adequate lighting.
- Eat with the person with dementia so that they can follow your lead.
- Serve familiar food.
Contact Long Island Alzheimer’s And Dementia Center
At Long Island Alzheimer’s and Dementia Center, we offer a full range of innovative day programs designed to help your loved one with Alzheimers and other forms of dementia remain active and engaged throughout the day. Our state-of-the-art center focuses on what diagnosed individuals can still do, happily and productively, and not on what they can no longer do. All of our programs are designed to be stage specific, such as:
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What Are The Warning Signs That Life Is Nearing An End
When an elderly person with dementia is almost bearing their end, it can be very traumatic especially for the loved ones. It is important to have an idea of what signs one needs to expect when the end comes as this can give you some sort of comfort.
When you think of a condition such as Alzheimers disease, a person can live for over 10 years with it. It is possible to make the person happy over those years. Since we are not immortals, at some point life does come to an end when you have dementia and it is something that one needs to be prepared for especially if they are caregivers.
Handling the final stage of dementia is much easier, especially when you are aware of the things that you should expect. It is important to give the person the kind of care that will award him or her dignified and peaceful death.
Usually, when a person is about to reach the end, the dementia symptoms usually get worse and this can be quite upsetting. Some of the things that you may notice include:
- Limited mobility so they may have to be bed bound
- Limited speech or no speech at all
- Double incontinence
- Difficulties swallowing and eating
It is important to note that the above symptoms do not really mean that the person will just die. There are people who can have such symptoms for quite some time. You should also remember that about two-thirds of dementia patients succumb to other ailments such as pneumonia.
Some of the other signs that can indicate that death is indeed close include:
Support Their Cultural And Spiritual Needs
Its good to be aware of the persons cultural and spiritual needs and make sure these are respected and supported. You can make use of any advance care plans or documents, friends and family input and your knowledge of the person. Its important to try and meet these needs as much as possible, they are just as important as medical care.
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Why Do Dementia Patients Stop Eating
There are multiple reasons why do dementia patients stop eating and it is important to understand why they may start to avoid food.
Dementia patients might refuse to eat if they either dislike the food or are trying to tell you their meal is too hot or too cold.
They may not even know that they should chew and swallow it.
Patients diagnosed with dementia will experience a as well as problem-solving and other thinking-related skills.
Alzheimers disease is the most common type of dementia and as many as 50 percent of these individuals find it difficult to eat at some point during their disease .
It becomes increasingly difficult for affected patients to perform normal daily activities. For this and other reasons, patients with dementia will spit out their food or stop eating entirely.
Chewing And Swallowing Problems
Individuals with dementia often suffer from an inability to chew or swallow properly and experience throat pain that accompanies many medical conditions. And as we all know, not eating means not getting enough nutrients in our diet, which ultimately affects our overall well-being.
Factors That Can Contribute to Swallowing and Chewing Difficulties
Some factors that can contribute to these difficulties, including dental issues such as cavities, gum disease, tooth abscesses, and dentures that don’t fit properly. Apart from that, there can be problems with coordination of tongue movements in the mouth and lack of saliva due to dehydration or medications.
Poor Dental Hygiene and Mouth Problems
The sensitivity and pain caused by dental problems such as decaying teeth or teeth that have become loose or cracked can make eating and swallowing difficult. Having mouth ulcers or sore gums can also be a source of difficulty when eating, and they may contribute to decreased oral intake in people with dementia.
The person’s sore gums or mouth ulcers may also be affected by ill-fitting dentures, which can cause great discomfort. Dentures must be checked for fit, and regular dental visits should be scheduled by the caregiver.
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Loss Grief And Dementia
One of the most powerful feelings that people experience when someone close to them develops dementia is a sense of loss and grief. Carers may not recognise these strong feelings when the person with dementia is very much alive and in need of care and support.
A carer may grieve many things:
- the person they once knew
- the future they had planned together
- the relationship they once shared
- the companionship, support or special understanding
- their own freedom to work or to pursue other activities
- finances or a lifestyle that they once took for granted.
Loss Of Appetite And Dementia
- Check with the doctor to make sure that there are no treatable causes for loss of appetite, such as acute illness or depression.
- Offer meals at regular times each day.
- Allow the person to eat when hungry.
- Encourage physical activity.
- Provide balanced meals to avoid constipation.
- Offer ice-cream or milkshakes.
- Try to prepare familiar foods in familiar ways, especially foods that are favourites.
- Encourage the person to eat all or most of one food before moving on to the next some people can become confused when tastes and textures change.
- Try to make meal times simple, relaxed and calm. Be sure to allow enough time for a meal helping the person to eat can take up to an hour.
- Consult a doctor if the person with dementia experiences significant weight loss .
- Check with the doctor about vitamin supplements.
- Carers should also make sure their own diet is varied, nutritious and enjoyable.
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Stocking Up And Storing Food
A person with dementia might need help keeping track of what food they have at home and storing food safely. You could try:
- storing food in ways that are easy to access and eat, such as pouring cereals into clear pots or cutting cheese into cubes
- buying frozen ready meals but be mindful that the person might need help reheating frozen foods safely. You could put labels with clear cooking instructions on the top of the meal. You could put notes reminding the person that the meals are in the freezer on the freezer door
- buying ambient temperature ready meals is another option, as these do not need to be stored in the fridge or freezer, so may be more accessible for some people
- checking the persons cupboards and disposing of anything out of date
A Look At The Evidence
Studies that observed changes in thinking of people who ate the Mediterranean or MIND diet suggest it might help the brain. For example:
- In one observational study of 116 cognitively normal adults, those who followed a Mediterranean diet had thicker cortical brain regions than those who did not. These brain regions shrink in people with Alzheimers, so having thicker regions could mean cognitive benefit.
- A follow-up observational study showed lower glucose metabolism and higher levels of beta-amyloid protein both seen in Alzheimers in people who did not follow the Mediterranean diet closely, compared to those who did.
- An analysis of diet and other factors found that, after an average of 4.5 years, people who adhered most closely to the MIND diet had a 53% reduced rate of Alzheimers disease compared to those who did not follow the diet closely.
- In a similar study, following the MIND diet was associated with a substantial slowing of cognitive decline during an average of almost 5 years.
- The Age-Related Eye Disease Studies originally looked at diet and eye disease. Further analysis by the researchers showed that people who followed the Mediterranean-style diet had a lower risk of developing cognitive problems while maintaining a higher level of cognitive function.
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How To Test For Dementia
There is no single test that can determine a person is suffering from dementia. The doctor can diagnose different types of dementia such as Alzheimers based on their medical history.
This has to be done very carefully. In addition, the doctor may conduct laboratory tests, physical examinations, and changes in the way the patient thinks.
When all things are considered carefully, a doctor can be able to determine that a person is actually suffering from dementia with certainty. Determining the type of dementia can be hard, especially due to the fact that brain changes and symptoms that are associated with the different types of dementias sometimes overlap.
It is normal for the doctor to give a diagnosis of dementia without really specifying the type. In such a case, it is important for the patient to visit a specialist in this area like a psychologist or neurologist for a more specific diagnosis.
Have An Nhs Health Check
An NHS Health Check is a free check-up of your overall health for people aged 40 to 74 who do not have heart disease, diabetes or kidney disease, and have not had a stroke. It’s offered every 5 years.
The NHS Health Check can help find early signs and tell you if you’re at higher risk of certain health problems that can also increase your risk of dementia. These include:
- heart disease
- kidney disease
If you’re over age 65, you’ll be told the signs and symptoms of dementia to look out for. You’ll also be given advice on how to lower your risk of dementia.
If you have not been invited for an NHS Health Check, ask your GP surgery.
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