People With Dementia May Experience Weight Loss
As we have already mentioned, one of the primary reasons for weight loss in people who have been diagnosed with dementia is the inability to swallow or chew food properly, which can lead to less intake of calories.
Other causes for this weight loss are decreased interest in food, reduced energy levels, forgetfulness about meals, depression, and some medications’ side effects. There may also be increased urination which can cause dehydration and constipation due to changes in metabolism.
Causes of Appetite Loss
Loss of appetite is a quite common symptom of dementia, but there are other possible causes for a decreased interest in food. It can be caused by depression or anxiety disorders or side effects from medications that they may be taking for another health issue or even another unrelated illness that could make someone feel too sick to eat.
If a lack of interest in food continues and the reason why can’t be ascertained, it is essential that a doctor or another medical professional is consulted so the root cause can be determined and addressed appropriately.
Here are some of the common causes:
Memory loss – Is one of the most common symptoms of dementia. A person with dementia may forget to eat or drink because they have difficulty recalling when the last meal was served or what time it is in the day.
Dealing With Stressed And Anxious Caregivers
Dealing with adverse eating behaviours can be stressful and burdensome for family, relatives, and carers. An appropriate care package and social support over the course of dementia are crucial for people who are living alone with dementia and for carers who need a break.
Tips for dealing with stressed and anxious caregivers:
- Put yourself in their shoes
- Explain why dementia can lead to a reduced oral intake in different stages and it may not be possible to meet their nutritional requirement
- Signpost to social services to arrange support and respite care
- Signpost to charity helplines
Where To Get Help
- Your local community health centre
- National Dementia Helpline Alzheimers Australia Tel. 1800 100 500
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care Tel. 1800 500 853
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Respite and Carelink Centres Tel. 1800 052 222
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Where To Start Helping The Person To Choose Foods They Enjoy
Its important to try to offer a choice of foods and to show the choices to the person. For example, if youre trying to work out a persons food preferences, show two types of breakfast cereal or hold up two tins of soup. This will help the person to make the connection more easily between the words you are using and their memory of that food .
If a person has difficulty expressing their preferences, they may still point or look closely at the item they prefer. Observing a person during mealtimes will also give some indication as to how well they are enjoying their food.
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Do Not Try And Alter Undesirable Behavior
Lack of understanding may push one to try and change or stop any undesirable behavior from patients who have dementia. Keep in mind that it is almost impossible to teach new skills or even reason with the patient. Try instead to decrease frequency or intensity of the behavior. For instance, respond to emotion and not the changes in behavior. If a patient insists on always asking about a particular family member reassure them that he or she is safe and healthy as a way of keeping them calm and happy.
Eating And Drinking At The End Of Life
People with dementia can develop problems with eating, drinking and their ability to swallow at any stage of their illness, although it is most common to see this at the more advanced stages. In this section you’ll be able to explore why this happens and how you can help.
When a person with advanced dementia takes in only a very limited amount of food and fluids or can no longer swallow safely, it can be an extremely difficult and emotional time for family and care staff as they try to work out how to best respond and care for the person with dementia. It is important to try and maintain eating and drinking, even in very small amounts, for comfort and enjoyment. Speech and language therapists can help and advise about swallowing changes at this time.
What happens when Pete can no longer swallow? Will he just starve to death? I dont want him suffering.
A woman speaking about her husband who has dementia.
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But Is My Loved One Suffering
As a caregiver, the most important concern is that the person with dementia is not suffering. Once we understand that this is a normal part of the disease, it makes it easier to see why the person does not need as much to eat or drink. In most cases, they will not show any sign of being hungry or thirsty, but if they do show interest, have an assessment done and get recommendations on what type of alternatives you can give to keep them comfortable.
Supporting A Person With Dementia Who Lives At Home To Eat Well
Over time a person with dementia is likely to develop problems preparing food, using cutlery, recognising food and drink, and remembering to eat and drink. In time, they may develop problems with chewing and swallowing also.
One of the biggest challenges for home care staff is having enough time to support a person at mealtimes.
When a person with dementia lives at home especially if they live alone these problems can lead to poor food and fluid intake. Malnutrition and dehydration can increase a persons care needs, worsen the symptoms of dementia and increase the risk of delirium, an acute confusional state.
So, supporting a person with dementia who lives at home to eat and drink well is crucial. This feature looks at some of the most important things home care workers need to know to support a person with dementia who lives at home to eat and drink well.
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Solutions To Help Alzheimers / Dementia Patients Eat
The following tips can make eating less stressful for your loved one:
In Early to Mid-Stage
Quiet DownSomeone with dementia may need to concentrate harder to accomplish any task, including eating, so make it easier by lowering noise and activity in the environment. Eat in quiet, clean, simple settings. You want your loved one to feel comfortable, without needing to rush.
Keep It SimpleToo many food options can cause frustration and overwhelm someone with dementia. Plate small portions.
Show HowDemonstrate the steps, like using a fork and knife to cut a piece of meat or spreading jam on toast. Resist the urge to feed your loved one, who may just be missing that one step or cue to continue with the meal.
Smaller BitesUse of utensils becomes more difficult as dementia progresses. Cut food into smaller bite-sized pieces, or serve finger foods.
BowlingServing meals in bowls rather than on plates can facilitate eating, as the sides make it easier to scoop food onto a fork or spoon.
Sip AssistsSomeone with dementia will probably have an easier time drinking if you provide a straw.
Stay HydratedPeople with dementia are less able to recognize their thirst. Watch for signs of dehydration: dry mouth, sticky saliva, and dark urination. Serve your loved one fluids, like water or juice, several times throughout the day . And offer foods that have high water content, including watermelon, cantaloupe, cucumbers, lettuce, soups, yogurt, and cottage cheese.
In Late Stage
When Seniors With Dementia Wont Eat
What can you do when your older adult loses interest in eating? For seniors with Alzheimers or dementia, this could be caused by a variety of factors, including loss of taste or smell, distractions, too many food choices, or having trouble with utensils.
Of course, youre trying to make sure they eat enough to maintain their health. This can make mealtime frustrating or unpleasant for both your older adult and you.
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Managing And Addressing Cravings
Whether your loved one is craving sugar and experiencing weight gain or you are having trouble getting him or her to eat at all, there are few basic guidelines to ensure proper nutrition.
1.Eat in a quiet and calm room with limited distractions so that your loved one can focus on eating.2.Eat meals together which can increase the likelihood that your loved one will eat the healthy meal provided.3.Pack in protein. Even if your loved one cannot chew meat well, try eggs, milk-based pudding, or even protein powder.4.Cut food into small pieces to make eating easier if your loved one can no longer use utensils.5.Puree vegetables and add them to a shake if your loved one will not eat vegetables on their own.6.Strengthen the prefrontal cortex responsible for dietary self-restraint by avoiding alcohol, getting adequate sleep, and exercising.7.At the end of life,allow them to indulge. Registered Dietician, Jillian Ball of Ball & Associates Nutrition Counseling says:
Food is one of the last things people can enjoy when theyre sick.
She cautions that if they still have a long life ahead of them to watch their sugar intake and monitor blood sugar if they have diabetes.
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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.
Dysphagia
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Do Not Engage In Arguments
One of the worst things a person can do to an individual who has dementia is to start an argument or even force them to do something that makes them upset or angry. When the discussion or argument is too heated, it may be better to walk away to create an environment where everyone can remain calm. Experts agree that one of the ways that can yield results when it comes to dementia behavior problems is to get rid of the word no when dealing with patients. Avoid forcibly restraining a dementia sufferer at all costs.
Dont Overwhelm The Patient
Whatever you do, dont go overboard and try to overfeed the person with dementia.
The Alzheimers Society site advised: Try not to overload the plate with too much food small and regular portions often work best.
Consider serving half portions to keep hot food from going cold and losing its appeal.
If the patient prefers to eat little and often or doesnt want to eat meals at set times or at a table, make finger foods and allow them to pick at what they want.
The advice reads: Try finger foods such as sausage rolls, falafel, samosas, spring rolls, sandwiches, slices of fruit and vegetables so they can snack on these instead.
Some full meals could be served as finger foods, for example, roast dinner, as long as theyre presented in easy-to-hold pieces.
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Changes In Food And Taste Preferences
As dementia progresses, a persons likes and dislikes for different foods may change. Some people may start to enjoy unusual food combinations, such as mixing sweet and savoury flavours. As a carer, it can be difficult to understand these changes and the following tips can help:
- Add a teaspoon of sugar or honey to savoury foods such as quiches, pies and omelettes.
- Serve sweet sauces with a main meal to add sweetness.
- Be adventurous and cook new dishes with herbs and spices.
- Roast vegetables such as carrots and parsnips with honey.
Tips For Eating And Drinking With Dementia
Eating a healthy and balanced diet is important for the physical and mental wellbeing of someone with dementia, so heres some tips to make eating and drinking a more positive experience for them.
People with dementia can experience problems with eating and drinking. Medical conditions such as depression, a urinary tract infection, constipation, pain due to problems with dentures, sore gums, or painful teeth maybe putting them off their food and drink.
Symptoms of dementia, like communication and co-ordination issues, recognising hunger, or chewing and swallowing difficulties could be inhibiting their appetite too.
Importantly, a problem with eating or drinking is unique to that person, so consider that persons beliefs, culture, life history, routines, preferences and needs to help find a solution tailored to them. Its also about positively encouraging them to eat and drink with gentle reminders, while enabling them to retain as much independence as possible.
Concentration issues could be tiring the person out and making them feel the mealtime has gone on for too long. Try finger foods, or smaller portions and snacks, on a more regular basis to make the task easier and so the food doesnt go cold.
If food goes cold it will lose its appeal so it may help to serve half portions to keep food warm. However, remember to test food so its not too hot as someone with dementia may not be able to judge this.
Well lit rooms will help the person to see the food better.
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Practical Tips To Help Someone With Dementia To Eat More
People living with Alzheimers or dementia often eat less than they used to. This can be due to medical problems associated with chewing, swallowing or digesting food.
Sometimes people just lose interest in food. This can happen for a long list of reasons including loss of taste, the ability to smell, memory loss, and thinking they have already eaten. Certain medications can also affect appetite.
The ability and want to eat tends to get worse as the disease progresses and ensuring someone living with dementia eats a nutritious meal, or eats enough, can become a real practical and emotional issue for the carer. We have compiled a list here of 8 practical tips for helping someone with dementia to eat more.
It Takes Time: Supporting A Person With Dementia At Mealtimes
One of the biggest challenges for home care staff is having enough time to support a person at mealtimes. Offering this support for example, prompting and encouraging a person to eat takes time and patience, and is as important as the quality of the food prepared. Food and drinks that are left untouched are of no nutritional benefit.
If you are finding that you need more time to give proper support at mealtimes, report this to your line manager. Social services need to be aware of extra needs a person may have and if a reassessment of time or type of input is required.
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What Is Artificial Nutrition And Hydration
ANH refers to any method used to provide food and fluids to anyone who is unable to swallow or take in food through the mouth. Usually, ANH is administered through a feeding tube that passes through the nose into the stomach, but may also be done through a tube that goes directly into the stomach wall. Fluid is also given intravenously or inserted under the skin subcutaneously. Sometimes ANH is difficult for the person with dementia. Forced feeding at this phase is a point for a debate in the process of care and is not recommended.
Understanding The Problem By Stages
In earlier stages of dementia, your loved one may be able to eat a meal without problems. However, preparation with multiple steps, like assembling a sandwich or making a salad, may be too difficult. Simpler meals that dont require assembling may be best.
As the disease advances into middle stages, your loved one may become messy at meal time, playing with or picking at food. Eating out, especially in crowded restaurants, can cause anxiety and may not be a good idea. Using utensils gets harder. Appetite begins to decrease. Its possible that appetite issues in the middle stages are related to frustration in a person unable to self-feed.
In late stages, the ability to swallow becomes compromised and care must be taken to avoid choking or blocking airways or filling the lungs with food . Eventually, you may have to remind your loved one to chew and even to swallow. For more, see below.
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