What Causes A Dementia Patient To Stop Eating 4 Factors To Consider
The global statistics for dementia are mind-boggling. As of 2017, the total number of people with dementia was estimated to be 50 million.
This number is expected to rise to 75 million by 2030. Furthermore, in the US alone, one in three elderly people dies from Alzheimers or another form of dementia.
These increasing numbers of cases bring with them increasing challenges.
Feeding such patients is indeed one of the biggest challenges.
Poor nutrition increases the risk of dehydration, muscle loss, higher chances of infection, a decline in the overall well-being, and even death .
In the seven stages of Alzheimers a patient moves from their dementia being barely detectable to an extremely severe, steady, and visible decline .
Its not abnormal for Alzheimers patients to stop eating or drinking in the later stages of their diagnosis.
Approximately 50 percent of diagnosed Alzheimers patients wont eat enough food or drink sufficient fluids . The resulting weight loss develops into a larger problem as their disease progresses.
As per research, following are the four main reasons dementia patients stop eating and drinking as their disease progresses.
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.
Reasons Why Your Loved One Has Stopped Eating And Drinking
There are many reasons why a person with dementia may lose interest in or turn down, food, and drink.
- Depression: A common sign of depression is a loss of appetite, and depression is common in people with dementia. If your loved one has depression, then their appetite should improve if their depression is treated appropriately.
- Communication: As dementia progresses, people with dementia have difficulty communicating their needs including the need that they are hungry or dont like the food they have been given.
Alternative methods of communication and speech therapy to help your loved one express themselves better is often the solution for poor eating and drinking-related to communication difficulties.
- Pain: Weve all experienced a bad toothache or sore throat. Your loved one may be having problems with their dentures, teeth, or gums. If they have difficulty communicating, then they wont be able to tell you theyre experiencing pain.
Oral hygiene and regular mouth checks are essential to prevent oral pain and discomfort.
- Tiredness: If your loved one is fatigued, then they may stop eating partway through a meal or simply not eat at all. This can also cause concentration and coordination difficulties, so its best for your loved one to eat while theyre most alert.
- Medication: People react to medicine differently, and changes in brand or dose can result in appetite changes. Monitor your loved one carefully and speak to their doctor if you have any concerns.
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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.
Why Do People With Dementia Stop Eating And Drinking
One of the most distressing phases during the span of time caring for someone with dementia can be when the person has stopped eating or drinking. As hard as it is to see, this is often a natural part of the disease. As a caregiver, it is important to understand some of the causes of this stage of the disease, what it means for the person you care for and some ideas that may help.
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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.
Dont Forget To Hydrate Dehydration Can Mimic Dementia
We need both food and water. The symptoms of dehydration can mimic dementia. Look for ways to get more water into your loved one or clients routine. Find something they like to drink and offer it often.
Poor nutrition, low blood sugar, and dehydration all make people physically uncomfortable, and physical discomfort can make us unpleasant company. Looking for ways to maximize nutrition and hydration is another important way we can improve the caregiving relationship.
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Rule Out Medical Issues
If the person with dementia or Alzheimers has a sudden change in their ability or interest in eating, or if they have a sudden weight loss, its important to first rule out any medical explanations, Drew says. They may have dental problems, pain, indigestion, constipation or some other medical explanation that they are unable to articulate, she explains. People with dementia often have trouble communicating pain, which means that it can be under-recognized and treated.
While getting a senior with dementia or Alzheimers to eat enough can be a huge challenge, these expert tips can make the process much easier for caregivers.
How To Ensure The Person Eats Well
In the later stages of Alzheimers disease, many people lose interest in food and caregivers may notice changes in how or when they eat. They may not be aware of mealtimes, know when they’ve had enough food, or remember to cook. If they are not eating enough different kinds of foods, they may not be getting the nutrients they need to stay healthy.
Here are some suggestions to help a person with late-stage Alzheimer’s eat better. Remember that these are just tipstry different things and see what works best for the person:
- Serve bigger portions at breakfast because it’s the first meal of the day.
- Offer several smaller meals throughout the day.
- Serve meals at the same time each day.
- Make the eating area quiet. Turn off the TV or radio.
- Control between-meal snacks. Lock the refrigerator door and food cabinets if necessary.
- If the person has dentures, make sure they fit. Loose dentures or dentures with bumps or cracks may cause choking or pain, making it harder to eat. Remove poorly fitting dentures until the person can get some that fit.
- Let the person’s doctor know if they lose a lot of weight, for example, if he or she loses 10 pounds in a month.
You can also try different ways of preparing the person’s plate. For example:
If the person needs help eating, you might try to:
When choosing foods to eat and liquids to drink, these suggestions might help:
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How To Help With Memory And Concentration Changes
Over time, a person with a dementia can have difficulties concentrating and sitting at a table to eat a meal.
If you are caring for a person with a dementia, you might think:
- they have finished eating
- they aren’t hungry
If they don’t eat enough or eat unhealthy food, they can become vulnerable to other illnesses. People with a dementia can become more confused if they get ill.
To encourage them to eat and drink, you can:
- invite them to the table when the meal is ready so they dont have to wait
- direct their attention to the food
- put the cutlery or cup in their hand if needed or guide them to take the first mouthful
- feed them the first mouthful if necessary and then encourage them to feed themselves
- remind them to swallow each mouthful as needed
- use gentle physical prompts, like putting the cutlery or cup back in their hands
- if they leave the table, gently guide them back and prompt them to continue
- if they forget they have already eaten or are concerned about when is their next meal, reassure them and provide them with a snack if appropriate
- eat with them, this makes eating a social activity and can help them stay independent as they may copy what you are doing
- keep encouraging them to feed themselves, if they are having difficulties, feed them some or all of the meal
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.
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What Health Problems Can It Cause
Not getting enough to eat or drink can lead to:
- Dehydration: To make sure they get enough fluids, give them drinks that are easy to drink and they like. Try flavored water, juices, sport drinks, lemonade, or Popsicles. Itâs common for people with advanced Alzheimerâs disease to stop drinking to the point of dehydration. This is often part of the process at the end of life. If your loved one gets dehydrated often or theyâre in the advanced stages of Alzheimerâs, you should have a plan about whether to use feeding tubes or an IV.
- Weight loss: This can be a sign of other problems, but if someone doesnât eat, this is the most likely cause. If your loved one has lost more than 5 pounds in a week or 10 pounds in a month, they should see a doctor. To help them keep weight on, skip low-fat or low-calorie foods. Serve high-calorie foods, like milkshakes, protein drinks, ice cream, and smoothies. If the weight loss continues, talk to their doctor.
Additional Resources For Dementia And Eating Issues
Read and download the NHS helpful Dementia Care Guide Support with eating and drinking . This guide talks about the common problems those living with dementia can have at meal time, and offers some tips to resolve them.
Another great tool that carers can use is The DMAT . The DMAT enables carers to assess, select interventions and generate a person centred care plan to support mealtime eating abilities and meal behaviours in people with advancing dementia. You can learn more about the DMAT and its benefits on their website.
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Are You Looking For Dementia Care Resources
Hope Hospice offers a free education series for family caregivers. The live webinars cover a variety of topics, including four presentations specifically on aspects of dementia care.
People living with dementia generally do not need to follow a special diet, unless they have co-morbidities or allergies that
What To Do About Incontinence
Incontinence means a person can’t control his or her bladder and/or bowels. This may happen at any stage of Alzheimer’s disease, but it is more often a problem in the later stages. Signs of this problem are leaking urine, problems emptying the bladder, and soiled underwear and bed sheets. Be sure to let the doctor know if this happens. He or she may be able to treat the cause of the problem.
Accidents happen. Try to be understanding when they occur. Stay calm and reassure the person if he or she is upset. Incontinence supplies, such as adult disposable briefs or underwear, bed protectors, and waterproof mattress covers, may be helpful. Learn more about dealing with incontinence.
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Why Are There Swallowing Problems
As dementia progresses it affects the area of the brain that controls swallowing. In advanced dementia the person may have a weak swallow or lose the ability to swallow safely. For example, they may cough or choke after swallowing food or drinks. See the Chewing and swallowing problems feature in the Eating well section.
Swallowing problems can also be caused by general weakness and frailty of the person, that is, their swallowing muscles become very weak. In addition, changes in sensation and sensory awareness means that some people will find the experience of eating feels very different and may, at times, feel unpleasant to them.
Other problems such as having a sore mouth or sensitive teeth can cause a person to take in less food or develop swallowing problems. You should bring these difficulties to the attention of a doctor, nurse or dentist as soon as possible to review.
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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How To Still Eat Well In Late
We all require adequate nutrition and hydration in order to stay healthy, but those with late-stage Alzheimer’s disease are at a higher risk for malnutrition because of problems with eating and swallowing. Additionally, those with swallowing difficulties can breathe liquids or food particles into the airway and lungs, putting them at an increased risk for developing pneumonia. If your loved one has late-stage Alzheimer’s, the following strategies can help him or she eats and drink safely:
Mouth Chewing And Swallowing Problems In Dementia
- Arrange a dental check-up of gums, teeth and dentures.
- Moisten food with gravies and sauces if a dry mouth is causing problems.
- 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, check the mouth to see if food has been swallowed do not give foods that are hard to swallow, instead offer smaller bites and moisten food.
- Consult their doctor if choking problems develop.
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Tips To Help Make Mealtime Go Smoothly
Theres no one-size-fits-all method to combat feeding challenges, so try out a few of these methods to see what might work for your patient.
- Provide a calm environment free of distractions like television and loud conversation.
- Play relaxing music at a low level.
- Keep the table clutter free. A busy tablecloth design, a centerpiece of fake fruit, and stacks of paper items can confuse a person who already struggles with sight deficits.
- Serve only one or two food items per meal and keep portions small.
- Be flexible. Start with known food preferences, but dont be discouraged if the old stand-bys arent always well received.
- Ensure dentures fit correctly.
- Be patient. It may take up to an hour for him to finish, and thats okay.
How Can Dementia Affect A Person’s Appetite
A person with dementia may lose interest in food. They may refuse to eat it or may spit it out. The person may become angry or agitated, or behave in a challenging way during mealtimes.
If a person isnt eating enough, it can lead to weight loss and less muscle strength. They may also feel tired and weak. This can make them frailer and less able to recover from infections or viruses.
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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.