Drinking Their Meals Is Also Possible
Another great way for your loved one to receive their calories and nutrients are smoothies. They represent a great way to mix in vegetables like carrots, kale, or spinach to the fruit mix, mixing together various different foods in a tasty, liquid package.
Some other foods you could add to the smoothie are peanut or almond butter, avocados, yogurt, flax seeds, soy or almond milk, and even wheatgrass powder.
If you want to enhance the taste, you can also add vanilla extract or liquid stevia, which will also add a sweet taste to the smoothie.
Alternatively, you can also have a few nutrition drinks around, since these are also a great way for your loved one to receive their nutrients when all else fails.
Why Do People With Dementia Have A Change In Appetite
There are multiple reasons for a dementia patient to eat too little or too much. Some people may have difficulty noticing their hunger or may have a problem with communicating their hunger due to their condition, especially if they are not being monitored by someone. There are also some medications that can cause a patient to not be able to taste their food, this, in turn, can result in the patient losing interest in eating. Dementia patients may even forget the purpose of food or how to chew or swallow food.
Eating and drinking is a process that involves the control center of the brain and muscles such as the neck and throat. The progression of dementia affects these areas ultimately leading to coughing or choking, struggling to swallow, exaggerated movements of the tongue and mouth, or outright spitting out food.
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.
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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.
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.
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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?
Arrange The Food On The Plate
You may need to experiment with different sizes, textures and flavours of food to see which the person responds to the best. Here are some tips to help you change things up:
- Add variety in the colour of food different colour vegetables help to really brighten up the plate.
- Try less quantities of food and fewer individual items on the plate.
- Think about what types of food they have always enjoyed in the past. Put it on the plate with another food right next to it.
- Cut up the food into small pieces.
- Change the texture of the food potatoes could be mashed, boiled, baked for example.
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Should Food And Drink By Mouth Be Continued
If the person wants to eat or drink but struggles with swallowing, it is important to have a healthcare professional assesses their ability to swallow, such as a Speech Therapist or General Practitioner. A balanced diet at this stage is not so important. Rather, offer the person foods and drinks that they appear to be able to swallow and appear to be desirable foods. If they want only sweet things or cold things, accommodate them.
How To Help A Person With Dementia Manage Overeating
- Giving the person healthy snack options when they want to eat can help. Snacks like fruits and nuts can satisfy their hunger in between main meal times.
- In general, try to buy and cook healthy foods. Too much of anything is bad for you, but youd probably rather have them eat too many carrots rather than too much lasagne.
- Make sure most of their plate is salad or vegetables.
- Ensure that theyre drinking enough water. Sometimes they may have mistaken thirst for hunger. Make sure theyre hydrated and give them a glass of water with their meal.
- Another reason they could overeat is if they feel bored or lonely. Try to keep them occupied. Here are some memory care activities that you can do at home.
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Can You Forget How To Swallow Why Do Alzheimers Patients Eventually Stop Eating
I am sending this question directly to my co-author Dr. Rosemary Laird, an amazing Geriatrician and Medical Director of the Aging Institute at Health First Hospital system in Melbourne, Florida. Dr. Laird is a wonderful expert in geriatric medicine, a friend, and the co-author of Take Your Oxygen First:
Alzheimer’s is a disease that affects the brain. As the disease progresses to later stages and the changes in brain move from the memory and thinking centers, it creates “memory loss” in some of the physical parts of the body as well. Even the somewhat automatic actions, such as chewing and swallowing, become uncoordinated and ineffective. Ultimately, the brain is responsible to make the decision to swallow.
Similar to how you might see a patient with Alzheimer’s disease become less steady on their feet or a bit more clumsy when using utensils, a patient may eventually “forget” how to swallow. In some cases, this may lead to a diminished gag reflex and drooling. At initial signs of difficulty, help with swallowing may be available through the use of thickening agents and new eating techniques recommended by a speech-language therapist.
For some patients, these changes in ability to chew and swallow result in their eating and drinking less. For other patients, while they maintain ability to chew and swallow, they lose the usual response to hunger that leads us to eat throughout the day.
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.
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What To Do About Swallowing Problems
As Alzheimer’s disease progresses to later stages, the person may no longer be able to chew and swallow easily. This is a serious problem. Difficulty with swallowing may lead to choking or cause food or liquid to go into the lungs, which is known as aspiration. This can cause pneumonia, which can lead to death.
The following suggestions may help with swallowing:
- Make sure to cut food into small pieces and that it is soft enough for the person to eat.
- Grind or blend food to make it easier to eat.
- Offer soft foods, such as yogurt, applesauce, mashed avocado, sweet potatoes, and bananas.
- Don’t use a straw, which may cause more swallowing problems. Instead, have the person drink small sips from a cup.
- Offer drinks of different temperatures warm, cold, and room temperatureto see which might be easiest for the person to drink.
- Don’t hurry the person. He or she needs time to chew and swallow each mouthful before taking another bite.
- Encourage the person to feed themselves as much as possible during meals. If the person needs support, try using overhand, underhand, or direct hand feeding approaches.
- Don’t feed a person who is drowsy or lying down. He or she should be in an upright, seated position during the meal and for at least 20 minutes after the meal.
- Say “swallow” to remind him or her to swallow.
- Find out if the person’s pills can be crushed or taken in another form.
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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Ways To Help Manage Overeating
- Ensure that the person has something to do, so that they dont feel bored or lonely.
- Divide the original portion into two and offer the second one if the person asks for more.
- Fill most of the plate with salad or vegetables.
- Make sure the person is well hydrated as they may be mistaking thirst for hunger. Ensure they have a drink with their meal if possible.
- Leave bite-sized fruit or healthy snacks, such as chopped bananas, orange segments or grapes, within reach for the person to snack on when they want to.
- Offer the person a low-calorie drink instead of more food.
- Consider not having certain foods in the house, or substituting them with low-fat or low-calorie versions.
If the person has developed a strong preference for particular foods, and is not eating enough of other foods, or if they are struggling with excess weight gain, ask the GP for referral to a dietitian.
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Eating Appetite Changes And Weight Loss In Dementia
When we think of dementia, we typically focus on memory loss, difficulty finding the right word, disorientation or poor decision-making skills. These cognitive aspects are central to Alzheimer’s and other kinds of dementia. However, other challenges in caring for the person with dementia include those related to activities of daily functioning, such as eating, drinking, bathing, and dressing. This includes difficulties in eating and appetite changes, which often result in unintended weight loss.
According to a study of more than 16,000 adults published in Alzheimer’s & Dementia: a Journal of the Alzheimer’s Association, unplanned weight loss is strongly correlated with dementia severity.
Adequate nutrition is critical to maintaining the highest functioning possible for each person, perhaps especially in dementia, where needs like hunger might not always be fully communicated.
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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.
Try Some Of These Best Foods For Dementia Patients To Eat
There are lots of fads and daily news on the latest food to help slow down dementia. Advice from the Alzheimers Society and other expert dementia organisations is clear: there are foods that can help reduce some of the symptoms, but mostly its common sense. A healthy balanced diet with treats in moderation of course. Some suggestions include:
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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.
Where To Find Help And Support
Living with a dementia can bring different changes to a persons life that are individual to them. As a carer, there are ways you can help support them in their everyday life and activities.
If you’re concerned about the person you’re caring for, you can speak to their GP.
They can refer you to a relevant health professional including:
- dietitian
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Eating And Drinking For A Person With Dementia
Dementia often has an impact on peoples appetite and ability to eat and drink. Read our advice on some of the changes you might notice and how to support the person you care for.
People with dementia may experience problems with eating and drinking, and its quite common for their appetite to change as their condition progresses.
They might:
- forget to eat or drink
- not recognise when they are hungry, thirsty or full
- have trouble preparing food or drinks
- struggle to recognise food items
- have a change in appetite or taste
- find certain colours, textures or smells of food off-putting
- struggle to follow particular diets, for example for diabetes, coeliac disease, or religious or cultural diets
- have difficulty handling cutlery and feeding themselves
- find it difficult to swallow
- develop a sweet tooth
Helping a person with dementia to maintain a healthy diet can be difficult, but its important to encourage them to eat well. You could try:
A person with dementia may not always be able to recognise when they are thirsty, or communicate their thirst. This means it can be difficult for them to drink the recommended eight to 10 glasses or mugs of fluid per day. You could try:
- making sure the person always has a drink beside them
- offering squash if they dislike water
- offering a choice of hot and cold drinks
- helping if they are struggling to pick up or hold a cup
- offering different shapes and sizes of cup
- using a favourite mug, glass or cup, if they have one
Offer Them Some Of Their Favorite Foods
If you can cook, try to make something that your care-receiver used to love. If not, try finding it in the local store or restaurant. They might respond positively to some foods from their past as a child, which could help bringing back their appetite.
If possible, dont deny them the food that they prefer, as sometimes, calorie-rich foods take precedence before nutrition. Do keep in mind that junk food cant be a substitute for a healthy diet. However, if theyre already on a fiber and vitamin-rich diet, an occasional candy wouldnt hurt.
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