Eating

It is important to do what you can to make sure that the person you are caring for enjoys their food and eats a healthy, balanced diet. As dementia progresses eating can become difficult for some people. However, by making a few changes you can help keep mealtimes as enjoyable and stress free as possible.

Problems with eating are common in dementia. At times, the person with dementia may refuse to open their mouth, or need to be reminded to do so. Sometimes, they may accept food but will not swallow it, or they may accept it but then spit it out. At other times, they may resist the person who is trying to feed them and push them away, or they may throw their food about or turn their head away.

This can be exasperating or distressing for the person trying to feed them, but it is important not to take it personally. These reactions are not signs that the person is determined to ‘wind you up’ or is being deliberately difficult – they are more likely to be due to discomfort in the mouth, or to be the result of damage to the brain.

The three main tips for helping someone with dementia to eat are:

• Keep calm A calm, regular routine is reassuring for a person with dementia. Meals should be relaxed, unhurried occasions, so allow plenty of time and make sure that there are no distractions such as television or radio. Never try to feed a person when they are agitated, or if they are drowsy or lying down, as there is a danger of choking.
• Be flexible Changes in eating habits often take place as dementia progresses. Accept that mealtimes might become very different to how they used to be or how you would like them to be.
• Help the person to feel involved If you have to feed the person, try putting the food into their hand and guiding it to their mouth, so that you involve them in the process of eating.

Dementia affects people in different ways. However, some problems, such as appetite loss and overeating, are particularly common in people with dementia. There are many ways to help overcome these problems and ensure that the person eats a healthy, balanced diet.

Appetite loss

There are several reasons why a person with dementia may have a poor appetite or seem uninterested in eating. These include:

• Depression – Loss of appetite can be a sign of depression. Depression is very common; when someone becomes aware that they are in the early stages of dementia, feelings of despair and hopelessness are understandable. There are effective treatments for depression, including medication and other therapies. If you suspect that this is the problem, consult your GP. When the depression lifts, the person’s appetite should return.
• Physical discomfort – The person may be having problems with badly fitting dentures or sore gums, both of which will make eating uncomfortable. If you think this might be a problem, ask your dentist to check.
• Lack of exercise – If the person is not very active during the day, they may not feel hungry. Try to encourage them to move around during the day and take part in physical activities or exercise.
• Damage to the brain – In the later stages of dementia, the person may no longer be able to understand that the food in front of them is there to be eaten, even if they are hungry. This is because the nerve pathways in the brain are damaged, so the message is not getting through. You may need to keep reminding them to eat, or guide the food to their mouth.
• Difficulties with chewing and swallowing – Chewing and swallowing can become difficult as dementia advances. If this seems to be the case, ask your GP to put you in touch with a speech therapist, who may be able to offer some advice.
• Constipation – This is a common problem, especially in the later stages of dementia, and can make the person with dementia feel bloated and confused. Try to prevent constipation by making sure the person eats a fibre-rich diet and drinks plenty of fluids. If constipation becomes a severe problem, consult your district nurse or GP.

Other things to look out for include:

• Weight loss – In the later stages of dementia, weight loss is a common symptom, but we do not yet know why. If the person you are caring for is losing weight but is not at this advanced stage, consult your GP. If they are very restless and physically agitated they may be using more energy than the calories they are consuming, or there may be a medical problem.
• Appetite loss in those living alone – If the person is living on their own, you may find that they are not eating any food that you have provided, or they may start hiding food. Meals on wheels may no longer be helpful because they forget to eat the meal delivered. These are signs that the person needs more help. It is possible to arrange for home caregivers to visit the person at mealtimes and either prepare a meal for them, or stay with them while they eat. Contact your local social services department for more information.

continue: Overeating

top . Pages 1 2 3 4 5 6 7 8  . send to friend . alzheimer's site map

Reviewed: 02/2006