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Monday, 15 August 2016

Dementia and nutrition

Many people living with dementia may experience a change in their relationship with food, eating and drinking. As dementia progresses, the behavioural, emotional and physical changes that occur can make eating and drinking more difficult.

Depending on the individual, these changes can result in dehydration, weight loss or weight gain.

As a carer, this can be upsetting and you may find it reassuring to understand how you can help the person you care for to eat and drink well.

There are some simple ways that you can help a person with dementia to enjoy meal times and get the best from their diet.

Carers UK has a partnership with social business Unforgettable, which was founded by a carer and aims to create a vibrant marketplace for products and services to help people to cope better with dementia. Some of these are designed to help with mealtimes, from dignified bibs and specially-adapted tableware to products to improve dental hygiene.

How can dementia affect diet and nutrition?

Weight loss

In some cases, a person living with dementia may lose weight unintentionally due to a variety of reasons, including the following:
  • Poor appetite – People with dementia may have a poor appetite for several reasons. Mood changes can affect a person's feelings towards food and some people may no longer enjoy the food they are used to eating. Problems in chewing and swallowing, or coordination problems can make eating difficult and put people off their food. Depression is also common when someone becomes aware that they have dementia, and this can sometimes lead to a loss of appetite.
  • Chewing and swallowing problems - Sore mouth and gums or ill-fitting dentures can make it difficult and painful to eat. Some people may also struggle to communicate to you that they are having these problems and will simply stop eating as much, leading to weight loss.
  • Changes in food preferences - As dementia progresses, a person’s likes and dislikes for food may change. This can affect the amount and variety of foods eaten.
  • Coordination problems - Eating using cutlery or drinking from a glass can become difficult due to coordination problems. This can make mealtimes a challenge and take the pleasure out of eating and drinking.
  • Increased energy needs - Some people with dementia may be very active or like to walk around a lot, and as a result they will use more energy and could start losing weight if they do not increase the amount they eat.
  • Independent living - If someone is living alone, they may find it difficult to prepare food or may forget to eat the food they have, especially if it is not visible and readily accessible.

Poor appetite

There are many ways to stimulate a person’s appetite and the following hints and tips can help encourage a person’s interest in food:
  • Be flexible with mealtimes and make the most of ‘good eating times.’ Different people will have more of an appetite at certain times of the day, whether this is breakfast or teatime.
  • Offer small portions of food, more frequently throughout the day.
  • Try not to overload the plate with too much food and have a gap between the main meal and dessert.
  • Include foods that are both familiar to the person and also new, adventurous foods that they may not have had before.
  • Make meals look appetising and eye-catching by including different colours, such as a bowl of chopped fruit or mixed vegetables.

Co-ordination problems

Make finger foods that are easy to pick up and can be eaten without using cutlery. These are ideal for people who have difficulty using cutlery or for those that are restless and like to walk around at mealtimes.

Finger food ideas include the following:
  • small sandwiches or crackers with soft cheese
  • potato wedges or chunky chips
  • chicken breast cut into pieces, fish fingers, meatballs, cocktail sausages or sausage rolls
  • hard-boiled egg (quartered)
  • slices of fruit cake, scones, teacakes or hot cross buns
  • orange segments, slices of apples or bananas, seedless grapes

Changes in food and taste preferences

As dementia progresses, a person’s 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 (e.g. apple sauce) 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 gaining weight and increasing nutritional intake

Some people living with dementia may struggle to eat for a variety of reasons and this can lead to weight loss. There are some practical tips to help improve their nutritional intake here.

Eating a healthy, balanced diet is vital for maintaining good health for us all. This includes eating foods from all the different food groups, to provide the body with all the nutrients it needs.

Studies have shown that certain combinations of nutrients may help to support healthy brain function. These nutrients include healthy fats, such as omega-3 fish oils, vitamins and minerals, which can be found in the following foods:
  • Plenty of fruit and vegetables to provide a good source of vitamins and minerals.
  • Nuts, seeds and olive oil to provide a variety of healthy fats.
  • Twice weekly intakes of oily fish to provide a good intake of fish oil, which is rich in omega-3.

What happens if food isn’t enough?

Eating a healthy, balanced diet plays a key role in keeping the body strong. But for people living with dementia it can sometimes be hard to get enough food, which can weaken the body further.

What is medical nutrition?

Medical nutrition has been specifically designed for those who find it difficult to get adequate nutrition from a normal diet alone. Medical nutrition is a scientifically formulated liquid food that is available in the form of a drink containing energy, protein, vitamins and minerals. There are also options available for specific types of dementia, such as the early stages of Alzheimer’s disease. Speak to your pharmacist about these options.
For advice about medical nutrition, speak to your GP.


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