People with dementia may experience problems with eating and drinking. There are many reasons this might happen. They might:
forget to eat or drink
experience difficulties preparing food or drinks
have difficulty recognising food items
have a change in appetite or taste
Eating a healthy and balanced diet is important for a person’s physical and mental health. Not eating and drinking enough can increase the risk of dehydration, weight loss, a urinary tract infection and constipation. These health problems can be particularly problematic for someone with dementia as they can increase confusion and the risks of delirium, and sometimes make the symptoms of dementia worse.
Helping a person with dementia to maintain a healthy diet can be difficult for the people caring for them. This leaflet aims to provide some positive tips on ways to help.
It’s important to consider the person’s likes and dislikes regarding food, however, tastes do change throughout our lives. These changes may be more pronounced for someone with dementia. They may find certain colours, textures or smells off-putting or sometimes eat certain foods they previously wouldn’t have. An increasingly sweet-tooth is common. This and other factors may make it more difficult for the person to stick to specific diets such as those for people with diabetes or coeliac disease, or those with religious or cultural needs.
Understanding the person’s previous relationship with food, as well as any cultural or religious reasons for avoiding particular food or drink, will be useful.
Poor appetite and weight loss are quite common as dementia progresses. But there are also medical reasons why a person may have lost interest in food and drink, which your pharmacist, GP or perhaps your dentist could advise on. These include:
depression, which can lead to poor appetite
mouth pain and dental problems, which can lead to discomfort and a reluctance to eat or drink
constipation, which can make a person feel full and nauseous
infections or other physical illness
Setting the scene for mealtimes
A familiar, sociable environment can help a person with dementia to feel more comfortable eating and drinking. You could try:
turning off noisy TVs and radios, or playing some soothing, familiar music
being flexible about meal times, avoiding times when the person is tired or distressed
giving the person lots of time to eat, so there is no rushing
eating with the person, if they enjoy the social side of this. It might be encouraging for them to see you eating, but bear in mind some people may be self-conscious and embarrassed to eat in company
making sure the room is well-lit and describing the food. This might help the person recognise the food they are eating more easily
using plain coloured plates and cups so they can see the food easily. Specially adapted cutlery is available for people with dementia
Encouraging a person with dementia to eat
Involve the person by asking them what they would like to eat. If they struggle to decide, you could give them two options of simple things you know they like and can manage. If appropriate, you could involve them in the food preparation. You could try:
offering something easy to eat, that you know the person likes
giving the person small, regular portions rather than large meals
being flexible: a person with a sweet tooth might like to eat their dessert first. You could add sweet condiments like ketchup or apple sauce to savoury food
offering a small snack before a meal to see if that helps the person realise they are hungry
using different tastes, smells and colours to stimulate the appetite
If someone with dementia is having difficulty swallowing, please seek the advice of a speech and language therapist before considering a diet of pureed or soft food, as this can lack nutrients. You should be able to request a referral from your GP. Your GP may be able to advise you on food to offer while you wait for a referral, but it’s a good idea to keep offering food you know the person likes and can manage.
Encouraging a person with dementia to drink
A person with dementia may not always be able to recognise when they are thirsty, or they might not be able to communicate their thirst. But nevertheless, it is recommended to aim for about eight to ten glasses or mugs of fluid per day. You could try:
having a drink beside the person at all times
adding a little flavoured squash if the person is not keen on water
offering a choice of hot and cold drinks
helping the person if they are struggling to pick up or hold a cup
offering the person different shapes and sizes of cup
finding out if they have a favourite mug they like to drink from
Stocking up and storing food
A person with dementia might need help keeping track of what food they have at home and storing food safely. You could try:
storing food in ways that are easy to access and eat, such as pouring cereals into clear pots or cutting cheese into cubes
buying frozen ready meals; but be mindful that the person might need help reheating frozen foods safely. You could put labels with clear cooking instructions on the top of the meal. You could put notes reminding the person that the meals are in the freezer on the freezer door
buying ambient temperature ready meals is another option, as these do not need to be stored in the fridge or freezer, so may be more accessible for some people
checking the person’s cupboards and disposing of anything out of date
Weight gain or weight loss
Some of the eating and drinking issues associated with dementia can lead to weight loss and people with dementia are at risk of malnutrition. If a person with dementia needs to eat pureed food, it’s helpful to be aware that this can be less nutritious. In this instance, you could try:
adding skimmed milk powder to whatever you are serving. Skimmed milk powder is available from most supermarkets
mixing skimmed milk powder with milkshake powder and full fat milk to create a high nutrient drink. Choose milkshake powders such as Nesquik that are fortified with vitamins.
It is important to note that there is different nutrition and healthy eating advice for people with dementia. For most younger people, the standard advice is to follow a low fat, low sugar diet. But older people and those with dementia especially need higher nutrients, including a purchased 10 microgram Vitamin D supplement every day.
People with frontotemporal dementia might be especially drawn to sweet things or starchy foods. If overeating or weight gain is an issue, you could try:
serving food in a portion rather than bringing out the packet or whole dish
replacing sweet or high calorie foods with healthier alternatives such as fruit or low calorie jelly
encouraging the person to become more active, by taking walks or swimming, or seated exercises for people with mobility issues
storing food away from the person’s line of sight so they aren’t tempted