Webinar: Nutrition and Dementia
Dementia Australia webinars are free videos where subject experts discuss topics relating to dementia for a general audience.
Dementia may impact regions of the brain involved in appetite regulation and eating behaviours. Having an awareness of the changes a person living with dementia may experience can help identify nutrition concerns early and promote early intervention.
In this webinar, Dietitian Emma Butler describes how you can maintain adequate food and fluid intake, with simple practical tips to implement on a daily basis.
You will learn:
- how dementia can impact nutrition intake
- tips for improving appetite and preventing weight loss
- tips for making mealtimes enjoyable.
Transcript
[Beginning of recorded material]
Emma: Hello and welcome. My name is Emma Butler, and I've been at Dementia Australia for the last 20 months working as a Dementia Support Specialist. Prior to coming to Dementia Australia, I was an accredited practising dietitian for around 25 years. I worked in a variety of settings, from hospitals to community health, private practice, and aged care. I have many years experience working with people living with dementia, their carers and family. My passion and goal as a dietitian has always been to provide easy and practical tips to help clients and carers improve their health outcomes. I hope after today's webinar; you are able to implement some of these positive changes. So, we'll move on through to our first slide. I'd like to begin by acknowledging the traditional owners of the land on which we meet today. Today, I'm coming to you from the lands of the Awabakal and Worimi people, and I pay my respects to Elders past, present, and to our shared futures. This session outline for today, there's so many topics that come to mind when we think about nutrition. For today's webinar, I've tried to highlight the nutrition issues most relevant to dementia. The outline today will include the following:
• How dementia can impact nutrition intake.
• Nutrition issues that we do see and present with dementia.
• Unintentional weight loss.
• How we can work on improving appetite and preventing weight loss.
• We'll talk a little on nutrition supplements.
• We'll also talk on fluid intake, stimulating the senses and how we can make mealtimes enjoyable.
So, as you can see, there is a lot of information to cover but hopefully after listening today, you'll have a little bit more awareness and understanding of some of the nutrition concerns that may occur for a person living with dementia. Dementia may impact regions of the brain involved in appetite regulation and eating behaviour. Memory loss can affect food related behaviours, such as buying food at the supermarket and remembering to eat and drink. A person living with dementia may experience a loss of ability to plan and carry out food preparation. The ability to follow recipes or using cooking equipment and utensils may be impacted, therefore, meal preparation can become daunting. A person living with dementia may have reduced concentration and experience a reduced attention span, which again, may impact on the person's ability to sit still for a length of time to eat. And of course, we know that they can become, may become easily distracted at mealtimes. A person living with dementia may develop a lack of interest, which can result in reduced motivation to eat and drink, ultimately, affecting a person's food intake. A person living with dementia may experience changes in movement, or even increased movement, such as walking, which can result in increased energy expenditure. Awareness of these possible changes can identify nutrition concerns early and promote early intervention.
So, just moving on to some of those issues that we've just touched on in the last slide. During the early stages of dementia, a person will generally have the ability to continue to eat and drink normally. As dementia progresses, additional supports and strategies may be required to maintain optimal nutrition. The nutrition goals should focus on maintaining a variety of healthy food choices and adequate food and fluid intake. Weight loss is a prominent clinical feature of dementia and continued weight loss can impact on cognitive capacity and physical capacity. And of course, we know that nutrition intervention is essential to help us minimise and prevent weight loss. Don't be afraid to seek support from a dietitian or a GP, friend or family member if food and nutrition is becoming impacted. Remember, early intervention is important. Unintended weight loss can impact progression of dementia and increase the risk of infections, delayed wound healing, falls and malnutrition. Keep a check on weight or any signs of weight loss. Keep a check on appetite. Any changes in appetite can be picked up and early strategies can be implemented. Not all people will experience weight loss. Some people may gain weight. However, weight loss is more common.
So how do we spot signs of weight loss? A couple of take-home points just to have as an option to keep a check on things like poor appetite, clothes, rings, jewellery or dentures may become loose. A person may feel more tired or have a lack of energy. There may be a reduced physical performance. There's a greater risk of falls. There may more signs of constipation or changes in a person's bowel movements. Altered mood and changes in behaviour, poor concentration, and poor wound healing. So how can we help prevent weight loss? A couple of strategies in the next few slides. We've got eating small meals, frequently throughout the day. This could mean three small meals and two or three snacks throughout the day. Don't always rely on appetite. Try to eat by the clock and maybe try every two to three hours to have something to eat or drink, the protein part of your meal first. Chicken and meat, always first, so that we don't feel too full.
Food-first approach. This is a great concept. It's a way of always remembering we can achieve extra protein and energy at home by fortifying the foods that we naturally eat throughout the day. So, this could look like making milkshakes and fruit smoothies. We could add ice cream, yoghurt, milk powder, and of course, fruit. We can add cream. We can use a neutral powder. We can add this to porridge, to soups, to desserts, and to custards. When we have a sandwich, make sure we're adding a protein filling at on all occasions. This can be tuna, chicken or some leftover cold meats. We can add cheese, mayonnaise and avocado again just to bulk up the protein and calories. Adding cream, butter and cheese is a great way to add and boost the calories into mashed potato and mashed vegetables. So, if we've done all of that with the food-first approach, it's a great first option. However, if we do see that appetite remains poor and weight loss has become evident or has continued, a supplement may be needed to boost the energy between meals.
Nutrition supplements definitely have a place, when needed and you can always talk to Doctor, Geriatrician or a Dietitian regarding nutrition supplements. There's a large variety. You can go to the supermarket and of course the Chemist. Some of the ranges include powdered supplements. So, you may have heard of words such as 'Sustagen Hospital Formula', 'Ensure', 'Advital'. Or, sometimes even you can just think of full cream milk powder, which you can get from the supermarket as an ideal addition into the homemade milkshakes that we just spoke of. Ready to drink supplements. They can include the Sustagen Tetra packs. You can get the high protein versions. There's great Tetra packs in the ‘Up and Go’, with a variety of flavours. Other examples are 'Resource', 'Fortisip', and they can be really useful and convenient, especially when someone is travelling or they have a long day trip planned. And it's a great thing to have as a backup when you need something to drink. And of course, add in that extra protein and calorie component. And lastly, the last dot here, is mentioning a supplement called 'Souvenaid'. So, this is a product from the company 'Nutricia', and it is a formulated nutrition supplement that is designed to support memory and cognitive function in early Alzheimer's disease. Please talk to your GP, Dietitian, or Geriatrician to determine if this is a suitable option for you.
And what about fluid intake? Adequate fluid intake or a decrease in fluid intake can lead to dehydration. As we get older, our sense of thirst, naturally diminishes. Dehydration makes people more tired and cranky. It can bring on stiff joints, headaches, nausea and cramps and can result in incontinence, constipation, increased risk of falls, poor oral intake, and low blood pressure. So how can we spot signs of dehydration? A person may present with dry skin. The membranes of their nose and eyes may become very dry. They may be more confused or lethargic. They may experience dizziness and urine can be dark in colour with a strong odour. Also, frequent UTIs, which is urinary tract infections, can also be a sign of a poor fluid intake. Tips to increase fluid intake. So, let's think of some easy ways we can make sure we're all getting enough fluid each day. Chilled drinks might stimulate someone's appetite. Certainly, try not to have too much fluid before a meal, but definitely lots of chilled drinks so that we can stimulate appetite. Try smoothies, milkshakes, and ice blocks. This also offers protein, calories, along with the fluid content. Incorporate foods with high water content such as watermelon and soup. Always have a glass of water readily available when at home and carry a water bottle when out. Prompt and encourage regular drink breaks and just as a reminder, trying to aim for six to eight glasses of fluid, each day.
Okay, so we are going to move on to our senses. As we age, the number of taste buds reduce, and less saliva is produced while eating. A person living with dementia may experience a reduction in the ability to taste, smell, and see foods. As the brain starts to change, a liking of sweet foods can become more dominant factor for food choices. Sensitivity to sour, bitter, and salty taste can be reduced, whereas sensitivity to and enjoyment of sweet foods can increase. So, some of the strategies that may help combat these sensory changes includes:
• Using aromas, herbs, and spices to evoke and stimulate our appetite.
• Using strong flavours to enhance dishes such as spices, herbs, cheese, soy sauce, et cetera.
• Make food look appealing with different colours, shapes and textures.
• And switch between foods. Switch between different foods. Taste buds and senses can become saturated quickly, making it unappealing to taste the same foods frequently.
• Try to satisfy any sweet cravings with foods that have some nutritional value, such as milks, milkshakes, fruit, and yoghurt.
I'll tie it all up with the last couple of slides that brings on some of the good strategies that can make mealtimes enjoyable. So that's always some couple of good words to remember, making mealtimes enjoyable. So, some things to consider is to have a variety of pre-prepared meals available, which can be served at any time of the day. Prepare meals in bulk and freeze leftovers. Flexible with food preferences. It is possible the person living with dementia may suddenly develop certain food preferences or reject foods he or she may have liked in the past. Allow plenty of time to eat, making mealtimes sociable. Enjoy meals with family and friends. Eating socially can help a person living with dementia to eat more, eat better choices, and eat more regularly. Making mealtimes pleasurable and free from distractions and loud noises, such as the TV. Still on that same topic of making mealtimes enjoyable. We've touched on the idea that mini-meals can be really manageable and less daunting than large quantities of food. Leave healthy snacks and fluid on the table. Grazing throughout the day is absolutely okay. Finger food is ideal as a snack or as a light meal. This can be chopped up fruit, bite-sized sandwiches, chicken tenders, fish bites, and many other things that we can use in that bite-sized, finger food style with meals and snacks at any time in the day. Something like breakfast cereal, or a bowl of porridge can be a great, quick, easy option for a meal to eat at dinner or at any time that someone needs a quick, easy option. All of the information discussed in the webinar today has been sourced from highly reputable organisations and research bodies. For further reading, you can always look to Dietitians Australia and their website is on the page here. Nutrition Education online, they have some fabulous materials that can be very helpful for some tips and resources. Ageing and Dementia Research Center. National Institute on Ageing. Alzheimer's Association. Health Direct and Nutricia, which has information regarding Souvenaid. For any further information or support, please reach out to the National Dementia Helpline on 1800 100 500, that's available 24 hours a day, seven days a week. Thank you for listening.
[END OF RECORDED MATERIAL]
More for you
- Nutrition and dementia
A good diet is essential to good health. Learn what to eat, what to avoid and what to expect when you’re living with dementia.
https://www.dementia.org.au/living-dementia/staying-healthy/nutrition-and-dementia - Eating and dementia
Dementia can affect your ability to enjoy food or eat. Learn why this happens and what you can do to eat well.
https://www.dementia.org.au/living-dementia/home-life/eating-and-dementia - Souvenaid
Souvenaid® is a nutritional supplement that claims to support brain functions affected in early Alzheimer’s disease.
https://www.dementia.org.au/about-dementia/treatment-and-management-dementia/souvenaid
The National Dementia Helpline
Free and confidential, the National Dementia Helpline, 1800 100 500, provides expert information, advice and support, 24 hours a day, seven days a week, 365 days a year. No issue too big, no question too small.