The importance of good nutrition
The type of food we eat affects our health and our quality of life. Poorly nourished people get sick more often and recover from injury and illness more slowly. Poor nutrition is a major health problem for many older people.
For people with dementia, maintaining good nutrition presents extra challenges. A person with dementia may:
- Experience a loss of appetite
- Develop an insatiable appetite or a craving for sweets
- Forget to eat and drink
- Forget how to chew or swallow
- Experience a dry mouth, or mouth discomfort
- Be unable to recognise the food and drink they are given
Daily nutritional balance
The nutritional requirements of someone with dementia will be similar to other people of their age. However some people with dementia experience increased physical activity such as pacing, which means they will need larger amounts of food to prevent them from losing weight.
Dietary guidelines for older Australians recommend:
- Enjoying a wide variety of nutritious foods
- Eating at least three meals every day
- Drinking plenty of water
- Eating plenty of vegetables (including legumes) and fruit
- Eating plenty of cereals, bread and pastas
- Eating a diet low in saturated fats
- Choosing foods low in salt and using salt sparingly
- Including foods high in calcium
- Using added sugars in moderation
Common nutritional problems
Forgetting to eat
What to try
- An alarm clock, or a phone call, may be a useful reminder at mealtimes
- Snacks that are easy to eat and don’t need to be refrigerated can be left out where they can be easily seen
Can’t or won’t prepare meals for themselves
It can be particularly difficult for people with dementia who are living alone when they can't or won't prepare meals for themselves.
What to try
- Meals should be shared social occasions whenever possible
- Delivered meals such as meals-on-wheels. However these may not provide all of a person’s daily nutritional needs or may not be what the person is used to eating
- Home support to assist with meal preparation, serving and to discretely prompt with eating
- Pre-prepared meals from the supermarket
- Family and friends helping to prepare meals and or eating together
- Preparing large quantities of food, then freezing into meal size amounts
- Home delivered ready-to-eat food from restaurants or fast food outlets
- Eating out. However check first that the person with dementia will be comfortable with the venue and food
- Stocking up on healthy snacks such as yoghurt, cheese or dried fruit that do not need preparation or cooking
Person with dementia is a heavy drinker
Alcohol may stimulate the appetite and add to the enjoyment of a meal. However, too much alcohol can replace food and people can run the risk of becoming malnourished. If a person with dementia is a heavy drinker it may be difficult to change their drinking habits.
What to try
- Make sure that they are well nourished
- Discourage drinking on an empty stomach
- Offer drinks other than alcohol
- Water alcohol down
Difficulty using cutlery
All food should be able to be eaten with dignity. If a person with dementia is having difficulty with cutlery, finger foods can be a nutritious and easy alternative.
Finger foods are simply foods prepared so that they can be eaten with the fingers. This enables people who would otherwise lose this level of independence to feed themselves.
What to try
- Prepare a plate of nutritious and attractive food that can be picked up in the fingers
- Make sure that the food is accessible. Put it on a flat plate with no pattern so that the food can be seen clearly. Make sure the plate is in comfortable reaching distance
- Don’t use complicated table settings and avoid lots of different cutlery, crockery, glasses, foods and drinks together
- Serve only one plate of food at a time
- Impairment to taste and smell senses can reduce appetite - the preparation of tasty, strongly flavoured and aromatic food may help
- Allow time for the memory to respond
- It may be necessary initially to help fingers to convey the food from the plate to the mouth
It can help to eat together so that the person with dementia can copy you
- Types of foods served need to take the culture and past eating habits of the person into consideration
Eating in the later stages of dementia
It is common for people in the later stages of dementia to lose a considerable amount of weight. People may forget how to eat or drink, or may not recognise the food they are given. Some people become unable to swallow properly.
Providing nutrition supplements may need to be considered. If a person has swallowing difficulties, or is not consuming food or drink over a significant period of time and their health is affected, nutrition supplements may be considered for consumption other than by mouth.
This information is based on Finger Foods for Independence: For people with Alzheimer’s disease and other eating difficulties, by Lois Newton and Dr Alan Stewart, and Reduce the risk: A common sense guide to preventing poor nutrition in older people, by Carolyn Bunney and Rudi Bartl.
Attend a family and carers education session to learn more about this topic.