Eating when you have dementia
Diet is particularly important when you have dementia, and your dietary needs can change as the condition changes. Senior Dietitian Victoria Taylor gives her advice.
If you have dementia
A healthy diet can help you to keep as well as you can for as long as you can. There’s evidence that a Mediterranean-type diet with lots of fruit, vegetables and fish can be good for your mental health as well as helping to slow the decline. Eating healthily and drinking enough liquid can also help you to avoid or recover from illness and infections.
If you’re losing your appetite
If you don’t have much appetite, small portions can feel easier than a big plate of food. There may be times of the day that you feel more like eating, so try to have your main meals at those times (even if it’s the morning.) You could try foods that are easier to eat, such as cherry tomatoes instead of large ones, or buy individual portions of cheese if those are easier for you to manage. Try to find foods you’ll enjoy and want to eat.
It can be useful to weigh yourself regularly and keep a note of your weight so you can see if you’re gaining or losing weight. If you are losing weight without meaning to, choose foods that will provide you with plenty of energy, like bread, pasta, avocadoes, nuts, and vegetable spreads and oils (for example in salad dressing). In this situation it’s probably better to focus on eating enough rather than the standard healthy eating advice.
Focus on your food
Whether you have dementia or not, it’s good to focus on your food, without any distractions such as the TV. That way you’re more likely to finish your meal and enjoy it too. Try to make time for your food - don’t rush.
Remember to drink
It’s surprisingly easy to forget to drink. Try to keep water on hand throughout the day. A water bottle might hold more than a glass and means you don’t have to worry about knocking it over. Tea and coffee will also help provide the water your body needs.
If you’re caring for someone with dementia
What a healthy diet looks when you have dementia will change over the course of the condition. Changes in appetite or tastes, ability to shop and cook and simply remembering to eat or what has already been eaten can occur.
A dietitian will be the best person to advise on individual needs, but if you’ve noticed changes to appetite or weight loss in someone with dementia there are some simple things you can do to encourage eating that might help.
Little and often
Small portions can be less overwhelming than a big plate of food for someone who doesn’t have a good appetite. Try offering a small amount and then make sure there are seconds available. There may be differences in appetite at different times of the day too, maximise the times when appetite is good and offer more then. This might mean a bigger breakfast rather than evening meal.
If only small amounts are eaten at meals, topping up with snacks can become more important. Choose foods that will provide energy that are also nutritious – milky drinks and puddings, nut butters on oatcakes, egg sandwiches or fortified cereal with milk are all good options.
Poor appetite and weight loss are often seen as dementia progresses, but it’s not always as a result of the condition. There could be other reasons for a change to someone’s ability to eat that can be easily fixed – problems with teeth or dentures that make eating uncomfortable, for example, or problems such as constipation, depression or an infection that can affect appetite. If you notice any unexplained or unusual changes in appetite or weight it’s worth discussing with the GP.
In the later stages, just making sure the person eats can become the priority. That can mean that a high-energy diet is more appropriate than the standard healthy eating advice for the general population.
Avoid distractions at meal times
Make food the focus when it comes to meals and try to make time so that you’re not rushing. Switch off the TV or radio, make meals more sociable by eating with others or at different times if people are distracting and using plain, unpatterned plates, bowls and mugs can also be helpful.
Make it easy
Offering familiar foods and describing what’s on the plate can help encourage eating. Foods that are easy to eat, like sandwiches, can also be a good option for people who find cutlery difficult to manage.
Making food easier to eat can also be a good way to make sure it doesn’t go to waste and to remind them to eat it. Cut up foods like fruit, veg, cheese and put them in clear boxes in the fridge so that the person with dementia can see them and they are easy to eat.
Adapted cutlery is available if there are physical difficulties with eating, as well as specially designed crockery and cups which might be lighter, unbreakable or with a special spout or lip to avoid spillage. An occupational therapist can offer help with these sorts of issues. If you think this would be helpful, speak to your GP about a referral for some advice.
If you think that there may be problems with swallowing, it’s important to see your GP who can refer to a speech and language therapist. They can assess the swallow and advise on foods with a suitable texture that are safe to eat. A soft or pureed diet might be recommended, for example. Often this is done in combination with a dietitian to make sure that even though the texture of the foods needs to be changed it doesn’t compromise nutritional intake.
It’s easy to forget to drink and recognition of thirst can also be affected by dementia. Food will provide some fluid but try to make sure that drinks are easily available to help prompt the person to drink.Make sure they’ve always got a glass of water to hand and offer cups of tea or coffee or other drinks they like regularly.
Clear out old food
Keeping a track on what is in the cupboards and freezer can be even more important for someone with dementia to make sure they don’t eat food that is out of date or has gone off. If you are caring for someone with dementia who lives alone, check the cupboards and fridge with them regularly to clear out any out of date food.