Dementia & Nutrition

What is dementia?  
Dementia is a term used to describe the slow decline of an individual’s cognitive function, often affecting an individual’s thinking, memory, intellect, behaviour and ability to complete everyday tasks.  

There are a range of types of dementia, all of which can vary in severity and symptoms depending on the individual. Despite not being a normal part of the ageing process, dementia is most common amongst the elderly, affecting one in ten people over the age of 65. While the symptoms of dementia can be severe and frightening, many diagnosed with the condition can lead active and fulfilling lives for years.   

The importance of good nutrition for those suffering from dementia 
Mealtimes are an opportunity to spend time together with family and friends, while eating good, nutritious foods. For someone with dementia however, mealtimes can be difficult. They may:  

• Experience loss of appetite 
• Experience an insatiable appetite 
• Crave sweets 
• Forget how to eat and drink 
• Forget how to chew and swallow 
• Have difficulty using cutlery 
• Experience a dry mouth or discomfort of the mouth 
• Be unable to recognise the food and drink they are given  
• Be distracted by the environment 

All of these factors provide obstacles to enjoying the mealtime experience and receiving the nutrition a person needs to stay healthy and appropriately nourished. It is important to remember to implement strategies to encourage healthy and nutritious eating for someone with dementia to help prevent malnutrition, whilst also making mealtimes more enjoyable for everyone.  

How to make mealtimes easier for people with dementia 
There are a number of strategies that can be implemented to make mealtimes easier for people with dementia, depending on the difficulties the individual is experiencing.  

Loss of appetite or forgetting to eat and drink 
A person with dementia may lose their appetite due to ill-fitting dentures, forgetting how to eat and drink, insufficient physical activity or embarrassment (like forgetting how to chew and swallow). If this happens it’s important to try a range of different tactics to ensure, the person is still eating and receiving the nutrition they need. For instance, carers and food service staff could try:  

• Offering meals at regular times each day 
• Offering favourite foods, ice cream and milkshakes  
• Preparing finger food or snacks that are easy to eat and can be left in easily seen locations 
• Preparing foods in ways that are familiar to the individual 
• Encouraging physical activity where possible 
• Making mealtimes simple and relaxed with plenty of time, so they don’t feel rushed or pressured  
• Encouraging them one food at a time to minimise confusion over tastes and textures 
• Consulting a doctor to make sure there are no underlying causes for the appetite loss and to check if vitamin supplements are required 

Insatiable appetite 
Dementia can also cause some individuals to experience an insatiable appetite or overeating. If this is the case, staff working in food service can try to manage the overeating by:  

• Leaving snack foods out in clearly visible locations 
• Offering 5 – 6 small meals a day 
• Offering higher protein snacks such as crackers and cheese, yoghurt, milk drinks 
• Encouraging physical activity like walks or increasing social contact, which may distract the individual 

Craving sweets 
Another common symptom of dementia is a craving of sweets. While this can be harder to overcome, staff can try:  

• Offering sweet foods that have a higher nutrition value like milkshakes, or a dairy based dessert 
• Checking medications for side effects (sometimes some medications like antidepressants can cause these cravings) 

Chewing and swallowing problems 
Sometimes problems with eating can come from issues with the mouth, like a dry mouth, mouth discomfort, ill-fitting dentures or forgetting how to chew and swallow. If this is the case, staff can try:  

• Consulting a speech pathologist who can advise if the person requires a texture-modified diet 
• Consulting a dentist for a check-up of the person’s gums, teeth and dentures 
• Moistening foods with gravy or sauce 
• Offering small bites 
• A light pressure on the lips or under the chin to remind the person to chew 
• Reminding the person to swallow with each bite or stroke the throat gently to encourage swallowing 

At the dining table 
As the person with dementia symptoms deteriorate, they can experience increased memory loss and distraction in the dining environment, resulting in issues using cutlery, forgetting how to eat and drink, inability to recognise familiar foods and/or embarrassment over these difficulties. To ensure that someone with dementia can still enjoy the mealtime experience and receive adequate nutrition, food service staff and carers can try:   

• Serving nutritious and attractive finger food so that they can eat with their fingers, without losing their sense of independence 
• Serving familiar foods 
• Placing food on flat plates with no patterns so the food can be clearly seen  
• Serving one course at a time 
• Removing distracting items like extra cutlery, glasses or decorations 
• Eating with the person so that they can copy you 
• Minimising noise and activities in the dining room so the person isn’t distracted 
• Providing adequate lighting, so the person can clearly see their meals and the dining setting 
• Allowing plenty of time for the person to eat, so there is time for their memory to respond 
• Considering past eating habits and culture of the person (serving meals that they used to cook can help) 
• Allowing participation in or watching of kitchen activities 
• Using contrasting colours to highlight specific features of the dining room  
• Open plan dining and kitchen settings so the aromas from the meals reach residents 

For more specific strategies on how to provide an optimal dining experience and meet the nutritional needs of someone with dementia, get in touch with one of Nutrition Professionals Australia’s Accredited Practising Dietitians.