People living with Alzheimer’s or dementia often eat less than they used to. This can be due to medical problems associated with chewing, swallowing or digesting food.
Sometimes people just lose interest in food. This can happen for a long list of reasons including loss of taste, the ability to smell, memory loss, and thinking they have already eaten. Certain medications can also affect appetite.
The ability and want to eat tends to get worse as the disease progresses and ensuring someone living with dementia eats a nutritious meal, or eats enough, can become a real practical and emotional issue for the carer. We have compiled a list here of 8 practical tips for helping someone with dementia to eat more.
1. The plate colour matters
In a study conducted at Boston University, researchers found that patients eating from red plates consumed 25 percent more food than those eating from white plates. This appears to be connected with the way someone living with dementia sees food on a plate. If you can’t really see food because it’s on a white background you are much less likely to eat it.
The use of colour helps to stimulate interest in dementia patents, as often they have trouble distinguishing between colour. If the food is too close to the colour palette of the plate, people with dementia can struggle to distinguish the contrast between the two and realise there is food to be eaten.
A company called Eatwell Tableware have a fantastic selection of innovative tablewear designed for those with dementia or motor impairment.
Sentai - Meal reminders and much more
Using smart technology, Sentai can take care of daily reminders like gently telling someone with dementia that it’s time to eat. Sentai can help them to retain their independence by giving you piece of mind with live updates and insights as to their wellbeing, without being intrusive. If something doesn’t seem right, or they press and emergency button, Sentai will immediately let you know.
2. Make eating easier
At some stage in the dementia patients life, there’s a good chance eating will become an issue. Using utensils can also become more difficult. It is worth considering finger food to help them eat more frequently, little and often.
Some examples include:
- Fruits – raspberries, strawberries, banana and grapes are great examples and have strong contrasting colours.
- Nuts – almonds and brazil nuts are protein packed and contain essential fats.
- Crisps – healthier options are available, even vegetable crisps.
- Bite size protein – fish fingers, chicken pieces and prawns.
- Vegetables – crudites with dips.
Making your parent feel comfortable as possible at the table should also help with their eating, helping them to focus on the food.
When you sit down at the table, sit directly in front of them, make eye contact, smile and wait for them to smile back at you. Then you can start eating without talking (you start first). Try to keep quiet, be patient, keep making eye contact and wait for them to follow your lead.
It’s important to remember that ‘being patient’ is the most important part here. You might have to do this for a while before it starts working. Hopefully the more frequently you follow this routine the easier it will become for both of you.
3. Try some of these best foods for dementia patients to eat
There are lots of fads and daily “news” on the latest food to help slow down dementia. Advice from the Alzheimer’s Society and other expert dementia organisations is clear: there are foods that can help reduce some of the symptoms, but mostly it’s common sense. A healthy balanced diet – with treats in moderation of course.
Some suggestions include:
Veggies such as spinach, kale and Swiss chard are all great sources of folate, or Vitamin B9, which is shown to improve cognition in older adults. Folate helps ward off depression (a common dementia side-affect) by contributing to serotonin levels. The Vitamin E in leafy green vegetables has also shown positive affects on the brain.
A study published in Molecules suggests that the phytochemicals found in vegetables such as broccoli, cauliflower, bok choi, cabbage and brussel sprouts help retain memory. They contain carotenoids and folate, which lowers levels of homocysteine, an amino acid linked with cognitive impairment.
Berries and Cherries
All varieties of berries contain anthocyanin, a phytochemical that protects your brain from damage caused by free radicals, inflammation and radiation according to a study in Molecules. Blueberries are packed with the most antioxidants, as well as plentiful amounts of Vitamin C and E.
Flavanols, the antioxidant in cocoa powder, help improve blood flow to the brain. The darker the chocolate, the better for you, since you’ll be getting more flavanols and less added sugar.
A study by the American Academy of Neurology found that people 65 and over who ate three or more weekly servings of omega-3 rich fish had a nearly 26 percent lower risk of having brain lesions that can cause dementia, compared to those who never eat fish. The high levels of the omega-3 fatty acids eicosapentaenoic (EPA) and docosahexaenoic (DHA) keep the brain in tip-top shape.
A small handful of nuts packs a ton of nutrients, including omega-6 and omega-3 fatty acids, Vitamin E, folate, Vitamin B6 and magnesium. According to a study in Age and Ageing, these nutrients help protect against age-related memory loss, as well as work to improve mood. All varieties of nuts, including peanuts, cashews, hazelnuts, walnuts, almonds and pecans, offer these benefits.
Seeds provide lots of Vitamin E, a vitamin associated with lower rates of age-related cognitive decline. Choline, a compound found in sunflower seeds, helps improve brain function. The zinc present in pumpkin seeds improves memory and cognitive function, while the tryptophan fights depression. Flaxseeds are excellent alternative to fish, since they’re packed with memory-boosting omega-3s.
Certain spices not only add flavour to your favourite dishes, but also add antioxidants and memory-boosting compounds. The mere scent of cinnamon, for instance, enhances cognitive processing. In a Newcastle upon Tyne University study, participants who consumed sage performed better on memory tests. And curry lovers can rejoice; Curcumin, a main ingredient in turmeric, has been shown to break up brain plaque and reduce inflammation that can cause memory problems.
4. Be patient while trying to help someone with dementia not eating
Trying to convince a person living with dementia who is at the point of not eating, that they must eat is counterproductive. Trying to explain why is also detrimental.
You need to be the food guide. Your role as the guide is to show this person how to eat each and every bite, just like it’s the first time they have ever eaten. Keep using strong eye contact and a nice big smile and not disrupt the person by talking.
It can be frustrating when you are trying to help someone and it is not working as effectively as you may hope. It’s like teaching a child to tie their shoelaces, or of course, to eat their vegetables!
They will watch how you do it and slowly copy, but if you don’t show them a demonstration they are not going to be able to learn. If you find yourself becoming agitated, take a deep breathe, and have another try.
If your relative with dementia becomes agitated or frustrated in the afternoon and evening, this may be due to 'sundowning'. Find out more about what it is and how you can manage it from our sundowning guide.
5. Arrange the food on the plate
You may need to experiment with different sizes, textures and flavours of food to see which the person responds to the best. Here are some tips to help you change things up:
- Add variety in the colour of food – different colour vegetables help to really brighten up the plate.
- Try less quantities of food and fewer individual items on the plate.
- Think about what types of food they have always enjoyed in the past. Put it on the plate with another food right next to it.
- Cut up the food (especially meat) into small pieces.
- Change the texture of the food – potatoes could be mashed, boiled, baked for example.
6. Praise the food
If someone is visibly enjoying their meal it encourages others round the table to dig in. As a family, share your enjoyment, praise the food and how tasty it is.
A simple “this food is delicious” can spark an interest in others and encourage them to try their food. Try this the next time you sit down together, taking the lead by eating first and giving that positive comment right away.
7. Stop talking
People living with Alzheimer’s and dementia are easily distracted and can get confused if you try to get them to multi-task. We want to make the job of eating their food to be as simple as possible and for them to feel comfortable and relaxed while doing so.
Stop talking to the person while you are eating with them, small comments about the food are beneficial but not too much. Make sure that they can focus on the task at hand, one thing at a time.
8. Eat small all day long
Contrary to what we believe, we do not need 3 main meals a day. Research shows that there is no major differences between 3 regular meals a day, 2 large meals a day or 5 little ones. In fact 5 little meals can help to regulate steady blood pressure which is an added bonus.
If you can only get your parent to eat small amounts, that’s not a problem as long as this is at regular periods throughout the day. It’s all about finding what works best for you.
Additional resources for dementia and eating issues
Read and download the NHS’ helpful Dementia Care Guide – Support with eating and drinking (PDF). This guide talks about the common problems those living with dementia can have at meal time, and offers some tips to resolve them.
Another great tool that carers can use is The DMAT (Dementia Mealtime Assessment Tool). The DMAT enables carers to assess, select interventions and generate a person centred care plan to support mealtime eating abilities and meal behaviours in people with advancing dementia. You can learn more about the DMAT and it’s benefits on their website.
You can also listen to expert advice on dementia in our podcast with Dr Alex Bailey. We spoke to Dr Alex Bailey, an old age psychiatrist who has shared his expert advice on dementia. This includes details of memory services, supporting those with dementia to live well, psychological therapies, supporting carers and much more.
If you are worried about the health of your relative with dementia, or about how little they are eating, then the best place to go to is your relative’s GP or health professional in charge of their care. There is more detailed information about dementia on the NHS website.