“When seniors are too thin, they don’t have a weight reserve to see them through pneumonia, flu or other illnesses,” says Juliet Holt Klinger, a gerontologist and Brookdale’s expert on dementia. “They become more vulnerable to infection.”
Seniors may lose skeletal muscle mass, a condition known as sarcopenia, which can raise vulnerability to injuries. “They have a greater risk of falling and, if they do, they are more likely to become what’s known as functionally dependent, or needing help from others to carry out the activities of daily living,” Holt Klinger adds.
If a senior has significant weight loss, it’s important they see a physician. A range of illnesses, from cancer to endocrine disorders, could account for the problem, but it may also stem from undiagnosed Alzheimer’s disease.
“Dementia can impair the olfactory sensation up to two years before it’s detected,” Holt Klinger says. “The ability to smell plays an important role in the desire to eat and the perception of taste, so this impairment can diminish appetite even before other dementia symptoms become evident.”
As dementia progresses, numerous factors can interfere with eating, according to Holt Klinger. Here are a few tips:
- Make sure foods are “dementia-friendly.” Try to avoid foods that require a “second step,” such as bones, tails, or skins that can’t be consumed safely. Long pastas can be replaced with those that can be easily speared with a fork like bow-tie and ziti, Holt Klinger says. “Simple adaptations can make the dining experience much more successful for someone living with dementia.”
- Ensure that you’re honoring former tastes and preferences. Increasing consumption can be as simple as ensuring that the person with dementia enjoys what they’re eating. “Ability to taste and smell may diminish or change drastically by the middle stages of dementia, which can affect the person’s desire to dine,” Holt Klinger says.
- Support recognition and give a helping hand. For loved ones having trouble using utensils, consider gently placing your hand over or under theirs and helping guide the fork or spoon to their mouth. “Oftentimes you can ignite the starter button and tap into overlearned physical movement memory by just tapping the hand where you want them to take the action.” Holt Klinger explains. “It’s also important to support the person’s ability to visualize the food on the plate. Many persons with advanced dementia have issues with depth perception and these can interfere with their ability to see the food or the plate on the table.” You can help support these perceptual changes by creating a contrast between the plate and the table surface with a dark-colored cloth or placemat and use colorful garnishes like parsley on low-color foods.
- Adjust meals to restlessness. Restlessness during meal times can signify another unmet need. “Pay attention to the cues your loved one is giving you,” Holt Klinger says. “They may be responding to too much noise and stimulation in the dining environment or a lack of understanding of the task at hand.” It’s important to observe and determine the underlying cause of the restlessness and make adjustments.
- Get your loved one moving. Encouraging them to be more active throughout the day—for example, taking regular walks with you, if possible—will help encourage an appetite.
- Check for dental problems. “Again, if distress during dining is noted, it’s critical to observe your loved one for any specific cues,” Holt Klinger says. “The root cause of issues with dining may be related to tooth pain or ill-fitting dentures.” Keeping up with regular dental check-ups and denture cleanings is important.
- Pay attention to hydration. Being proactive with offering beverages throughout the day may help to prevent dehydration. “Loss of memory, meaning, and initiative associated with even early dementia can interfere in a person’s ability to stay hydrated,” Holt Klinger says. “It is critical to remember to offer water and other beverages throughout the day.”
Making the adjustments needed to the food and the dining environment can go a long way to make the dining experience more successful for persons living with dementia. “With a little care and few adjustments,” Holt Klinger says, “there is no reason why dining shouldn’t remain a very pleasurable part of life for persons living with dementia.”
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