March 26, 2025

Dining and Nutrition Strategies for Those Living With Dementia

About Brookdale Senior Living

Brookdale Senior Living offers multiple care levels for seniors in more than 600 communities nationwide. Brookdale helps you find the right care plan for yourself or your loved one. With amenities such as transportation services, salons and private dining rooms and activities such as gardening, fitness classes and trivia nights Brookdale caters to a wide range of interests and needs.

Margaret, who is living with dementia, has always been a good eater, but lately her daughter, Carla, has noticed that she doesn’t seem to have much of an appetite. She picks at her food, or totally ignores it, and she has been losing weight. Concerned about her mother’s health, Carla has voiced her concerns to Margaret’s primary physician, as well as to the staff at the assisted living community where she lives.

There are good reasons for Carla’s concerns, and she is not alone. As the Alzheimer’s Association^® points out, people living with dementia are at a greater risk for poor nutrition and weight loss. Continuing the cycle, poor nutrition may increase behavioral symptoms in a person living with Alzheimer’s or related dementia.

An estimated 7 million Americans are living with Alzheimer’s. Healthcare providers should take an active role in identifying and addressing potential issues, including those related to nutrition. That means working together with patients’ caregivers and families, as well as with staff at residential communities.

Why Good Nutrition and Hydration Remain Important

Although there is no specific diet for people living with dementia, proper nutrition is crucial for supporting their overall health, helping to prevent weight loss, and managing behavioral symptoms. Additionally, maintaining sufficient intake of vitamins, minerals and other nutrients can potentially help support cognitive and physical function and preserve quality of life.

A healthy, balanced diet for all older adults, including those living with dementia, should focus on nutrient-dense foods to help optimize function and prevent malnutrition. Nutrient-dense foods pack an abundance of vitamins, minerals, fiber, lean protein and unsaturated fats into each bite. Emphasizing nutrient-dense foods is a key strategy for meeting the nutritional needs of people living with dementia, particularly for those experiencing a decreased appetite or decline in eating abilities due to disease progression. Examples of nutrient-dense foods include lean meats, fish, eggs, beans, and lentils, which are rich in protein and vital for supporting muscle tissue. Other foods, such as dairy, leafy greens, fruits, vegetables, and whole grains are rich in one or more nutrients such as calcium, vitamins D and B12, and fiber, which play crucial roles in bone health, nerve function, digestion, and blood sugar control. Fortified foods — with added calories, protein, vitamins and/or minerals, can also be used to help maximize nutrient density or as a flavor enhancer to improve palatability and help with appetite. For example, adding peanut butter to oatmeal increases the calories, protein and unsaturated fat consumed in each bite.

A healthy nutrition plan should limit foods high in saturated fat, cholesterol, refined sugars and sodium.

Older adults also need to stay properly hydrated, which means ensuring adequate intake of water and other fluids. Failure to do so can lead to dehydration, with complications that can include heat stroke, heart problems, kidney failure, urinary tract infections (UTIs) and a weakened immune system. Because the sensation of thirst often diminishes with age and many medications can dehydrate the body, staying hydrated can be difficult for many older adults. People with dementia don’t always remember to drink, which further increases the challenge of staying hydrated.

Nutrition and hydration are especially important for older adults with complex medical needs such as dementia, and special attention may be needed during times of transition, such as to a new residential or care setting. Both malnutrition and dehydration can result from insufficient monitoring or care plans in long-term care settings.

Reasons for Changes in Nutrition Habits, Strategies for Improvement

There could be both physical and cognitive reasons for an individual’s dietary deficits, particularly for someone living with dementia in a long-term care setting. If the person has recently moved, the transition might create confusion or a change in mood. Memory loss may make it challenging for an individual to recognize hunger cues or recall whether they have already eaten.

Sensory changes can impact appetite, food preferences and the ability to feel discomfort. Although these sensations still occur, there may be a delay in processing them, making it harder to recognize temperature, hunger, thirst or pain. Difficulty processing sensory information can also make mealtime tasks like choosing utensils or navigating the dining environment overwhelming and hinder the person's ability to initiate or complete tasks. Caregivers should be attentive to non-verbal cues and consider these factors when identifying and addressing needs.

HCPs can encourage caregivers to use the following strategies for encouraging healthy dining habits:

Create a supportive dining environment. The physical environment plays a crucial role in the dining experience for individuals with dementia. A thoughtfully designed space can significantly help improve food intake, reduce behavioral challenges and enhance overall quality of life. Environmental modifications should address sensory, cognitive, and emotional needs.
Create a quiet, calm atmosphere. Reduce distractions by turning off the TV during mealtime. Soothing instrumental music played at a low volume during meals can help reduce behavioral expressions and promote a more positive, relaxed environment. Temperature control is essential — a room that’s too hot or too cold can cause discomfort and agitation, distracting from the meal. Give the person plenty of time to eat; if it takes them an hour to finish, that’s OK.
Keep it simple. Use strong contrasts between the colors of the plate, table surface, and floor to make the food stand out visually. This not only highlights the meal but also helps define the table’s boundaries, making it easier to navigate. Keep the table free of unnecessary items such as condiment packets, elaborate centerpieces, or unused utensils and glasses. This simple setup aids individuals with sensory or perceptual changes in distinguishing edible from non-edible items. Additionally, serving meals at regular times encourages consistent habits, while serving one food at a time can help remove the pressure to make decisions.
Keep it safe. Changes in tactile sensitivity may make it difficult for a person to recognize temperature — therefore, it is important to ensure the food is the right temperature before serving. Dementia-friendly foods should include foods that do not require additional steps at the table. For instance, avoid foods with bones, tails, or skins that cannot be consumed safely. Foods should also be easy to spear with a fork or scoop with a spoon. For example, opt for bow tie pasta instead of spaghetti, creamy risotto instead of rice, or creamed vegetables instead of plain peas. Be alert to signs of swallowing and chewing challenges, such as frequent coughing or pocketing food.
Be flexible. An individual’s tastes and preferences can change, so don’t be too tied to what they used to want to eat. Sometimes serving one item at a time can encourage increased food intake.
Maximize independence, and be ready to assist. Evaluate the type of assistance the person may need. At times, disruptions in executive function can make it difficult for them to start a task, requiring support to begin. Others may benefit from a gentle guide, such as assistance in moving the utensil from the plate to their mouth a few times to help get them started. Adaptive serving dishes and utensils can also be helpful, tailored to the person’s abilities. Options like weighted utensils, rimmed plates or offering finger foods may make eating easier and more manageable. While assistance may be necessary, allow the individual to maintain as much independence as possible. It is important to support by doing “with” and not “for” the person living with dementia.
Make meals a shared experience, when appropriate. The social aspects of dining can encourage some individuals to eat. However, be mindful that as dementia progresses, the individual may struggle to engage in conversation while also focusing on eating. Tailor conversations to enhance the mealtime experience. Discussing the meal can help the person focus and connect with the moment, such as saying, “Brenda, your chicken smells delicious!”

HCPs should urge caregivers to contact them if the older adult they are caring for experiences significant weight loss, a change in appetite or eating habits, or trouble chewing or swallowing. Caregivers also should consult a physician if they have other concerns about nutritional deficiencies.

Nutrition, Hydration and Brookdale

Brookdale Senior Living employs a comprehensive, proactive, whole-person approach to the health of our residents. This includes clinical and resident engagement programs and non-medical interventions. We monitor nutrition and work to help mitigate the effects of malnutrition.

Our dedicated Clare Bridge^® memory care program includes a dining program developed by a team of experts specializing in dementia care, culinary arts and nutrition. The Clare Bridge^® Dining Program features dementia-friendly menus of diverse, healthy and delicious offerings that are easy to manage, familiar and appealing to the senses. Our culinary teams’ preparation techniques help reduce the risk of choking. Individualized dining assistance helps preserve residents’ use of utensils for as long as possible. Small dining rooms with consistent seating help encourage familiarity and socialization.

Brookdale also takes fluid intake seriously, helping residents stay healthy and hydrated. At every meal and throughout the day, residents have access not only to water, but also to juices, tea, coffee and more. Many of our communities also feature Hydration Stations, offering a variety of fresh, infused water with colorful slices of fruits and vegetables in exciting flavor combinations.

Learn More

If you are a healthcare professional, we welcome the opportunity to discuss Brookdale’s focus on nutrition and hydration with you. Contact us to learn how we can work together to help keep your patients well fed, hydrated and healthy.

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