Seven Tips for Ensuring Those with Alzheimer’s Eat Enough

Being underweight has serious health consequences for seniors, and sudden weight loss can be a sign of significant illnesses. The problem is especially acute for people living with dementia, who can face a range of potential challenges when it comes to proper nutrition. Experts with Brookdale say a variety of techniques can help family caregivers ensure their loved ones are well nourished.

“When seniors are too thin, they don’t have a weight reserve to see them through pneumonia, flu or other illnesses,” said Juliet Holt Klinger, Senior Director of Program Development in Dementia Care of Brookdale Senior Living. “They become more vulnerable to infection.”

Seniors may lose skeletal muscle mass, a condition known as sarcopenia, which raises 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.”

If a senior has significant weight loss, it’s important to see a physician about it. A range of illnesses, from cancer to endocrine disorders, could account for the problem, but at times it stems from undiagnosed Alzheimer’s disease.

“Dementia can impair the olfactory sensation up to two years before it’s detected,” Holt Klinger said. “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 the condition progresses, numerous factors can interfere with eating, according to Holt Klinger. Make sure foods are “dementia-friendly”: Foods that require a “second step” at the table should be eliminated. No bones, tails, or skins that can’t be consumed safely should be served. Long pastas should be replaced with those that can be easily speared with a fork like bow-tie and ziti,” Holt Klinger said. “Simple adaptations to what is served can make the dining experience much more successful for someone living with dementia.”

  • Ensure that you are honoring former tastes and preferences: Increasing consumption can be as simple as ensuring that the person with dementia enjoys what they are 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 said. “At Brookdale, we have success using enhanced seasonings to emphasize flavors and support taste buds that are changing. But nothing is more important that knowing (and serving) what a person most likes.”
  • Support recognition and give a helping hand: For loved ones having trouble using utensils, gently place your hand over or under theirs and help 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 is 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.” 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 often signify another unmet need. “Pay attention to the cues your loved one is giving you,” Holt Klinger said, “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 is important to observe and determine the underlying cause of the restlessness and make adjustments.
  • Get your loved one moving: Encouraging your loved one to be more active throughout the day– for example, taking regular walks with you, if possible – will encourage an appetite.
  • Check for dental problems: “Again, if distress during dining is noted, it is critical to observe your loved one for any specific cues”, Holt Klinger encouraged “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: Be proactive with offering beverages throughout the day 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 said. “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, there is no reason why dining shouldn’t remain a very pleasurable part of life for persons living with dementia.” Holt Klinger said.