Eating and drinking
It is common for conversations about dementia to focus on the neurological symptoms of the disease, like forgetfulness or changes in communication. But it is important to remember that while these changes are important and have a significant impact on people’s day to day lives, they are not the only symptoms and eating and drinking is often a topic of concern.
Our vision, smell, taste and hearing all play an important role in the eating and drinking experience. If a person with dementia has changes in the areas of their brain that help them make sense of what they see, they may find it difficult to recognise what is in front of them. If they don’t recognise the food in front of them, they may not be prompted to realise that they are hungry and that it is time to eat. Therefore we have to be mindful that visual and cognitive changes can make it difficult for someone with dementia when it comes to eating and drinking. You might find this leaflet on Dementia & Sensory Challenges helpful as well as Agnes Houson’s dementia diary.
The impact of changes in vision
The impact of changes in hearing
Many people with dementia talk about finding it difficult to filter out the extra noise in an environment. This can contribute to making it harder for someone with dementia to focus on eating. Extra noise can be distracting, frustrating, or frightening – especially when it happens suddenly or close by. This is why the DSDC suggests the person may benefit from eating in quieter restaurants, at a quieter time, or in a location that doesn’t include too much background noise
The impact of changes in taste
You may notice that someone with dementia often favours sweeter food over savoury or spicy options, which is likely due to how well they can taste those foods. This may influence the foods they choose to eat, as well as how they season their food as they increase the amount of salt (for example) to reach the same flavour that they are used to.
It is not unusual for an individual to begin to eat something they used to dislike or to stop eating something that was a favourite and it is important to remember that this is not always due to a ‘loss’ in ability or significant progression in someone’s dementia, but to a loss of taste sensitivity.
If a loved one is diabetic and they are drawn to foods with a high sugar content, have a conversation with the GP about the possible risks to the individual should they choose not to follow that diet
The impact of changes in smell
A person’s sense of smell is often one of the things that changes as their dementia progresses, often leading to a difficulty in identifying particular smells, or detecting odours at all. A loss in someone’s sense of smell can significantly impact how much, how often, or what they choose to eat or drink.
An example of recognisable smells could be coffee and toast in a morning.
Cooking and eating as a social activity
Though we eat and drink to survive, eating and drinking are also social activities. Food is often deeply ingrained in how we interact with others, whether that is going out for a meal or socialising with friends and family. It is this social element that can be missing for many older people who live alone in the community that can, in turn, mean that people eat less over time. Eating with others provides social cues that encourage regular nutritional intake.
Eating with others provides several advantages: first of all, it gives us a pleasant, meaningful activity that we can do while staying connected to the people that are important to us. Secondly, it serves as a prompt. For someone experiencing short-term memory loss, remembering to eat isn’t always easy. Eating with others provides social cues that encourage regular nutritional intake.
It is important to remember, that cooking can still be an important and meaningful activity for a person with dementia, when they are encouraged and provided with appropriate support. There are numerous assistive technology devices available to support independence in the kitchen for someone experiencing short-term memory loss.
It is worth checking to see what services may be available to you locally, if cooking becomes too burdensome, or is no longer of interest to the individual and is impacting on their health and well-being.
TIP: Written reminders
One common strategy used by people caring for someone with dementia who may forget to eat or drink is to use a whiteboard (or similar) placed somewhere they will see it often that they can refer to throughout the day. These might include ‘remember to drink water’ or ‘your lunch is on the counter’, for example.
TIP: Make snacks and drinks visible
Consider keeping healthy snacks like fruit visible to increase the chance that they will be picked up and eaten. Keep in mind special, favourite treats that can be left in strategic places to be enjoyed throughout the day.
Pain is a very common contributor to appetite loss and is also under recognised in people living with dementia. One particular acute problem which impacts on eating is poor dental care.
Many people with depression, both with and without dementia, will also experience a change in appetite where they begin to over or under eat. It is particularly important to keep this in mind as many people with dementia will also have depression,
Encouraging a healthy diet and hydration
Encouraging fruit juices is a good way to increase fluid intake and encourage vitamin consumption, though check with a GP as certain fruit juices may interact with medications. Cranberry juice is a particularly good choice as it has been shown to be effective in the prevention and treatment of urinary tract infections.
While most of us imagine sandwiches when we hear finger food, finger foods can include anything that is easy to eat by hand, and can include cheese, hard boiled eggs halved or quartered, fish fingers and meat slices to name but a few examples. Most fruits and vegetables can be presented in a way which promotes eating by hand, while snacks like crisps, nuts or even ice cream cones lend options to meal time.
Nutrients to be encouraged:
Poor hydration affects mental function and can have a number of very serious consequences such as urinary tract infections, delirium, low blood pressure leading to dizziness and falls, constipation and kidney issues.
Warning signs of dehydration:
If you suspect someone is deliberately limiting the amount that they drink, to prevent frequent visits to the toilet, or just don’t drink a lot, then the list of fruit and vegetables below which are high in water content may help in trying to combat hydration issues
Fruit and vegetables with a high water content:
10 top tips for improving nutrition and hydration
The following are our ten top tips for better nutrition and hydration for people living with dementia.
Read more about eating and drinking for people with dementia in DSDC’s 10 Helpful Hints to Support Eating and Drinking for People with Dementia. If you live in Scotland you can request the 10 Helpful Hint series for free, thanks to funding.