How Dementia Affects Appetite
Patients with dementia undergo many behavioural, emotional and physical changes that could adversely affect their relationship with food. As many as 1 in 10 people with dementia who live at home suffers from poor nutritional intake, while one-third of patients in care homes and 70% of patients in hospitals are not having their nutritional needs met.1
Maintaining a balanced diet can help the body stay mobile, independent and strong. Unfortunately, unintentional weight loss among patients with dementia is common. The following are disease-related symptoms that may have an impact:
- Mood changes associated with the disease can affect a person's appetite. They may feel indifference toward food they used to love. In other cases, depression related to dementia can affect their appetite.
- People with dementia may develop a sore mouth or gums, which could make it difficult to chew and swallow food. In some cases, people might find it tough to communicate these difficulties to anyone, and so they just stop eating to take the path of least resistance.
- As dementia progresses, food preferences may shift. This can affect the amount of variety of food eaten. Even if someone appears to be eating enough volume wise, that doesn't mean their nutrition levels are where they're supposed to be.
- People with dementia may develop coordination problems. Eating meals then becomes a challenge, and they may be less inclined to eat as often as they should be. This is especially true if they live alone.
Tips to help and encourage eating
Here are some practical tips which provide solutions and help manage the nutritional intake of people with dementia.
Mealtime schedules should be as flexible as possible. Smaller portions of food given more frequently during the day can help encourage eating whenever the mood strikes. Background music has been shown to reduce the anxiety some people with dementia experience at mealtimes.
If using a knife or fork proves difficult, serve meals with food already cut up into bite-size pieces. As dementia progresses it may be useful to use coloured plates, or offer a spoon or special cutlery to make co-ordination of eating easier.
Food preference changes
For someone who may no longer like the foods they used to, try offering different ones – including new dishes they've never had before. There are tons of options out there.
As for nutritional intake, a healthy balanced diet is important to optimise health. For those with unintentional weight loss from their dementia there are a number of ways to improve nutritional intake – including nourishing, milk based drinks that boost energy and protein intake. Diet-wise, fish, eggs cheese, milk and meat are all protein rich foods. Starchy foods like bread, potato, rice, pasta and breakfast cereals are a good source of energy, whilst fruits and vegetables provide essential vitamins and minerals.
If you have concerns about diet, speak to your GP
It is important to speak to a health professional if the person with dementia is experiencing unintentional weight loss. If necessary your GP may refer you to a dietitian who can advise on the best course of action, which may require oral nutritional supplements. Oral nutrition supplements are used in conjunction with regular food and can meet your nutritional needs by providing a balanced mixture of protein, energy, fibre, salts, vitamins and minerals.
There are a variety of resources available for helpful information about unintentional weight loss, improving dietary intake and medical nutrition products. If you have any questions or concerns about unintentional weight loss and how to improve your nutritional intake or that of someone you care for, speak to your healthcare professional. A checklist which may help you discuss your concerns can be found at: http://www.patients-association.org.uk/wp-content/uploads/2016/12/The-Patients-Association-Nutrition-Checklist.pdf
For more information on dementia visit http://www.dementiaaction.org.uk.
Oral nutritional supplements are foods for special medical purposes for use in the dietary management of disease related malnutrition and must be used under medical supervision.