Good nutrition is important for people of all ages. But not all seniors are capable of managing their nutritional needs easily. And those with dementia can experience mental and physical hurdles that interfere with their abilities to eat and maintain healthy diets. Dementia may also make it more difficult for them to understand or express what has changed or become challenging.
Here is a quick guide to recognizing some of the potential hurdles to healthy eating—followed by some tips on how to overcome them.
Common Challenges
A number of characteristics common to people with dementia often make the simple act of eating healthfully challenging.
Distraction and wandering. Some seniors with dementia have short attention spans. They take a couple of bites and then want to move somewhere else or check on something. Music and noise at mealtimes can be very distracting and stressful, and they might get up to see where the noise is coming from or try to turn it off.
Loss of hunger signals. Seniors with dementia often lose or confuse hunger signals. The mind no longer tells the body it’s hungry. They might see food and say, “I just ate,” even though they haven’t eaten in quite some time. Or they might have just eaten and want to eat again.
Difficulties recognizing food. When dining, distinguishing color, contrast, texture, and identifying particular items may become challenging. Some seniors might not be able to identify the foods in front of them, leaving them confused and frustrated. If it’s a food they don’t like, they might spit it out without being able to tell you they don’t like it.
Unusual schedules. Conventional breakfast, lunch, and dinner times might not work for some seniors. For example, if they sleep in or take long naps in the afternoon, they might miss scheduled mealtimes. Mealtimes should be set around their schedules.
Difficulty swallowing or chewing. Food consistency and texture can really make a difference in eating habits. Many seniors have dentures that do not fit well, or teeth that have become painful. Those who have lost teeth may need chopped or pureed foods. Regular dental check-ups are important to monitor dental health. Swallowing problems should be addressed immediately with a doctor, who can make a referral to a specialist for a swallowing evaluation.
Underlying medical conditions. Loss of appetite and refusal to eat or drink are often the first signs of medical conditions that need attention. A person who usually eats well, and then refuses to eat or drink for more than a day or two may need to be seen by a medical doctor.
What You Can Do to Help
Eating is one of the pleasures of life, and for seniors with dementia, dining should be a time to be anticipated and enjoyed. For many, it was a social time in days gone by—involving gathering with friends, spending family time together, and celebrating holidays. By keeping to these traditions, you can use the happy times of the past to continue the good memories and create a safe, comfortable space in the present moment. There are a number of specific steps you can take that may be helpful.
Use contrasting table settings. Dementia can affect depth perception, making it difficult to differentiate plates and bowls from the surface they are sitting on. Use different colors for plates, tablecloths, and cups. Interestingly, in a study conducted at Boston University, researchers found that patients eating from red plates consumed 25 percent more food than those eating from white plates.
Make foods easy to identify. Prepare different colors of food and arrange them on a plate so it’s easy to discern the different types of food. Sometimes large portion sizes can be intimidating, so start with smaller portion sizes and give seconds if appropriate. Many seniors like to cut food up themselves; always ask their preferences before cutting food for them, helping them to be as independent as possible.
Provide easy-to-use tableware. It may be difficult for a person with dementia to use a fork to maneuver food off a flat plate. It can be better to provide a spoon and serve meals in a shallow bowl so he or she can scoop the food using its edge. Weighted utensils are helpful for seniors with shaky hands. Plates with separations in them, and scoop dishes also are very helpful and can make it easier to eat. A number of websites offer adaptive eating and drinking aids and other helpful dining aids.
Keep table settings simple but meaningful. Too many items and decorations can distract and confuse. Have a simple table setting using one or two items the senior likes to make it familiar and inviting. If you know what they usually used to set for the dining table, replicating it may help instill a sense of comfort.
Create a pleasant environment. Soft music, comfortable room temperature, good company and conversation, and allowing plenty of time to eat are all key to a pleasant dining experience. Make sure that the seating is comfortable and that utensils, plates and drinks are all easy to reach. If a caregiver is usually present during mealtimes, ask him or her to sit and eat with the senior; the companionship of a dining partner is pleasurable and nourishing.
Encourage eating, but be patient. Describe what you are serving, and give seniors ample time to process the information. Don’t try to convince or coax them to eat, but give lots of positive feedback and eat along with them. If possible, sit in front of them; it may be helpful to have a role model to guide them through the meal.
Encourage snacking. Offer small healthy snacks throughout the day—for example, juice and crackers, slices of fruit, half of a sandwich, and plenty of water.
(This article was updated February 2024 since it was originally published in July, 2016.)
