Tips on... Eating (Early and Middle Stages of Dementia)

by Edyth Ann Knox
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This caregiving tip comes in two parts: one for the early and middle stages of dementia and one for the late stage The eating problems associated with these stages can be very different, so what works earlier in the disease will not pertain to the later stage.

In the early to mid stages many things can develop eating problems for the individual affected by Alzheimer’s Disease. The sense of taste can change leading to a craving for sweets. But on a more basic level, the individual may have difficulty telling what is food and what isn't, as well as difficulty in knowing what to do with utensils and even what to do with the food at hand.

1) Mark plates and utensils so it is clear that they belong to your loved one: Some people affected by dementia have great difficulty in knowing which plate is theirs. Even with a dish in front of them, they may be confused about which plate of food is theirs. Try using heavy plastic picnic plates that have three compartments, with high sides. You might also buy matching plastic cups. This may help your loved one to determine which plate is theirs.

2) Locate a comfortable place to eat: For a few years we tried eating in the dining room at the table but my mother-in-law, Milly, was very anxious sitting at the table. She however would relax and eat very well in the living room. Instead of trying to insist on her eating where we felt was best, we just went with what Milly felt comfortable. Eventually we were able to move dinner back to the dinning room table.

3) Do not allow your loved one to eat alone: Your loved one may eat more food if she eats with the rest of the family. This actually was good for me as I had a bad habit of forgetting to feed myself. At least I would have three meals a day if I sat with Milly while she ate hers.

4) Encourage healthy snacking: At some point your loved one may develop a taste for sweets. If the food in front of them is not ice cream and cookies, to them it is not food. Most caregivers will try to steer away from sweets because of concerns about proper nutrition. I have found it much easier to let the sweet tooth work for you: bake cookies with dried fruits and veggies in them. Oatmeal cookies have excellent fiber and you can add just about anything to an oatmeal cookie to aid in nutrition. Pumpkin and squash can be used to make a bar cookie that is out of this world.

5) Enhance foods with spices: You will find that your loved one’s preferences for specific foods will change. I know my grandma (aged 94 with early stages of Alzheimer’s Disease) loves her food on the spicy side.  Grandma loves eating raw onions, and spicy hot foods. Milly enjoyed her food better when I spiced it up and made it flavorful (that does not mean salty).

6) Control intake of snacks: Place snack foods and finger foods in one area of the kitchen, so that they are easy to find and you can make sure that the food is nutritious. Apples, carrots, celery sticks, and popcorn make excellent foods to leave out.

7) Helping differentiate between food and non-foods: At some point, most people with dementia will find it difficult to tell what is edible and what isn’t. This may result in eating artificial or plastic fruits, bar soap, or just about anything that can be placed in the mouth. Clearly this is potentially very dangerous. Use the same caution that you would storing dangerous materials as you would with a child.

8) Assist with handling of utensils: Knives, forks, spoons and cups will become a problem as the disease progresses. As your loved one loses the ability to use silverware, provide finger food as much as possible. Some foods however do not lend towards eating with fingers, so help by spooning it into their mouth. Put their hand on your hand with the spoon as you fed her. Cups were a big problem because they may forget which end they are supposed to drink from. Buy some kid cups with a heavy duty built-in straw.

9) Dealing with hidden foods: As with personal effects, individuals with dementia may also hide food. Leaving snacks out can become a problem, yet snack foods are still in demand. Limiting the amount of snack foods left out becomes a better idea. Observe your loved one’s favorite hiding spots and check them when your loved one is not around. Then it is simple to remove food and other inappropriate items they have hidden.

10) Encourage adequate fluid intake: Don’t overlook the importance of fluids. I don't worry so much about them not eating as I do them not getting adequate fluids. Adding liquid meal replacements and supplements such as Ensure or an instant breakfast to their meal is a wonderful way of adding calories as well as fluids, vitamins, and nutrients. Don’t forget to drink plenty of water yourself!

Related Articles
Proper Nutrition 40+
    Eating and Nutrition Skill Builder
When Your Loved One Resists Care

Additional Reading
    Caregiver's Handbook: A Complete Guide to Home Health Care by the Visiting Nurses Association of America
    Alzheimer's Early Stages: First Steps in Caring and Treatment by Daniel Kuhn

Edyth Ann's Caregiving Tips
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