Dementia - eating

Mealtimes can become difficult for someone living with dementia. They might not know what the items on the table are, for example. To make mealtimes easier:

• serve familiar food
• serve one course at a time, in small portions you can refresh
• serve food at safe temperatures for eating
• use no-spill cups
• serve finger food they can eat with their hands
• serve food in a bowl if that makes it easier to eat
• remove distracting items from the table, like extra cutlery or glasses, or salt and pepper shakers
• remove items that might be mistaken for food, such as napkins or flowers
• use cutlery and plates (without complex patterns) that are a different colour to the place mat or table
• minimise noise, activities and other distractions
• make sure the room is well lit.

Nutrition and dementia

Eating a nutritious, balanced diet is vital for your health. It helps keep your body strong, which means you’re better able to:

• fight off illness and prevent injury
• manage other health conditions, like type 2 diabetes, high cholesterol and high blood pressure
• reduce health complications, like falls and infections.

If you live with dementia, you might have different food and nutrition needs, because your appetite, weight, physical activity and abilities have changed.

What to eat

Dementia Australia recommends choosing a variety of foods from the following food groups:

• vegetables in a variety of colours, like leafy greens, sweet potato and cauliflower
• legumes and beans, like lentils and chickpeas
• fruit
• grains, but choose mostly wholegrain and/or high-fibre cereals
• poultry, fish and lean meats
• eggs
• tofu
• nuts and seeds, like almonds, pumpkin seeds or sunflower seeds
• milk, yoghurt, cheese and dairy-free alternatives (mostly reduced fat)
• “good fats”, such as olive oil, avocado and oily fish.

While you might enjoy something sweet and salty as a treat, try to limit or remove food and drinks that contain saturated or trans fats, and added salt or sugars. These include:

• butter and cream
• full-fat dairy products
• fatty and processed meats
• palm oil and coconut oil
• biscuits, cakes and pastries
• deep-fried foods.

What to drink

Water is the best option for drinks. Increase your daily water intake by carrying a water bottle with you or pouring a glass of water with each meal. You can also stay hydrated by eating fruit with a high-water content, such as watermelon.

Alcohol can make memory problems worse and can affect your sleep. It’s also nutrient-poor and can lead to weight gain, so it’s best to avoid it. If you do drink, try not to drink on an empty stomach.

Dementia Expert webinar: Nutrition and Dementia

In this video from Dementia Australia, dietitian Emma Butler will describe how you can maintain a good intake of food and fluid intake, with practical every-day tips.

You can read about dementia friendly diets on the Dementia Australia website.

Appetite loss

You might find that the person you’re caring for wants to eat less or that they don’t want to eat at all.

To help with appetite loss:

• serve meals at consistent times during the day
• offer finger foods or snacks throughout the day
• keep mealtimes calm and relaxed, and if the person is agitated or distressed, postpone the meal until they feel calmer
• serve small portions of warm food, so it won’t go cold before they finish
• encourage them to eat all or most of one type of food, before moving on to the next. Or, only serve one type of food at a time
• allow plenty of time for the person to eat – meals might take up to an hour
• check in to see if they’ve finished before taking a plate away, as they might not be done yet
• serve familiar and favourite dishes often
• choose snacks with a high-water content, including fruits like melon
• provide a variety of nutritious foods to avoid constipation
• make sure they get enough physical exercise, which can help to boost appetite
• talk to their doctor or dietician if they lose a lot of weight or are struggling to eat.

Overeating

Dementia can change the way a person behaves around food. They might seem always hungry or obsessed with a specific food. This can lead to them eating too much.

To help with overeating:

• serve five to six small meals each day – instead of three large meals
• offer low-kilojoule snacks like apples and carrots
• lock away or hide problem foods
• offer water or a low-kilojoule drink instead of more food
• fill their plate mostly with salad or vegetables
• head out for a walk or increase their social activities. Boredom and loneliness can lead to overeating
• talk to their doctor or dietician if they gain a lot of weight.

Taste changes

Dementia can change the way someone experiences flavour because it can affect their sense of taste and smell. Dementia can also affect their mood, leading them to want comfort foods. These are often sweet or salty.

To help manage changes in taste:

• encourage healthy options like fruit or naturally sweet vegetables, instead of serving sweets
• use herbs, spices, sauces and chutneys to enhance the flavour of dishes
• let them eat odd food combinations, as long as they’re safe and nutritious
• check medications for side effects. Some antidepressant medications, for example, might cause cravings for sweets.

Mouth, chewing and swallowing problems

Dementia can make it harder to eat safely and comfortably. Some people with dementia experience a dry mouth, while gum disease or dentures that don’t fit properly, can also cause problems with eating.

To help with these problems:

• serve moist food or use gravy and sauces for dry mouth
• moisten food with water or other liquids
• offer foods like ice cream, yoghurt or milkshakes
• remind them to chew and swallow, and demonstrate how
• apply light pressure on their lips or under their chin to encourage them to chew
• gently stroke their throat to help them to swallow
• offer small bites, one at a time
• book a dental appointment to check their gums, teeth and dentures
• talk to their doctor if they’re developing choking problems
• talk to a speech therapist for advice and strategies around swallowing.

Support for families and carers

Carers should make sure their own diet is varied, nutritious and enjoyable.

Dealing with a range of issues can be difficult for some people with dementia and their families and carers. If you would like advice or to speak to someone personally about your particular situation, call the National Dementia Helpline or the Dementia Behaviour Management Advisory Service (DBMAS).

Where to get help

• Your GP (doctor)
• Dementia Australia video: Nutrition and dementia (17:15 minutes)
• Dementia Australia: Look after your body and reduce your dementia risk webpage
• Dementia Australia: Agitation and aggression webpage
• National Dementia Helpline: free telephone support for people living with dementia, their family and friends. Available any time, every day – 1800 100 500
• Dementia Australia library guides: a curated list of resources about eating and drinking well for dementia
• Dementia Behaviour Management Advisory Service (DBMAS): free 24/7 telephone support for dementia carers, 1800 699 799.