Boosting Mealtime for Elders with Dementia

 As we know Alzheimer’s affects a person’s memory, language, thinking skills and depth perception. Did you know that it may also affect the way a person eats and their nutrition? With so many changes happening at once, it’s important to keep our elders who are living with Dementia healthy as well as make sure they are getting all the nutrition they need. Here are a few tips I found on crisisprevention.com by a dietitian by the name Andrea Anderson, on how to maintain and build an elder’s nutrition with dementia.

1. Create the right dining environment

Keep mealtimes simple and try to minimize distractions as much as possible. Provide the Dementia patient with a table that does have centerpieces or extra silverware. Also, make sure to only offer them one or two food at a time, it can increase their focus and the amount of food they consume.

Dementia patients tend to benefit from a quiet environment, free of television, loud music or distracting conversations. Verbal cues and food setup such as opening containers and removing silverware from packaging may be necessary.

Finger foods like quartered sandwiches, cheese and crackers, and sliced fruits and vegetables encourage independence during mealtime since the ability to use silverware is not a limiting factor.

2. Observe mealtime

A person with dementia may have trouble expressing their preferences, so it’s important as a caregiver to observe the food eaten for customization on future meals. You may notice that someone always refuses peas or takes beverages from a straw better than a cup. This is a good time to watch for signs and symptoms of dysphagia (trouble swallowing) like pocketing food, coughing, choking, or food or beverages spilling out of the mouth, which warrant further swallow evaluation

3. Go with the flow

Anticipate that mealtimes may take longer or be extra messy. This is normal. People with dementia are constantly changing. People may forget that a meal already happened and insist on having another one. If this happens, make the most of it. Offer “multiple” meals like salmon followed by mashed potatoes, and then green beans during this time to boost overall food intake.

4. Focus on high-calorie and high-protein foods

Weight loss can be a serious issue with dementia. To build or maintain weight:

• Encourage small frequent meals; i.e., three meals and three snacks a day to help reach calorie goals.
• Add more fat. Of all the macronutrients, fat has the most calories per volume. Each of these equal about 100 calories:
  • One tablespoon of butter, mayonnaise, nut butter, or olive oil
  • Two tablespoons of avocado, salad dressing, or unsalted nuts
• Offer high-calorie beverages like whole milk, juice, regular soda, and lemonade instead of water or unsweetened coffee and tea.
• Fruits and vegetables are loaded with vitamins and minerals, but relatively low in calories and protein. Add extra fat (see above for ideas) or cheese to vegetables and sugar or honey to fruits to promote weight gain or maintenance.
• Promote protein at every meal and snack. Protein is important to maintain muscle mass, functioning, and strength through aging. Think meat: poultry, seafood, eggs; dairy: milk, yogurt, cheese; or even protein drinks and powders.
• Liberalize meals. When a person with dementia has multiple dietary restrictions such as consistent carbohydrate and heart healthy on top of a modified consistency like pureed or mechanical soft, foods can be overly restricted and decrease the amount of food consumed. General food plans with only restrictions in consistency determined by speech-language pathology will allow for the most food choices.
• Hydration. Let’s not forget keeping our elderly loved ones hydrated. As difficult as it is to get some elderly individuals to drink water, we want to make sure that they are always drinking throughout the day. This helps avoid urinary tract infections. UTI’s may cause hallucinations, combative behavior, falls, or hospitalizations.

It’s important to remember that each person is different, and care must be individualized depending on specific needs and through observation. Whether at home or in an assisted living facility, the dining room area is key when trying to get the elderly to eat their nutritious meals.