The latest in a series by Dr. Christina Hasemann, Ph.D., RD, L/CDN.
While no special diet is required for people with Alzheimer’s disease—unless they have another condition, such as diabetes, that requires diet monitoring—eating a well-balanced, nutritious diet is extremely beneficial. With the proper diet, your body will work more efficiently, you’ll have more energy, and your medications will work properly.
Proper nutrition is very important throughout all life stages. It gains even more importance as we age. Planning nutritious meals can be a challenge for anyone, but particularly for those with, or caring for, someone with dementia. I recently did an education session for the staff at the Kirkpatrick Day Program and I thought the information would be good to share more globally as well!
In the earliest of stages, persons with dementia may have a decreased variety of foods in their diet, may forget to eat, or forget that they have already eaten. They may not get thirsty and can forget to drink. Some become more sensitive to caffeine’s effects. Senses become dulled, especially smell and taste, and they may not be aware of spoiled food. Meal preparation becomes more challenging and they may forget that they are cooking and/or may lose track of cooking times. Grocery shopping may become more difficult – especially in today’s “superstores.”
Caregivers can help by serving high quality, nutritious foods and work to keep variety in the diet. Encouraging healthy snacks and adequate fluids can also go a long way to keep people healthy and hydrated. Switch to decaf /caffeine free beverages if sensitivity to caffeine is a concern. Regularly check refrigerator/cabinets for spoiled/out of date foods – or for food items that have been recalled. Keep an eye out for burned foods, cookware or utensils. And, provide assistance with shopping as needed.
In the middle stages, persons with dementia may forget to eat and drink, and weight loss may occur as a result. They may not feel hungry and may not even open delivered meals or packaged foods to prepare a meal or snack. Changes in ability to eat can occur due to forgetting dentures, difficulty opening containers, and poor/limited attention span. They may not be able to communicate hunger or thirst as they lose the ability to interpret the body’s signals. At some point they may not be able to prepare foods without supervisions/cueing and may use inappropriate table manners or not recognize utensils.
They may hoard foods for later consumption or even consume non-food items. They can become overwhelmed by a full plate of food.
Caregivers can help by supervising meals and assisting as necessary. Provide meals/snacks at regular times. Provide more finger foods and easy to eat items.
Serve foods one at a time so a large plate of food is no so overwhelming. Avoid distractions at meal time and redirect as necessary for meal completion. And, use food aromas to stimulate appetite and to increase interest in food.
In the later stages, persons with dementia may refuse to wear dentures to eat and as a result may begin pocketing foods. They may not recognize foods or what to do with certain foods or know which utensils to use. They may forget how to chew/swallow food safely. They may lose weight even with an adequate diet as the body shifts into hypermetabolism. They may require feeding assistance for meal completion.
Caregivers can help by encouraging them to participate as much as possible in the eating process with finger foods and cueing. Gently remind them to chew and swallow if they need cueing to do so. Offer liquid nutritional supplements such as Carnation Breakfast Essentials, Boost, or Ensure. Help them to maintain good oral hygiene to reduce bacterial growth that can lead to pneumonia. Modify foods as needed for appropriate textures (cut things up very small, puree, etc). Encourage to alternate bites of foods with sips of liquids.
Quite often caregivers need to get creative to get their loved ones to consume an adequate amount of nutrients and fluids. Support groups can be a helpful forum for additional ideas!
Dr. Christina Hasemann, Ph.D., RD, L/CDN is a member of the Alzheimer’s Association, Central New York Chapter board of directors. Dr. Hasemann is a registered dietician who specializes in senior nutrition, and president of NY-Penn Nutrition Services, Inc. Dr. Hasemann’s Nutrition Basics series appears on this blog on a regular basis. Consult a medical professional before adopting any dietary changes.