Nutritional Health For All

Feeding Strategies in Dementia

Dementia is a progressive illness of the brain and can often be associated with confusion, agitation and forgetfulness. If you are supporting or caring for someone with dementia you may have noticed that mealtimes can be particularly challenging.

This information is designed to help you understand how dementia affects someone with respect to eating and drinking and to help you manage some of these difficulties.

Examples of feeding difficulties:

  • Confusion and lack of coordination

You may notice that a person is becoming confused and uncoordinated. For example, the person may attempt to load food onto their knife or attempt to drink a food item.

  • Behavioural changes

These include refusal to open the mouth or spitting out food. This may be because the person no longer recognises the food in front of them or dislikes certain textures and tastes. This can even happen with foods that they previously liked. It may be because the person is having difficulty chewing or swallowing their food. If this is the case, check for loose-fitting dentures or painful gums or loose teeth. Remember, a person with dementia may not be able to communicate these problems to you.

  • Coughing after food or delayed swallowing

Be aware of subtle signs or symptoms such as coughing after food or drinks or taking a very long time to chew and swallow foods. This may need further investigation by a speech and language therapist. Ask your GP to make a referral.

Suggestions for managing feeding difficulties:

  • Ensure mealtimes are relaxed and as unhurried as possible.

  • Choose a calming setting with minimal noise or distractions.

  • Try not to become stressed at the mealtime if difficulties are encountered. A person with dementia can sense stress, making the situation worse.

  • If the person is confused at mealtime and not able to initiate feeding, use gentle reminders or prompts of how to use certain items. If this fails then load the fork / spoon for the person and gently guide the person’s hand to mouth.

  • Talk about the different foods you are offering so they can identify what they are eating.

  • Avoid mixing foods together as the person may dislike one particular ingredient and end up refusing all of the meal.

  • Finger foods are foods that can be easily picked up and eaten with the hands and are sometimes preferred to meals that require a knife and fork. They allow a person eat independently and at their own pace.

 Examples of finger foods:

    • Finger sandwiches
    • Pancakes rolled into fingers
    • Crackers with butter or soft cheese
    • Baby boiled potato
    • Potato wedges
    • Meat balls
    • Cocktail sausages
    • Chicken / fish goujons
    • Cheese sticks or cubes
    • Sliced apple
    • Melon wedges
  • Taste changes are common in dementia. Bland foods which were previously liked may not seem appealing now. Extreme flavours such as very sweet, salty or spicy foods may be more appealing to the person. Experiment with different flavoured dishes and desserts.

  • Check the temperature of food and drinks before offering it to the person. A person with dementia may not sense extreme temperatures which can make them prone to burning their mouth and tongue.

  • If food refusal or difficulties at mealtimes persist or if wandering becomes a problem, then weight loss is likely to occur. Offering small meals or high calorie snacks and drinks at regular intervals throughout the day will help keep energy levels sustained and minimise weight loss.

 If you are concerned about weight loss or any of the issues raised here, ask your GP to make a referral to a dietitian. You can also find a dietitian in the 'Find A Dietitian' section of our website. A dietitian can give expert, individualised advice on how to manage feeding difficulties.

 Other useful websites to visit

Created by Ciara Murphy, MINDI, October 2013

 Review date: October 2015

© 2013 Irish Nutrition and Dietetics Institute, INDI. All rights reserved. May be reproduced in its entirety provided source is acknowledged. This information is not meant to replace advice from your medical doctor or individual counselling with a dietitian. It is intended for educational and informational purposes only.

 

 

 

 

 

 

 

 

 

 

 

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