Caregiver Corner
By Jennifer Beach
I have seen many family members and caregivers struggle with the challenges of getting a loved one to eat, specifically those individuals with late-stage dementia, as well as with the later stages of many chronic diseases. Changes in appetite often come with dementia and chronic diseases. We know if a person is not eating enough, it can lead to weight loss, loss of muscle strength, balance issues, tiredness, weakness, susceptibility to falls, infection and viruses.
There can be many reasons why an individual’s appetite may change with dementia and other chronic diseases:
- Physical difficulties – problems with chewing, swallowing, bowel issues, vision impairments.
- Depression is common in people with dementia and chronic diseases.
- Communication – the person with dementia may have problems communicating that they are hungry, that they don’t like the food, taste, texture or temperature.
- Pain – the person may be in pain or discomfort, which can make eating difficult.
- Dental care – dentures, tooth fractures, infections and/or poor oral hygiene.
- Tiredness and lack of concentration can cause people to not eat or give up partway through a meal.
- Medication – changes to medications or dosage and/or side effects can result in changes in appetite.
- Physical activity – inactivity during the day may cause a person to not feel hungry. Equally, if the person is very active or restless, they may use extra calories and be hungrier than usual or lose weight more quickly.
- Changes in skills – The person may not know what to do with the food, or how to use the utensils.
Things we can do to help our loved one when there are challenges and changes in their appetite:
- Naturally, serve favored foods, however remember a person’s food preferences can change as their dementia or chronic disease progresses. Don’t be afraid to try different foods, even if they never liked a particular food, they may now be willing and they may now like it.
- Don’t stop someone from eating dessert if they haven’t eaten their meal. They may prefer the taste of the dessert. Most people like sweets over savory foods, but it’s important to be aware of their diet becoming majority sweet/sugary items. This can escalate other issues (dental, stomach/bowel issues, or weaken the immune system, to name a few.)
- Put small amounts of food on smaller plates. Seeing a plateful of food can be overwhelming and a person may refuse all the food as they see as too much.
- Try different types of food and drink with varying temperatures and textures, such as milkshakes or potato wedges.
- Gently encourage the individual to simply take a taste of the meal or food item.
- Don’t assume the person has finished because they’ve stopped eating. They may take a much longer time to eat food and graze or pick over time.
- If the person is agitated or distressed, don’t pressure them to eat. Wait until they are calm and less anxious before offering food and drink.
- Eat with the individual. Many people will eat more when others are eating at the same time.
- If the person doesn’t want to eat meals at set times or at a table, make finger food available throughout the day/evening. Bring small snack items to them. For example, cut a few slices of apple and set the food next to them in their visual field and allow them to eat when they are ready. Or you may need to model how to enjoy the snack. Say the name of the food item, pick it up and have a bite. Example: “Dad, here is a slice of a fresh apple.” You pick up a slice and eat;they can watch you and follow your lead.
- Eliminate some of the other stimulation in the room. It may be difficult or overwhelming to focus on the task of eating if the TV is loud, or other people are talking and moving about. You could try playing quiet, calm music too to enhance mealtimes.
- Serving meals on boldly colored plates and cups to individuals with dementia may boost food consumption. (Study by researchers at Boston University).
- If your loved one is at a point where you are supporting them by physically feeding them, place a spoon in their hand also. They may not be able to lift that spoon to their mouths, but the hand will tell the brain that food is coming, and this will help make the food times dignified, successful and about the person.
If you have the privilege and are supporting a person with dementia or a late-stage chronic disease and are assisting them with eating, remember considering some of these simple tips that may make a big difference in this important and sometimes challenging task.
