Education and Care - Eating

Alzheimer's Foundation of America

Weight loss is common among individuals with dementia, regardless of whether they are cared for at home or in a long-term care facility. Assessing why they are not eating and obtaining an accurate diagnosis are the first steps toward maintaining adequate nutrition and body weight.


Possible problems:
  • Has the individual forgotten how to feed himself?
  • Do they have trouble chewing or swallowing?
  • Are they having problems with dentures or gums?
  • Have they lost the ability to taste?
  • Is the individual having coordination problems, such as difficulty in using the silverware?
  • Are there co-existing medical or psychiatric problems, such as ulcers, depression or delusions, that are causing loss of appetite?
  • Do they seem disinterested in eating?
  • Is the person fearful at meal times? For example, do they say or think that the food is poisoned?
  • Are they unable to ask for food?
  • Do they dislike the food?
  • Is there too much noise or other environmental stimuli?
  • Do they eat only sweets, or like to eat them first?
  • Are they filling up on fluids?
  • Are other residents in a group setting eating the individual's food?
Tips:
  • Consult a physician to detect any medical causes.
  • Seek a swallowing assessment from a speech therapist if the person is regularly having trouble chewing and swallowing.
  • Have the individual sit in an upright, comfortable position.
  • Try to have them eat with others to increase socialization and make mealtimes more pleasant.
  • Check that their mouth is empty, especially if they hoard food or cigarette butts.
  • Make sure they have their glasses, dentures, hearing aids or any other appliances they need.
  • Prompt or feed those who can't feed themselves (apraxia).
  • Give the individual food they like and adequate snacks.
  • Provide nutritional supplements if there is significant weight loss.
  • Present one item at a time if the person seems confused by too much food in front of them.
  • Consider moving food to a different location on the tray or table.
  • Serve the drink last if the individual drinks too much and will not eat.
  • Serve pre cut or finger food, if using utensils becomes difficult.
  • Keep stressing that the food is safe if the individual believes it is poisoned.
  • Reassure the person that you will make sure they are well fed.

Note:If someone loses five pounds within a month or 2.5 pounds in two consecutive weeks, aggressive intervention should be undertaken to prevent further weight loss and to help them gain the weight back.

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