Alzheimer's Network-AlzNet

Caregiving Tips
--Strategies for Success
--Daily Routines
--Vacations
--Holidays

Communication
--Techniques
--Discussing Diagnosis

Activities of Daily Living
--Eating
--Bathing
--Dressing
--Incontinence

Behavioral Challenges
--Strategies
--Causes
--Anger
--Paranoia
--Traveling
--Sundowning
--Wandering

Therapies
--Storytelling

Safety
--Safeproofing
--Checklist
--Home Supervision

Medical Visits
--Ask your Doctor
--Tips
--ER Visits

Long-term Care
--Transitioning

EATING

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.