Providing Safe and Effective Nutrition for People with Dementia

Any number of reasons can affect a person with dementia’s ability to eat well:

• Being unable to recognize the purpose of eating 
• Failing to recognize food as edible 
• Forgetting when food had been eaten 
• Difficulty using utensils or feeding oneself 
• Too many food choices
• Some medications given for dementia have side effects such as weight loss, poor appetite, and being sleepy at meal times

Memories and memory loss play a role in eating:

• Those with dementia may remember the foods they ate as children and those served at special occasions  
• The family mealtimes as a child may play a much larger role in influencing what they want to eat

If nutritional intake is a concern, focus on the priority of EATING!

• People with dementia may need a mechanically altered diet to be safe (chopped, pureed, thickened liquids). Mechanically altered diets should be honored when recommended by a provider and if accepted by the person.
• Mechanically altered diets should be honored when recommended by a provider and if accepted by the person
• Eating a calorie-dense diet high in protein is most important 
• Avoid restrictions that make food less tasty 
• Concentrate on preferred foods 
• Small frequent high calorie/high protein meals/snacks

Make mealtimes easier:

• Limit distractions by providing a quiet environment 
• Avoid noises such as a TV playing, vacuum cleaner running, or loud conversations
• Avoid table centerpieces or plastic fruit: these items can be distracting or dangerous if eaten 
• Use only the needed utensils 
• Distinguish the food from the plate  
• Use contrasting colors – a white plate with a colored tablecloth or placemat 
• Avoid busy patterns that can be distracting

*TIP: Terra cotta plates and dishes stimulate appetite and promote increased intakes. Blues and greens do not!

• Check temperatures carefully: people with dementia may not know if something is too hot 
• Serve only one food at a time: too many foods may be overwhelming and confusing
• Allow plenty of time to eat 
• Swallowing or chewing difficulties may cause slow eating 
• Distractions or forgetfulness may also delay eating 
• An hour or more may be required to finish a meal

Remember that a person with dementia may not remember when or what they last ate: 

• If they ask for breakfast repeatedly, serve them breakfast foods 
• Provide snacks throughout the day

Encourage independence:

• Provide adapted serving dishes and utensils 
• Plates with rims or protective edges 
• Spoons with larger handles 
• Finger eating:
  • Chicken nuggets
  • Fish sticks
  • Easy to chew sandwiches cut into quarters
  • Fruit segments
  • French fries or potato wedges
  • Veggie sticks

Improving poor appetite:

• It is important to improve both the taste of food and the nutritional content 
• Serving tasty food that is also high in calories and protein can help prevent malnutrition and weight loss
• You can improve the taste of many foods by adding flavor enhancers, such as butter, sugar, honey, sauces, and gravies 
• In many cases, enhancers can make foods easier to eat and add additional protein and calories
• A person with dementia needs to get the most “bang for the bite” 
• Every bite they take needs to be nutrient-rich 
• Large portions of food at each meal can be overwhelming and prevent them from eating

Supplements…when food does not work:

• When a person with dementia is not eating, be sure that any underlying issues are identified before adding supplements 
• Supplements can hide underlying problems, such as difficulty with swallowing or feeding difficulties

Fluids are important too:

• Encourage fluid intake throughout the day 
• Add flavor enhancers, like Crystal Light or fresh citrus fruit, to water 
• Serve a variety of beverages to avoid flavor fatigue 
• Remember to honor thickened liquid needs if recommended by a provider and accepted by the person

The Aging & Disability Resource Center of Barron, Rusk, & Washburn Counties have locations in Spooner, Barron, and Ladysmith. Our office provides memory screening, dementia education, connections to resources and information, and training for businesses and other organizations to become dementia friendly. If you would like any of these services, concerned about a loved one or friend, or would just like to get involved in the dementia friendly effort in your community, please contact Trisha Witham at 1-888-538-3031 or trisha.witham@co.barron.wi.us.