Eating difficulties are a common problem encountered in caring for one with Alzheimer’s disease. As the disease progresses, getting the person to eat may become more challenging. In this handout some of the common reasons for decreased appetite are addressed as well as some of the steps you can take to overcome this challenge. It may be helpful to ask yourself the following questions:
Is there something physically preventing then from eating?
Things to look for: Ill fitting dentures, sores/diseases of the gum, jaw pain can also be a cause.
What can you do? Your dentist can address issues with dentures such as adjusting them. For sores in the mouth or jaw pain you should visit your family doctor for advice.
Do they have another medical problem?
Things to look for: diabetes, acid reflux, heart disease or constipation.
What can you do? Adequate control of underlying medical conditions is very important. Making sure they are taking their diabetes medications is very important as well as checking blood sugar levels. Acid reflux can usually be treated with over the counter antacids (e.g. Tums, Prilosec). If constipation is frequent, a visit to your doctor is advised.
Are they depressed?
Things to look for: loss of appetite, decreased interest in things they normally take interest in, isolation, etc.
What can you do? Interact with them as much as possible; try to engage them in activities to make them feel useful. If the symptoms persist, seeing a psychiatrist is advised.
Has their eating environment changed?
Things to look for: they appear distracted by objects in the environment (i.e. looking around, analyzing objects in room).
What can you do? Try to feed them in a familiar place, preferably wherever they are accustomed to eating (e.g. dinner table). Also try to minimize visual as well as auditory distractions such as the television, radio and telephone calls. The timing of meals is often overlooked, but it is important to adhere to an eating schedule. Alzheimer’s patients tend to do better when they have a schedule, this also applies to other activities as well (e.g. bathing, going for a walk, shopping, etc.). adequate lighting is also very important and often overlooked.
Is it the food?
Things to look for: they appear disinterested in the food, do they pick at it, turn their head when you try to feed them.
What can you do? : Keep in mind that their memory might be fading, but their food preferences haven’t changed. Try to give them foods that they are familiar with and enjoy. Ask yourself “is this something I would eat?”
Do they appear confused?
Things to look for: they may appear to hang up with certain tasks, such as which utensil to hold. They could be distracted by patterns on the plate, napkin, etc.
What can you do? : give them simple one step commands on using each utensil. Try to use plates and napkins with simple designs or just plain white dinnerware. Try to be patient, if you get agitated, so will they.
Adjust the consistency if they are having difficulties with chewing or swallowing. Soft foods such as scrambled eggs, applesauce or pureed food are preferable. Try to avoid hard foods such as nuts, corn, carrots because they may be too difficult to chew and can become lodged in the throat.
Help them maintain good posture while eating
Ensure adequate hydration during warm weather.
Use bowls instead of flat plates when possible and try to use utensils with large handles that are easier to hold by someone with arthritic fingers
Use of nonskid place mats under plates can help keep the plate from sliding on the table.
Important! You should become familiar with performing the Heimlich maneuver. It is quick and easy to learn and it can save the life of a loved one in the event they choke on a piece of food.
McDaniel JH, Hunt A, Hackes B, Pope JF., American Journal of Alzheimer’s Disease and Other Dementia. 2001 Sep-Oct;16(5):297-302.