Eating Issues

October 26, 2010

It seems that dementia patients always have eating issues, whether it’s eating too much or too little.  There usually isn’t a happy medium.  We’re going to try to address both sides of the issue in this blog and we welcome other suggestions!

TOO LITTLE:  We can all picture the fragile little old ladies weighing 95 lbs. soaking wet.  They don’t eat enough to keep a bird alive.  This is a very real problem for some dementia patients and their caregivers, but there are things you can do to improve the situation:

Appetite is controlled by the brain, as is the lack of appetite.  If the part of the brain that tells a patient she is hungry is affected, she may not want to eat.  Depression also affects appetite, usually creating a lack of appetite, but sometimes creating excessive appetite.  If your loved one doesn’t want to eat, he may be depressed.  Most anti-depressants also increase appetite, so these medications are often prescribed for people who lack appetite, even if they aren’t depressed.  Talk to your loved one’s physician.

If your loved one isn’t eating well, you need to make certain what they do eat is packed with nutrition.  Keep healthy snacks around the house, like cut fruit and vegetables.  Offer nutritious food often.  Consider serving 5 or 6 small meals a day as recommended in the diabetic diet.  In this as with any change, consult your loved one’s physician.

A little known problem with dementia patients is their lack of ability to PERCEIVE things (not necessarily “see things”) the way the rest of us do.  For instance, if you put mashed potatoes, coleslaw and grilled chicken on a white plate, they may not comprehend that there is anything but the plate there.  Place those same mashed potatoes, coleslaw and chicken on a medium tone plate and suddenly, the food “appears.”  (The same holds true for everything in the dementia world — color contrasts are visible, similar colors placed together (i.e. khaki pants on creme colored sheets) may not be visible.)  Additionally, patterned plates are confusing to dementia patients.  A nice medium tone solid in a contrasting tone to the table or tablecloth is best.

Especially if the change in diet is sudden, check the patient’s mouth.  My grandmother had an awful case of thrush, which explained why she wouldn’t eat.  Thrush is a painful yeast infection of the mouth made more likely by taking antibiotics.  Look for a white film inside the mouth.  For more information, go to http://www.mayoclinic.com/health/oral-thrush/DS00408.  Because this is not very common in adults, it’s often missed by healthcare providers.

If your loved one is in a facility, make certain they are not placed at the dinner table with someone who is stealing their food.  Over-eaters will take food off the plates of people who are sitting around them.  My father-in-law often stole food off the plates of others, so his dinner table placement was important.

TOO MUCH:  Over-eating is often a problem with dementia patients.  The weight gain that usually goes along with it can cause back and joint pain, and increase the patient’s risk of things like stroke, heart attack and diabetes.  Preventing over-eating is easier said than done, but here are some things we’ve found that help:

Don’t serve food “family style” around the table.  Patients have been known to sit down before anyone else gets to the table and eat everything out of several serving bowls before anyone notices.  Also, it’s easier to control portions if you serve the plate of the patient instead of allowing her to serve herself.

Don’t keep junk food / candy where the patient can find it.  If the patient must have snacks, serve fruit, raw vegetables, and other healthy foods that are high in fiber.

If the patient is in a facility and eats at a table with others, make certain he is placed at a table with patients who are cognitively intact enough to know and verbalize if their food is being stolen.

Eating too much, yet undernourished:  My grandfather ate amazing amounts of food, yet remained undernourished because his body was losing it ability to extract the nutrients and calories out of his food.  If this is the case, check with the patient’s physician or a registered dietician about adding nutritional supplements like Boost or Ensure.

Whether your loved one over-eats or under-eats, involve her physician (and possibly a registered dietician).  Above all, don’t obsess over the situation.  It may very well be a temporary problem as the brain continues to change with the disease process.  In this as in all things along this journey, as the caregiver, you should do the best you can under the difficult circumstances in which you are placed.



4 Comments

Categories Alzheimer's and dementia | Tags:

You can follow any follow up comments to this entry through the RSS 2.0 feed.

4 Responses to “Eating Issues”

  1. Fairly good post. I simply came across your site and wished to state that I have truly enjoyed browsing your blog articles. In any case I’ll be signing up to your feed and Do you create once again soon!

  2. ranveer kumar says:

    my father is 86 years old and we lost our mother in nov 2012.Upto 3 months back my father wanted to eat too much all the time and now he doesnot want to look at food.he only takes something cold to drink and craves for someone to sit beside him and press his head etc all the time

Leave a Reply