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Eating and Drinking

People with dementia can experience problems with eating and drinking. Poor appetite and weight loss are quite common as dementia progresses. But there are also medical reasons why a person may have lost interest in food and drink, which a pharmacist, GP or perhaps a dentist could advise on. Conditions such as depression, a urinary tract infection, constipation, pain due to problems with dentures, sore gums, or painful teeth maybe putting them off their food and drink.

Symptoms of dementia, like communication and co-ordination issues, recognising hunger, or chewing and swallowing difficulties could be inhibiting their appetite too. Importantly, a problem with eating or drinking is unique to that person, so consider that person’s beliefs, culture, life history, routines, preferences and needs to help find a solution tailored to them. It’s also about positively encouraging them to eat and drink with gentle reminders, while enabling them to retain as much independence as possible. Below are some key considerations & tips when encouraging a person with dementia to eat & drink:

  • Concentration issues could be tiring the person out and making them feel the mealtime has gone on for too long. Try finger foods, or smaller portions and snacks, on a more regular basis to make the task easier and so the food doesn’t go cold.
  • If food goes cold it will lose its appeal so it may help to serve half portions to keep food warm. However, remember to test food so it’s not too hot as someone with dementia may not be able to judge this.
  • Motor problems could be causing the person to struggle with using cutlery, cutting food up, and picking up glasses or mugs. Check that the person’s cup or glass isn’t too heavy or a difficult shape to grasp and look into getting adapted non-spill cups and cutlery.
  • Ensure the person is sitting upright and well positioned to eat food and help them to guide their food to their mouth. Certain foods that can be eaten with their hands will make eating food more enjoyable, like slices of fruit, sausages, sandwiches, and cheese.
  • Soft and moist food that needs minimal chewing works well, so avoid hard vegetables and focus on food like mashed potatoes, scrambled eggs, stewed fruits, milkshakes or smoothies.   And, foods that are heavy in fluid, like gravy, jelly and ice cream are easy to eat and can help with hydration.
  • If the person with dementia has limited vision they may have trouble seeing what their food is, so explain what the food is on their plate to help them to visualise what they are eating before they try it.
  • With drinks, offer the person the cup in their line of sight as this will help them know it is there and describe the drink to them.
  • Well-lit rooms will help the person to see the food better.
  • People who have dementia may find their food tastes change and they could begin to like unusual combinations of sweet and savoury food, or develop a fondness for sweet food. If the person doesn’t eat their savoury meal don’t withhold dessert as they may prefer dessert as it is sweet, but have a healthy dessert like fruit. On savoury food you could try using sweet sauces, chutney or a small amount of honey or sugar to make the food taste sweeter.
  • The environment is important for someone with dementia so this should be considered when they are eating and drinking. Let them decide where they would like to sit and eat, switch off background noise so there’s no distraction and it’s calm and relaxing.
  • Try to make mealtimes a social activity – by eating with the person with dementia it will encourage interaction and they may copy what you do when you eat and drink.
  • Senses – like taste, smell and sight – play an important role in making food appetising and appealing, so try foods that taste different, smell aromatic, and are full of colour.
  • Avoid putting food on patterned plates as this can be confusing and use different colours for the food, plate and table as the contrasting colours will help the person to identify what everything is.
  • A clear glass will help the person to see what is inside and colourful cups will grasp someone’s attention. Try and encourage at least 6-7 cups of fluid a day. A use of a straw or a cup with two handles can enable the person to remain independent when drinking.

Setting the scene for mealtimes

A familiar, sociable environment can help a person with dementia to feel more comfortable eating and drinking. You could try:

  • Turning off noisy TVs and radios, or playing some soothing, familiar music
  • Being flexible about meal times, avoiding times when the person is tired or distressed
  • Giving the person lots of time to eat, so there is no rushing
  • Eating with the person, if they enjoy the social side of this. It might be encouraging for them to see you eating, but bear in mind some people may be self-conscious and embarrassed to eat in company
  • Making sure the room is well-lit and describing the food. This might help the person recognise the food they are eating more easily
  • Using plain coloured plates and cups so they can see the food easily.

Encouraging a person with dementia to eat

Involve the person by asking them what they would like to eat. If they struggle to decide, you could give them two options of simple things you know they like and can manage. You could use pictures to help them decide. If appropriate, you could involve them in the food preparation by rolling dough, stirring ingredients or peeling vegetables. You could try:

  • Offering something easy to eat, that you know the person likes
  • Giving the person small, regular portions rather than large meals
  • Being flexible: a person with a sweet tooth might like to eat their dessert first. You could add sweet condiments like ketchup or apple sauce to savoury food
  • Offering a small snack before a meal to see if that helps the person realise they are hungry
  • Using different tastes, smells and colours to stimulate the appetite

If someone with dementia is having difficulty swallowing, seek the advice from a GP who may refer on to a speech and language therapist. Some people with dementia need pureed or soft food, but this can lack nutrients.

Encouraging a person with dementia to drink

A person with dementia may not always be able to recognise when they are thirsty, or they might not be able to communicate their thirst. But nevertheless, it is recommended to aim for about eight to ten glasses or mugs of fluid per day. You could try:

  • Having a drink beside the person at all times
  • Adding a little flavoured squash if the person is not keen on water
  • Offering a choice of hot and cold drinks
  • Helping the person if they are struggling to pick up or hold a cup
  • Offering the person different shapes and sizes of cup
  • Finding out if they have a favourite mug they like to drink from