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Alzheimer's: Making mealtimes easier
Date: February 4, 2012
By: Mayo Clinic Staff

Alzheimer's and eating can be a challenge. Understand what causes eating problems and take simple steps to ensure good nutrition.
By Mayo Clinic staff
Alzheimer's disease and eating challenges often go hand in hand. As Alzheimer's progresses, poor nutrition can aggravate confusion and lead to physical weakness, as well as increase the risk of infection and other health concerns. If you're caring for a loved one who has Alzheimer's, understand what causes eating problems and take steps to optimize good nutrition.

Consider underlying conditions

If your loved one is having trouble eating, consider whether any underlying conditions could be contributing to the problem. For example:
Ill-fitting dentures can make eating painful. If your loved one wears dentures, make sure they fit properly. Regularly check your loved one's mouth for sores or other oral or dental issues.
Medications can affect appetite. Many medications decrease appetite, including some drugs used to treat Alzheimer's. If you think medications are contributing to your loved one's eating problems, ask your loved one's doctor about substitutions.
Chronic conditions can affect appetite. Diabetes, heart disease, digestive problems and depression can dampen your loved one's interest in eating. Constipation can have the same effect. Treating these or other underlying conditions might improve your loved one's appetite.

Acknowledge declining skills and senses

In the early stages of Alzheimer's, your loved one might simply forget to eat or lose the skills needed to prepare proper meals. You might call your loved one to remind him or her to eat or help your loved one prepare food. If you make meals for your loved one in advance, you might need to instruct him or her through the steps of unwrapping, reheating and serving.

In addition, your loved one's sense of smell and taste might begin to diminish. If food doesn't smell or taste as good as it once did, your loved one might be less inclined to eat.

As Alzheimer's progresses, your loved one might forget table manners and eat from others' plates or out of serving bowls. Changes in your loved one's brain might cause him or her to lose impulse control and judgment and, in turn, eat anything in sight including items not intended as food. During the later stages of the disease, difficulty swallowing is common.

Expect agitation and distraction

Agitation and other signs and symptoms of Alzheimer's can make it difficult for your loved one to sit still long enough to eat a meal. Distractions at mealtime might make this even worse. To reduce distractions, turn off the television, radio and telephone ringer. Put your cellphone or pager on vibrate. You might also clear the table of any unnecessary items.

Get visual

Use white dishes to help your loved one distinguish the food from the plate. Similarly, use placemats of a contrasting color to help your loved one distinguish the plate from the table. Stick with solid colors, though. Patterned plates, bowls and linens might be confusing.

Try large-handled utensils

To prevent slipping, apply suction cups to the bottom of plates or use placemats that have traction on both sides. You could also make your own placemats from a roll of the rubbery mesh typically used to line shelves. Sometimes bowls are easier to use than are plates. Likewise, spoons might be easier to handle than forks. The larger the spoon's handle, the better. Try bendable straws or lidded cups for liquids.

Offer foods one at a time

If your loved one is overwhelmed by an entire plateful of food, place just one type of food at a time on the plate. You could also offer several small meals throughout the day, rather than three larger ones. Cut food into bite-sized portions. Finger foods are even easier but avoid foods that can be tough to chew and swallow, such as nuts, popcorn and raw carrots.

Take your time

Don't rush your loved one to eat quickly. Remind your loved one to chew and swallow carefully, and allow him or her as much time as necessary. It might take up to an hour to finish a meal. Encourage your loved one to follow your actions, such as holding a fork or drinking from a cup or gently place your hand over your loved one's hand to hold a utensil and bring food to his or her mouth.

Sneak in extra nutrition

If you're having a hard time getting your loved one to eat enough, prepare your loved one's favorite foods. Serve a filling breakfast or several light breakfasts in a row. You might also offer high-calorie snacks such as protein milkshakes. Consult the doctor if your loved one loses weight suddenly.

Ensuring good nutrition in Alzheimer's can be a challenge, but it's worthwhile. Good nutrition can help your loved one better cope both physically and emotionally with the challenges of Alzheimer's.

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