For a person with dementia, the simple act of eating can become overwhelming. Changes in the brain can affect everything from taste and smell to the ability to recognize food or even swallow safely.
As a care partner, understanding these challenges is the first step toward creating a more positive and successful mealtime experience. This guide offers practical strategies, based on advice from the Alzheimer’s Association, to help you address mealtime changes and the serious issue of dysphagia (swallowing difficulties).
Creating a Calm and Simple Mealtime Environment
The environment where a person eats has a huge impact on their success. A busy, noisy room can be distracting and confusing.
- Limit Distractions: Serve meals in a quiet space, away from a blaring television or a lot of foot traffic.
- Simplify the Table: Use only the utensils needed for the meal. Avoid patterned plates, placemats, or tablecloths that can confuse the eye.
- Use Contrast: A person with dementia may have trouble distinguishing food from the plate. Using a white plate on a dark, solid-colored placemat can make the food stand out.
Adapting to Changing Food Preferences
Don’t be surprised if your loved one suddenly rejects a lifelong favorite food or develops a new craving. The brain changes from dementia can alter taste and smell.
Flexibility is key. If your loved one is struggling with utensils, try offering finger foods like chicken strips, fish sticks, or steamed vegetables to promote independence. Patience is also critical; a meal can sometimes take an hour or more.
Understanding Dysphagia (Swallowing Difficulties)
As dementia progresses into the middle and late stages, dysphagia becomes a serious concern. This difficulty with swallowing can lead to poor nutrition, dehydration, and a dangerous risk of aspiration pneumonia, which occurs when food or liquid enters the lungs.
| Sign of Dysphagia | What to Look For |
|---|---|
| Coughing or Choking | Frequent coughing, choking, or throat-clearing during or after eating/drinking. |
| Wet, Gurgly Voice | A change in voice quality after swallowing. |
| Food Pocketing | Holding food in the cheeks for extended periods instead of swallowing. |
| Difficulty Chewing | Taking a very long time to chew or struggling to manage solid foods. |
| Refusing Food/Drink | A new reluctance to eat or drink, which may be a sign of fear or discomfort. |
Strategies for Managing Dysphagia
If you notice any signs of dysphagia, it is crucial to consult a doctor, who may refer you to a speech-language pathologist. This specialist can perform a swallowing evaluation and recommend the safest food and liquid consistencies.
Common strategies include:
- Thickened Liquids: Thin liquids like water and juice are often the hardest to control. You may need to use commercial thickeners to bring liquids to a nectar, honey, or pudding-like consistency.
- Modified Food Textures: This can range from chopping food into small, manageable pieces to serving soft, moist foods or even a pureed diet.
- Proper Positioning: Ensure your loved one is sitting fully upright at a 90-degree angle during and for at least 30 minutes after meals. This uses gravity to help prevent aspiration.
Mealtimes require patience, observation, and a willingness to adapt. By simplifying the environment and modifying food textures as needed, you can make meals safer and less stressful for both you and your loved one.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional for any health-related concerns, especially when you suspect swallowing difficulties.
References
[1] Alzheimer’s Association. “Food and Eating.” https://www.alz.org/help-support/caregiving/daily-care/food-eating
