Education and Care - Eating

Alzheimer's Foundation of America

Weight loss is common among individuals with dementia, regardless of whether they are cared for at home or in a long-term care facility. Assessing why they are not eating and obtaining an accurate diagnosis are the first steps toward maintaining adequate nutrition and body weight.

• Has the individual forgotten how to feed himself?
• Do they have trouble chewing or swallowing?
• Are they having problems with dentures or gums?
• Have they lost the ability to taste?
• Is the individual having coordination problems, such as difficulty in using the silverware?
• Are there co-existing medical or psychiatric problems, such as ulcers, depression or delusions, that are causing loss of appetite?
• Do they seem disinterested in eating?
• Is the person fearful at meal times? For example, do they say or think that the food is poisoned?
• Are they unable to ask for food?
• Do they dislike the food?
• Is there too much noise or other environmental stimuli?
• Do they eat only sweets, or like to eat them first?
• Are they filling up on fluids?
• Are other residents in a group setting eating the individual's food?

• Consult a physician to detect any medical causes.
• Seek a swallowing assessment from a speech therapist if the person is regularly having trouble chewing and swallowing.
• Have the individual sit in an upright, comfortable position.
• Try to have them eat with others to increase socialization and make mealtimes more pleasant.
• Check that their mouth is empty, especially if they hoard food or cigarette butts.
• Make sure they have their glasses, dentures, hearing aids or any other appliances they need.
• Prompt or feed those who can't feed themselves (apraxia).
• Give the individual food they like and adequate snacks.
• Provide nutritional supplements if there is significant weight loss.
• Present one item at a time if the person seems confused by too much food in front of them.
• Consider moving food to a different location on the tray or table.
• Serve the drink last if the individual drinks too much and will not eat.
• Serve pre cut or finger food, if using utensils becomes difficult.
• Keep stressing that the food is safe if the individual believes it is poisoned.
• Reassure the person that you will make sure they are well fed.

Note:If someone loses five pounds within a month or 2.5 pounds in two consecutive weeks, aggressive intervention should be undertaken to prevent further weight loss and to help them gain the weight back.