Sometimes people with Alzheimer’s disease have difficulty eating. Not getting enough calories and nutrition makes it difficult for your loved one to maintain a healthy weight, preserve brain function, retain muscle, stay energized, fight off illnesses, and maintain their quality of life.
Members of myALZteam frequently discuss their struggles and concerns around their loved one’s eating difficulties, which come in many forms. Some stem from physical challenges. “My dad is in late-stage Alzheimer’s and has started not wanting to eat. I have tried everything. He says his teeth hurt his mouth. Everything I fix has to be soft food. He might eat five or six bites all day. Sometimes I can get a milkshake in him. … Any suggestions?” wrote one member.
Others find their loved ones are willing and able to eat but have become very particular or no longer enjoy the foods they once did. “Husband will go all day without eating; for dinner he wants kid foods, like corn dog, taquitos, cheeseburger from cafe, pizza from convenience store, never a balanced meal. Lots of time he looks at a plate of food like it’s disgusting,” another member shared.
If you can relate to these scenarios, take heart. Following are tips from health experts and myALZteam members to help entice your loved one to eat, which can keep them healthier while giving you some much-needed peace of mind.
You may be able to get to the bottom of your loved one’s new or worsening eating difficulties by speaking with their doctor and possibly scheduling a health checkup.
Medications for Alzheimer’s and other conditions can cause side effects, such as a loss of appetite and nausea, which is why doctors often first assess a person’s treatment regimen to address eating problems. Common Alzheimer’s treatments may suppress a person’s appetite and cause weight loss. These include donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). A doctor may be able to change their dosages or prescribe an alternative medication.
During a health checkup, a doctor may discover that new or worsening health problems are contributing to your loved one’s eating difficulties. Sometimes conditions unrelated to Alzheimer’s can reduce appetite. Some examples include diabetes, gastrointestinal problems like inflammatory bowel disease or constipation, thyroid disease, and cancer. Treating those issues could, in turn, help with appetite. Doctors can also prescribe appetite stimulants, which may help promote an increased interest in eating.
Dysphagia (difficulty swallowing) is common in people with Alzheimer’s and can interfere with their ability and desire to eat. A speech and language pathologist may be able to help someone with Alzheimer’s by teaching them swallowing exercises and providing recommendations for food texture modifications.
Additionally, a dietitian could provide guidance about how to prepare balanced meals and incorporate supplements for both your loved one’s enjoyment and nutritional needs.
Depression is a common symptom of Alzheimer’s that can reduce a person’s desire to eat. A doctor or mental health professional may recommend treatments such as antidepressants and talk therapy. You could also ask about complementary or alternative therapies, including aromatherapy, massage, or bright light therapy, as suggested by the Alzheimer’s Society.
Oral problems like gum pain, missing teeth, or ill-fitting dentures can all interfere with a person’s ability and desire to eat. Your loved one may not be able to tell you about any discomfort from these issues, but a dentist might discover the problem during an exam.
Helping your loved one maintain good oral hygiene with daily brushing and flossing can help prevent further oral problems from developing.
As Alzheimer’s progresses, people may develop problems with chewing and swallowing that can make eating more difficult. These can interfere with their desire or ability to eat. They may also have difficulty using cutlery, which can be frustrating and impede eating.
Here are some ways to make meals easier and safe to eat:
Some myALZteam members have tried some of the tips above. “There’s a plethora of adaptations you can put on that make any utensil have a wider handle. Some spoons will rock and keep the food on it if they have tremors. You may want to try a lip plate or divided plate,” a member suggested.
Another member shared, “It has been suggested a solid color table and a contrasting plate — maybe red and maybe only one thing at a time on the plate. Easier to see and recognize and less confusing.”
Some people with Alzheimer’s have trouble focusing. Consequently, they may become distracted by what’s going on around them during mealtimes. Eliminate distractions by turning off the TV — though playing some pleasant, familiar music may help put you and your loved one at ease.
The Alzheimer’s Association recommends keeping your table setting as simple as possible. Avoid using patterned tablecloths, placemats, and napkins. Remove any unnecessary items from the eating surface, whether it’s reading material, a smartphone, or a vase of flowers.
Some people with Alzheimer’s become frustrated or agitated during mealtime. Often, feeling pressured to eat can lead to further frustrations and a loved one’s wanting to give up at mealtime. To reduce stress and maintain good spirits — for you, your loved one, and other family members — be patient and encouraging during meals. Try to make them fun and friendly. Talk about topics your loved one enjoys, or reminisce about past memories.
Don’t worry about neatness, and let your loved one feed themselves as much as possible. “My husband drops food all the time. I tell him it’s OK, enjoy your food. I’ll clean up later. It makes him feel better and enjoy his meal,” said one member.
Take care not to rush them. Pressure to eat can sometimes become a risk for choking or aspiration (when food enters the airway and lungs) because of poor chewing or rushing to swallow.
Encourage independence, but lend a hand if necessary. “They still want to drink or feed themselves and often fall short of their mouths by 2 to 5 inches. Take your hand and place it under their hand to be a support to them. They see their hand, not yours, so they believe they are still doing it on their own,” a member shared.
If your loved one has difficulty making choices, consider serving only one type of food at a time.
Your loved one’s food tastes may change as they age and as their condition progresses. They may no longer enjoy foods they once liked and may develop a taste for dishes they previously avoided. Some desire sweet foods more than they used to.
“My husband’s likes and dislikes are constantly changing,” a member shared. “He now dislikes some foods he has loved all his life. He dislikes spicy food but will order spicy food despite my warnings. He is diabetic but loves sweets and wants them all the time. Also chips. He will buy multiple bags of chips. I do what I can. I do want him to have choices, as many are gone, so it's a struggle.”
They also may not like certain food textures. “My father doesn’t like certain textures, like fruit in yogurts or hard vegetables. Everything needs to be soft, not too soft,” a member shared.
To make food more appealing, consider:
Additionally, they may eat more if you serve smaller meals and snacks throughout the day instead of three large meals.
Getting regular physical activity can improve your loved one’s appetite and support their overall well-being. If your loved one is in the early to middle stages of dementia, look for ways to engage them in moderately strenuous physical activity for 150 minutes per week. This is around 30 minutes, five days per week, but the 30 minutes can be broken up in shorter sessions throughout the day. Opt for activities your loved one enjoys and can perform comfortably.
Individuals with later-stage dementia may fare better with movements such as transitioning from sitting to standing positions, walking short distances, or switching chairs throughout the day.
Before trying any new physical activities, it may be worthwhile to consult with their physician to determine what may or may not be appropriate, depending on your loved one’s health and other conditions they may have.
On myALZteam, the social network and online support group for people with Alzheimer’s and their loved ones, more than 85,000 members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s disease.
Do you have a loved one who has difficulty eating? What strategies have you tried to support them? Share your story in the comments below, or start a conversation by posting on your Activities page.