We all know how important good nutrition is to our health. But imagine for a moment that you were no longer able to go to the shops, choose your own fresh produce, go home and prepare your favourite nutritious meal. Imagine you have no choice in this matter at all. You are presented with something, but you don’t know what it is. You find it difficult to even differentiate the food from the plate is it served on. You are not able to manoeuvre a knife and fork anymore, you struggle to pick up the food with your fingers and because you are hungry you want to get it into your mouth. Somehow you finally get the food into your mouth but the taste and texture are awful. It’s dry, it’s chewy. You struggle chewing it, you struggle swallowing it. So in the end, it seems easier to just walk away hungry than to eat what’s in front of you. The person caring for you forces you back to the table to sit down, they cut the food up, and feed it to you. But you don’t want this food in your mouth – you don’t recognise what it is and it’s unpleasant. Too often this scenario ends in a stressful situation where you both get very upset.
Sounds horrible doesn’t it! Well, that is what it can be like for someone living with moderate to severe dementia. As dementia progresses it can become difficult to maintain a healthy weight, eat well and stay hydrated. Sometimes people living with dementia can forget to eat. Sometimes they can struggle to recognise food. And if the food in front of them looks bland, boring, or impossible to even tackle, then there is also a risk of nutritional deficiency.
Sometimes it can be difficult to coordinate eating and drinking. So I would suggest presenting meals and drinks separately.
It can be difficult to distinguish salt, pepper, sugar or other condiments from one another. To avoid confusion just present the condiments that make sense with that particular meal.
It may not be possible for a person living with moderate to severe dementia to be able to use cutlery, so ensure food is easy to pick up with fingers.
It can sometimes be difficult to actually distinguish the food from the plate it is served on. Keep crockery in plain light colours, with no patterns, so that it is easy to see where the food is on the plate.
Think about taste and texture. Would you eat it too? If not, why should your loved one? Keep food crisp, fresh, colourful and juicy – this makes it pleasant to eat, and easier to swallow.
It is also important to consider the look of the food. If it looks like slop on a plate is it any wonder no one wants to eat it? Keep food colourful and easily distinguishable.
- Lots of bite-sized pieces of fresh fruits and vegetables
- Peeled and seeded citrus fruits
- Ribbon sandwiches with the crusts cut off
- Stir-fried veggies and tofu cubes sitting in lettuce cups
- Antipasto platter
- Green smoothies are a great way to get highly nutritious leafy greens into the body
- Soups served in a mug so there is no need for spoons
- Always make sure there is plenty of fresh water available to keep hydrated
- Vegetable and lentil patties that can be picked up with the fingers
- Dried fruits are tasty, don’t spoil and have some nutritional value as well
- Carrot, celery and cucumber sticks with dips
- Mini muffins – sweet or savoury
Keep table settings very simple, and stick to serving one plate of food at a time.
Do NOT serve:
It might seem an easy solution to serve mini pies and sausage rolls, but these hold no nutritional value, are highly processed and high in saturated fats.
Unless the person has swallowing difficulties don’t serve them pureed meals either. Would you want your whole dinner blended up and served to you?
Meat can be very difficult to chew and swallow. It is also difficult to eat with your fingers, so is best avoided.
Do not serve anything with pips and stones inside it (stone fruits, olives, cherries etc…) as these can break teeth and potentially be a choking hazard. Remove pips/stones before serving.
Ensure all food served has had time to cool – you don’t want to burn the fingers, mouth and throat of someone you love. Remember that they may not be able to sense the dangers of hot food.
While it is great to allow your loved one to be able to graze on food, do consider the risk of food becoming contaminated. Refrigerate anything not eaten immediately. It can be a great idea to serve smaller sized plates of food, but more often.
I recommend you cut the skins off from any fruit pieces you serve as you do not want your loved one chocking on the rind of the watermelon or pineapple.
Keep access to sweets, biscuits and other junk food to a minimum. They serve no nutritional purpose.
Always consider your loved one’s independence and dignity by making food nutritious, easy to recognise, pleasant to look at, and easy to eat.
Loneliness and isolation can lead to feelings of depression, so continue to enjoy sharing your meals together. This helps to put the occasion of mealtimes into context as well.
If you have any nutritional concerns for your loved one living with dementia, I highly encourage you to discuss this with their GP, and get a referral to a dietician or nutritionist who specialises in dementia.