For the third time this week, your father or mom won’t eat.
Not only have you prepared his favourite dish of spaghetti and meatballs, but you’ve also offered a fruit smoothie – usually a surefire hit. Yet, he’s wordlessly pushed it all aside.
What’s going on?
“There could be a number of reasons why someone with dementia isn’t eating,” says Ruth Drew, the director of family and information services at the Alzheimer’s Association’s national office in Chicago. “You have to be a bit of a detective to figure it out.”
It might be he’s overwhelmed by choice. “If there are too many things on the plate, it can be confusing. Try offering one food item at a time,” says Drew.
Try offering one food item at a time.
In later stages of dementia, forks, knives and spoons can also cause confusion. Picking up the correct utensil, loading it with food and bringing that food to his or her mouth becomes too much to process; the sequencing gets muddled. “Then it’s time to move to finger food,” Drew advises. She suggests trying chicken nuggets, fish sticks, orange slices, steamed broccoli or cauliflower pieces.
It could also be your charge may not be hungry at the time you’re offering a meal. As people age and their level of activity lessens, their metabolism slows down. And a sluggish metabolism affects appetite.
“Determine at what point in the day they’re hungriest and try offering their favourite foods at that time,” suggests Nancy Wellman, a registered dietitian and former director of the U.S. National Resource Center on Nutrition, Physical Activity and Aging. She says you may find offering several mini meals during the day nets better results than three large ones hours apart.
What else? Don’t feel bound by convention. “Break away from offering breakfast food only in the morning,” Wellman says. There’s nothing wrong with French toast for dinner a couple of times a week.
If there’s one thing many experts agree on, it’s not to get too strict about ensuring each meal has maximum nutritional value. “Don’t feel every single food group has to be present in every meal,” says Drew. Particularly if the person you’re caring for has a tendency to lose weight, the intake of calories should be top priority.
Try to present the meal in a way that’s appealing.
“Food should still be a pleasure.”
– Remember to respect his likes and dislikes. If he’s never liked spinach, he’s not about to now.
– Make mealtimes social; eat with him.
– Try to develop a routine with external cues such as setting the table.
– As much as possible, minimize distractions; mealtime should be a peaceful, quiet time.
– It sounds obvious, but check to see your charge isn’t experiencing mouth pain (e.g. ill-fitting dentures, mouth sores or poor oral hygiene)
Sarah Moore is a Toronto writer and editor