Most of us would turn up our noses at the prospect of eating roast beef with maple syrup.
But one of Nancy Lerner’s patients at Maryland’s Copper Ridge Institute, crinstitute.org – a research facility dedicated to Alzheimer’s Disease and other forms of dementia – would gobble that up. “If you put maple syrup on anything, she would eat it,” she says.
Lerner, DNP, RN, is a geriatric nurse and assistant professor at the University of Maryland School of Nursing. A preference for sweet foods is innate in human beings. “All of the other preferences, we develop as we get older,” she says. “That makes sweet a very powerful taste preference.”
As most care providers know, it’s tricky enticing patients with dementia to eat. There’s a normal decline in our tastebuds as we age, says Carol Greenwood, a nutritionist and professor at University of Toronto and senior scientist at Baycrest Applied Research Unit.
We tend to need foods that are more intense in flavour in order to get the same level of pleasure.
In addition, says Lerner, there’s evidence that, even in the early stages of Alzheimer’s Disease, people are less able to identify smells. The problem: smell and taste are intertwined functions in the brain. Our tastebuds are only equipped to distinguish five distinct tastes, Lerner explains: sweet, salty, bitter, sour and umami (savory). The more minor distinctions of flavor come through our sense of smell, which makes it “critical in terms of making us want to eat.”
As our sense of smell declines, food begins to taste bland and boring – just think back to the last time your nose was blocked from a cold.
For people with dementia, then, heavily flavored foods – often either sweet or salty – can be more appealing. (Sour and bitter, not so much, says Lerner.) Of course, a high-salt, high-sugar diet isn’t the healthiest option. Instead, when mom won’t eat, Greenwood suggests caregivers enhance flavor with herbs and spices. Lerner agrees, pointing out that one of the more popular dishes at Copper Ridge was huevos rancheros, a spicy Mexican breakfast dish. “[Residents] would gobble that up like there was no tomorrow, whether because of the heightened flavours, or the heightened smells.”
Other strategies used at Copper Ridge included baking cookies or bread to stimulate patients’ sense of smell and appetite, as well as boosting nutritional content. Make “super cookies” by adding ingredients like protein powder, fruit, and peanut butter, Lerner suggests, or sneak veggies like zucchini and carrots into cakes and bread.
Fruit (with its innately sweet taste) is often an easy sell too, notes Greenwood, particularly if you cut it into bite-sized pieces. And, while “vegetables are probably not the best consumed foods, if you put them in a soup or a stew, they’re gone.”
Give your care recipient what they want to eat, advises Lerner. “At some point, you have to give up worrying about cholesterol levels,” she says. “You’re just trying to get food into them and get some weight on them.” That may mean adding butter and other high-calorie ingredients to food, or switching out milk with cream. “Something you would not eat if you were on a diet works really well,” Lerner says.
Camilla Cornell is a health reporter based in Toronto, Canada.
Copper Ridge Institute, Maryland: 410.795.8808, firstname.lastname@example.org
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