Loss of appetite that leads to weight loss and poor nutrition are common effects of moderate or late stage dementia.  As the day gets later, those with dementia can also experience what’s called Sundowning, which creates confusion or agitation that is often expressed by pacing and wandering.

Meals times can become frustrating for both the caregiver and the person with dementia.  Besides seeing the decline in memory and ability to function independently, families can begin to notice their loved one losing a significant amount of weight, and being more prone to illness because of the lack of quality nutrition in their loved one’s diet.  So how do you address poor appetite or challenges at meal times?  Let’s take a closer look at some of the solutions for dining with dementia.    

Focusing on “Can” Instead of “Can’t”

Family caregivers (and some senior housing communities) tend to focus on what’s been lost, rather than what can still be done.  Those with dementia can experience loss of appetite, loss of communication skills, loss of cognitive capabilities, loss of motor control, and loss of sensory processing.

Focusing on what’s been lost may lead you to address dining challenges with solutions that don’t encourage independence, but rather stifle it.  For example, if focusing on loss of motor control, you may feel inclined to feed the person with dementia, but when a spoon meets pursed lips because of frustration, it can be hard to know where to go next.    

Rather than focusing on loss, Care Partners at Highgate at Temecula receive specialized training in dementia care to focus on promoting independence and finding creative solutions for improving appetite, regardless of the “losses” the resident may have experienced. 

Care Partners at Highgate have identified three ways to encourage appetite and create flexible dining options for dementia residents with the three common challenges outlined below.  

Pacing at Meal Times

Residents sometimes just don’t want to sit down.  If the resident doesn’t want to sit down, Care Partners rely on finger foods that the resident can take with them as they walk around.  Finger foods include things like sandwiches, or putting food in a waffle cone so it can easily be transported.  “You have to meet them where they are at.  Forcing someone to sit down just causes agitation, frustration, anxiety, or even anger,” says Executive Director, Kathleen Williams. 

Poor Appetite

With dining, Care Partners show residents two different plates with two different entrees they can choose from.  They may not be able to name the food they see before them, but they can visually see it and point out the one they want.  Having two options gives the resident the freedom to choose the foods they prefer, but also prevents being overwhelmed by too many options to choose from.  If they aren’t eating the entre they selected, care partners can offer to get the resident the other option to try instead.  If that doesn’t work, other options are also available; everything from cold sandwiches to hamburgers.  

Being Easily Distracted

The environment can play a large part in appetite as well.  At Highgate, they create a calm, peaceful environment for residents to enjoy their meal.  Aroma therapy heated hand towels are used at the beginning of each meal.  These warm towels sanitize hands, and have scented aromas meant to encourage appetite.  With soft music playing in the background, you won’t find a distracting loud environment here. 

Worldwide, 47.5 million people have dementia and there are 7.7 million new cases every year. Dementia is one of the leading causes of disability and dependency among older people worldwide.  Identifying ways to promote independence, encourage appetite, and ensure a well-balanced diet can be done with training and a commitment to finding creative meal-time solutions.