Dementia and Eating Problems: Why Do Dementia Patients Stop Eating?


People with dementia can have problems eating, drinking, swallowing, and chewing food. Caregivers and family members of people living with dementia need to be aware of these potential challenges when caring for them at home. There are many ways to address this problem, with some of them being medication adjustments, diet changes, or even simply giving the caregivers more time to assist them at mealtimes.

No matter what you do, it will help tremendously if the patient can be eased into accepting your solutions as something they need and want rather than something forced on them by someone else. This article discusses how caregivers can help dementia patients overcome their problems with food intake by implementing some simple strategies.

Chewing and Swallowing Problems

Individuals with dementia often suffer from an inability to chew or swallow properly and experience throat pain that accompanies many medical conditions. And as we all know, not eating means not getting enough nutrients in our diet, which ultimately affects our overall well-being.

Factors That Can Contribute to Swallowing and Chewing Difficulties

Some factors that can contribute to these difficulties, including dental issues such as cavities, gum disease, tooth abscesses, and dentures that don't fit properly. Apart from that, there can be problems with coordination of tongue movements in the mouth and lack of saliva due to dehydration or medications.

Poor Dental Hygiene and Mouth Problems

The sensitivity and pain caused by dental problems such as decaying teeth or teeth that have become loose or cracked can make eating and swallowing difficult. Having mouth ulcers or sore gums can also be a source of difficulty when eating, and they may contribute to decreased oral intake in people with dementia.

The person's sore gums or mouth ulcers may also be affected by ill-fitting dentures, which can cause great discomfort. Dentures must be checked for fit, and regular dental visits should be scheduled by the caregiver.

Dysphagia

Dysphagia is common in people with dementia; it is a condition in which swallowing becomes difficult because of problems with the muscles that control the food passage to the oesophagus or stomach. Coughing and choking are common symptoms of this swallowing disorder.

They also have a higher risk of aspiration pneumonia, a potentially life-threatening infection caused by food or fluid entering the lungs. Dysphagia can lead to malnutrition and dehydration if not treated properly. When caring for someone with dysphagia, do everything you can to help them manage this problem and keep them as safe as possible.

Signs That a Person with Dementia Has Chewing or Swallowing Problems

The following are signs that a person with dementia has chewing or swallowing problems:

  • Drooling excessively
  • Food spilling from the mouth
  • Spitting out food during meals because they cannot chew it well enough
  • Increased coughing or clearing of the throat
  • Grimacing or having a pained expression when eating
  • Exaggerated mouth movements
  • During and after swallowing, they have a wet or gurgly voice
  • Dehydration
  • Weight loss

People With Dementia May Experience Weight Loss

As we have already mentioned, one of the primary reasons for weight loss in people who have been diagnosed with dementia is the inability to swallow or chew food properly, which can lead to less intake of calories.

Other causes for this weight loss are decreased interest in food, reduced energy levels, forgetfulness about meals, depression, and some medications' side effects. There may also be increased urination which can cause dehydration and constipation due to changes in metabolism.

Causes of Appetite Loss

Loss of appetite is a quite common symptom of dementia, but there are other possible causes for a decreased interest in food. It can be caused by depression or anxiety disorders or side effects from medications that they may be taking for another health issue or even another unrelated illness that could make someone feel too sick to eat.

If a lack of interest in food continues and the reason why can't be ascertained, it is essential that a doctor or another medical professional is consulted so the root cause can be determined and addressed appropriately.

Here are some of the common causes:

Memory loss - Is one of the most common symptoms of dementia. A person with dementia may forget to eat or drink because they have difficulty recalling when the last meal was served or what time it is in the day.

Loss of memory and other dementia symptoms can also make it more complicated and more dangerous for the individual to prepare food. The kitchen is typically one of the worst places to be when a person has dementia. This is because it's easy for them to forget what they're doing or get distracted, also while dealing with hot pans and sharp knives.

Agitation during meal times - The changes in behaviour that accompany dementia can make mealtimes a difficult time. The individual might find it hard to concentrate on consuming enough food if distracted or agitated.

Cognitive issues can also make mealtimes especially difficult for those living with dementia. We will discuss shortly how to prepare the dining environment so that they can enjoy their meal without distraction and in a peaceful frame of mind.

A diminished sense of smell and taste - A person's sense of smell and taste may change as dementia progresses, and this is common as the disease advances. This can result in a decreased ability to appreciate food as much as before or even recognise familiar smells. If you are a caregiver cooking for someone with dementia, ensure that the food is flavourful. It might be that some dishes will require additional seasoning to make them more appetising.

Lack of exercise - For people with dementia, a lack of exercise can result in a loss of appetite, leading to weight loss. To maintain healthy eating habits and keep up their strength, it is important that these individuals can continue exercising regularly. The exercise doesn't have to be strenuous; a short walk every day could help boost their metabolism, stimulate the brain and improve their mood and mental health.

Medication - Certain pills and medicines can cause decreased appetite that is not necessarily directly related to dementia. Older people living with dementia also may have other comorbidities or suffer from depression.

Some medications may reduce the person's interest in eating because it alters their mood or makes them feel sick and nauseous. There are also other medications that have side effects, such as dry mouth, which can lead to dehydration and nausea if not taken with enough fluids.

The most common culprits are opioid painkillers, antidepressant medications and antianxiety drugs. Caregivers for people with dementia should talk with their doctor if they think this may be happening as they might be able to help adjust the dosage or prescribe an alternative medicine that doesn't have this adverse side effect.

Constipation - Constipation can be a painful and uncomfortable experience for anyone, but it becomes more challenging when you have dementia. Constipation causes bloating, gas, abdominal pain and reduced appetite.

It is vital to make sure that a person with dementia has a healthy fibre-rich diet and drinks plenty of fluids. You should also talk to the doctor about any over-the-counter medicines they might need to help them stay regular.

Weight Gain in People with Dementia

In contrast and less common some people with dementia experience weight gain due to decreased mobility due to lack of exercise or an increased appetite. Frontotemporal dementia patients may be particularly attracted to sweet and starchy foods.

If you are concerned that the person is overeating or gaining weight, you should implement portion control when serving food or provide four or five small meals throughout the day rather than three large ones. If they feel the need to snack, replace high-calorie food items with low-calorie items such as fruit or crudites and dips. Keeping foods locked away or out of sight, so they are not encouraged to eat is also a good idea.

Increased activity will also help; depending on their mobility, they should be encouraged to go for walks, but exercises in a chair can also help if they cannot walk.

Tips to Encourage a Person with Dementia to Eat More

As we have discovered, reduced interest in food for people with dementia could be due to many factors like changes in taste and smell as well as difficulty chewing food. Whatever the cause might be, there are some things you can do that will hopefully stimulate them into eating more.

Preparation for Mealtime

Choose the best time - There are often times when the person with dementia has more energy or is more hungry than usual; try to schedule mealtimes during these times whenever possible.

Understand their preferences - You should consider if they enjoy the social aspect of eating and want you to share mealtimes with them or if maybe they feel self-conscious and prefer to eat alone.

Explore different food types and textures - Experiment with different recipes, spices, and textures to see what appeals. You could also try finger foods or cutting food into bite-sized pieces to make it easier for them to eat.

Prepare moist foods - Adding sauces or gravy to a meal will make it easier to swallow, especially if a dry mouth is an issue.

Thicken liquids - If you serve thin liquids to a dementia patient, they can easily lead to aspiration choking and coughing as they make their way down the throat. You can thicken them with pureed fruit or commercial thickeners.

Mealtime Best Practices

Be patient - Make mealtimes as straightforward, calm, and undisturbed as possible. People with dementia may require a significant time to eat meals, so factor in that it could take an hour or more. If the caregiver is needed to assist them with eating, they must be sensitive to each person’s eating rhythm, establishing the amount of food necessary for each mouthful and the rate to feed them.

Remove distractions - Turn off the TV or radio at mealtimes to ensure they are focused on their eating. You could play some gentle and familiar music in the background.

Use coloured plates - Studies have shown that brightly coloured plates can encourage people with dementia to consume more food. The researchers found that when a red plate is used instead of a white plate, dementia patients consumed 25% more food on the red plate.

Be mindful of hot food and beverages - Keep an eye on the temperature of the food. Some people with dementia have lost the ability to distinguish between hot and cold food and drinks. Also, use caution with drinkware and choose cups that won't be prone to tipping over.

In Conclusion

People with dementia often have difficulties with chewing, swallowing and digesting foods. They may also be unable to smell or taste their food which can lead them not to want to eat at all.

If you are looking for ways to help someone diagnosed with dementia remain healthy, we’ve outlined some strategies you can use to make eating easier. However, there is no single best method for helping someone who has lost interest in eating; it really depends on what works best for each individual.

Dr Jamie Wilson
Founder and Chief Medical Officer at Hometouch
Dr Jamie Wilson is hometouch’s founder and Chief Medical Officer. Jamie’s creation of hometouch was inspired by his work as a dementia psychiatrist in the NHS, and he has written about healthcare issues in The Times and the Evening Standard. Jamie has a MBBS from the University of Leeds and has spent a decade in the NHS, working as a Psychiatric Registrar and Memory Specialist at Imperial College Hospital.