Dementia and a Healthy Diet: Tips for Caregivers

Eating regular, nutritious meals can be a challenge for people with dementia. They may forget to eat or get distracted during meals. Or they may have trouble chewing and swallowing. But as a family caregiver, you can make a big difference. Here’s how to help your loved one with dementia eat healthy foods.

What is a dementia diet?

People with dementia need a varied, balanced diet. But they may also need to make changes in what or how they eat. The goal is to help deal with specific eating challenges, such as trouble swallowing or lack of appetite. Such challenges become more common in the middle to late stages of dementia.

Tell your loved one's healthcare provider about any problems that arise. If needed, the provider may suggest consulting a:

• Registered dietitian nutritionist about foods and nutrition

• Speech-language pathologist about chewing and swallowing issues

• Occupational therapist about ways to help your loved one eat

How can this diet help someone with dementia?

Good nutrition helps the body stay strong and healthy. It also helps prevent weight loss, a common issue in the later stages of dementia. For someone with swallowing problems, the right foods may reduce the risk of choking.

Does this diet have any risks?

Loss of appetite is often a problem as dementia gets worse. Many people with dementia also have trouble staying focused on eating. Plus, they may find it hard to coordinate the movements to feed themselves. As a caregiver, you may not always know exactly what the problem is or how to manage it. Make a list of questions to ask at healthcare visits.

Which foods should be included?

Aim for a variety of healthy foods. Provide plenty of fruits, vegetables, and whole gains. Also include low-fat or fat-free milk and dairy products and healthy protein foods such as lean meats, skinless poultry, fish, and beans.

Offer small cups of water and other drinks throughout the day. Foods that contain a lot of water can also help meet fluid needs. Examples are milkshakes, smoothies, soups, and fruits.

If chewing and swallowing are issues, your loved one may need to eat soft foods. They should be soft enough to smash easily with a fork. Examples are applesauce, soft-cooked veggies, cottage cheese, scrambled eggs, soft fish, and tender chopped meat. Cut large chunks of food into pieces no bigger than ½ inch per side. Talk with a dietitian for more tips on preparing soft foods.

If the person is at risk for accidentally inhaling food or liquid (aspiration), you may need to use thickened liquids. Ask the speech-language pathologist if this is a concern for your loved one.

Which foods should be skipped?

Heart health and brain health seem to be closely linked. For a heart-friendly diet, limit foods high in saturated fat, such as butter, shortening, whole milk, cheese, and fatty cuts of meat. Also limit foods high in salt and sodium.

In general, limit sugary foods and drinks with added sugars. But if your loved one has a lack of appetite and weight loss, talk with the provider or dietitian. In some cases, you may add sugar to foods to encourage better eating.

Don't serve these foods to someone who has trouble swallowing:

• Hard or crunchy foods, such as carrot sticks, nuts, popcorn, and raw apples

• Chewy foods, such as dried fruit and caramel candies

• Dry foods, such as dry, coarse bread and unmoistened breakfast cereal

• Sticky or gummy foods, such as peanut butter and overcooked oatmeal

• Poultry, fish, or meat served with skin, bones, or gristle

• Mixed-texture foods, such as chunky soups and cereal served in milk

Tips for following this diet

• Provide reminders about mealtimes. For example, you might put a whiteboard in the kitchen and use it to post a daily schedule.

• Allow plenty of time for the person with dementia to eat. It might take an hour to finish a meal.

• Reduce distractions while the person eats. Serve meals in a quiet spot and turn off the TV.

• Keep the table setting simple and uncluttered. Avoid patterned plates, placemats, and tablecloths. Provide only the utensils needed.

• Choose dishes, utensils, and cups that promote a successful eating experience. For example, you might serve dinner in a bowl or on a plate with a rim rather than a standard plate.

• Make mealtimes a pleasure. Cook up some favorite recipes. Eat together whenever possible.

Suggestions for planning meals

• Instead of unmoistened breakfast cereal, soften it first in milk. Then pour off the milk before serving. Or offer oatmeal.

• Instead of chewy, high-fat cheese cubes for a snack, offer low-fat cottage cheese.

• Instead of a cream soup with large chunks of food, serve a low-sodium broth soup with a smooth texture.

• Instead of crispy vegetables with dinner, serve vegetables that have been steamed or boiled until soft.