People need to eat, it is part of the human condition and although we can go for periods of time with some abstinence, if we stop eating, we eventually die, it is literally a lifesaving thing we do each and every day.
People can have food issues, eating disorders or distress eating. It can be overeating or undereating and mostly we have favourite or preferred foods and drinks. And whilst this is normal, in that it happens to lots of people, it still might take some managing to ensure that a person with dementia has enough to eat and enough of the right kind of food to give them the nutrients that their body needs.
Eating disorders are not likely to go away with dementia, any preference that they had before they had dementia, may well last into their dementia.
The only thing that appears to be consistent with dementia and food is that as the dementia progresses, people either forget that they are hungry or don’t register their hunger, so it is common that they will lose weight. In the beginning, if they are overweight, this might be a good thing, it will make their mobility easier, but eventually it will become a problem as they become underweight and then don’t have the calories for their body function. This means that if they get injured for example, they will not have enough calories to recover or recover easily. Commonly it can have an effect on wound healing, if the person with dementia has a serious wound by accident.
People with dementia can at times develop problems with their swallow, as they struggle to get food down and either forget to swallow or their swallow function become impaired, so they are at risk of choking, either noisily, as they cough or silently, as food or fluid goes down into their lungs and they develop pneumonia. These kinds of issues need to be carefully and skilfully managed.
Institutional environments often have criteria for the food, that it should be balanced, low in salt and high in fibre. Then there will be other specialist diets, such as a diabetic diet or high or low calorie diet. They may even have religious requirements within their diet.
But having considered what is necessary, it is then worthwhile considering what is pleasurable, what will make the person with dementia happy. Whenever I ask this question about what foods people like, sometimes it is chocolate, actually it is often chocolate, but it can also be crisps, cheese, nuts, biscuits, cake, sweets or many other things. Sometimes people have a favourite brand of a particular thing, so a certain meal or snack. They might have a favourite kind of food, so takeaway from a particular chain or restaurant. I have a client who has a curry delivered to the care home every Friday, along with a bottle or wine!
We are all able to have little moments of pleasure in our lives, food is an easy one for many of us. It can make us happy each and every day. It is worth putting the effort into the dietary requirements for a person with dementia to make sure that not only is their body nourished, but that it is something that can make them happy too.
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