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Dementia & Food: 11 Tips to Make Sure a Senior Is Eating Enough

Liane Starr
April 20, 2018

Get creative and colorful to make mealtime pleasant.

Image via Stocksy.com/Mosuno

Veronica had become forgetful -- but that wasn't the first thing her family noticed when they made a recent, routine visit to her home. At 83, the once-heavyset grandmother had become shockingly svelte. While fitting into a smaller size might have been a goal before she began showing signs of dementia, Veronica seemed unaware that her dresses no longer fit properly, much less that she'd shaved off 40 pounds without effort. A review of the contents of her almost-empty refrigerator made it clear something had to change.

Experts say seniors can sometimes benefit from small dietary changes -- thoughtful shifts in everything from how food looks and tastes to how it's presented. But these tweaks shouldn’t stop at the food.

"In addition to making the food taste better, I also recommend that our caretakers work on the emotional aspects around mealtimes," Scott Kroll, of Pennsylvania-based in-home senior care service By Your Side Home Care, told Care.com.

Here are some easy changes to institute at mealtime that might make a big difference for an elderly loved one.

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1. Make the Food Easy to See

Megan York, direct care manager for Right at Home of Eastern Worcester County in Westborough, Massachusetts, and a certified dementia practitioner, said spending time making a meal look appealing is worth the extra effort. While Grandma may love her old china pattern, it's not helping her appetite.

"The color contrast of red plates, drinkware, or placemats for people with dementia makes food more visible and, in turn, more appealing," York said.

She also recommended turning up the lights.

"Ensure that the dining area is well-lit so people with poor eyesight can see what they’re eating,” she said.

2. Put Exercise on the Menu

Getting an elderly person walking may help fire up their appetite.

"It makes a big difference in seniors' appetites, [if] they live a very sedentary lifestyle, when they get out and exercise," said Stephen Zimmerman, COO of AEC Living, a California-based group of independently operated senior living communities and a Medicare-approved rehabilitation agency.

3. Don't Serve Mush

While some seniors have problems chewing and need to eat soft or pureed food, that doesn't mean they should be served unappetizing mush.

Jay Zwiebaum, vice president of dining services at Holiday Retirement, said that at his assisted living communities “they mold and sculpt the pureed food they serve into the shape the food ought to look like. So, when they serve chicken breast, chefs will form the shape of a chicken breast with the pureed chicken, and they’ll even add grill marks. They pipe macaroni and cheese out of a pastry bag to make it look like spirals or shells, and they do the same for broccoli and green beans."

4. Give the Meal a Presentation Upgrade

As Lauren Kelly with Alliance Homecare points out, presentation is key. 

"Add color and plate the food in a way that’s presentable and exciting,” she said. “This alone can often be enough to entice someone to eat."

Kelly suggests that bypassing "beige" food for more colorful options is a game-changer. Substitute mashed sweet potato for white potatoes, add a side of greens, or even layer pureed berries or creamy peanut butter in Greek yogurt for dessert.

"Colorful pureed soups can also be a great option in serving a more enticing dish,” she added. “Butternut squash is a great example, and avocado can be added for creaminess and extra-healthy fats and calories, without really changing the flavor at all."

5. Make Eating a Social Event

Eating alone isn't fun for anybody, and for those with a diminished appetite or challenges eating, isolation can make an already difficult process even more unappetizing.

"Make mealtime a social activity," York said. "People who have difficulty eating might be more encouraged if dining with others."

Involving people beyond the senior and a caregiver can make a big difference, according to Kelly.

"Oftentimes, someone who is less inclined to eat will eat more when surrounded by others eating," she said. "It takes the pressure off, as compared to eating when someone is watching you, and makes it a more enjoyable experience."

6. Add Flavor

It’s not uncommon for smell and taste experiences to diminish as we age. And no one wants to eat food that doesn't taste like much of anything.

"If a pureed diet isn’t necessary, just adding more flavor to food with different herbs and spices can really improve the palatability and excitement around the dish," Kelly said. "For instance, instead of chicken simply sautéed with garlic and onion, bake the chicken with rosemary and paprika to boost the flavor profile."

7. Try Smoothies

Smoothies became a hot trend for the same reason they're a great choice for seniors: They’re an easy way to get fruits and vegetables into a diet, they're portable, and they taste great.

"Smoothies can be so vibrant, exciting, and nutritious," Kelly said. "This can be especially appropriate for seniors who either have a hard time getting in a variety of nutrients or are on a pureed-style diet. I love to make smoothies that include a healthy fat, fiber, a serving of fruit, and protein, so they are well-balanced. An example would be one cup frozen berries, a handful of spinach, a quarter of an avocado, one tablespoon ground flaxseed, one cup unsweetened almond milk, and a hemp or whey protein powder."

8. Make the Food Bite-Sized

Though not all seniors need a pureed diet, other issues may make mealtime problematic, such as limited attention spans or wandering often associated with dementia. At the Bistro at Integrace Copper Ridge, which serves breakfast and lunch to individuals with dementia, options are given to seniors who may feel overwhelmed by a complete meal.

"Some meals are served in nutritious, bite-sized portions that can be eaten without utensils, or carried by diners who find it difficult to remain seated while eating," Bill Rodgers, Integrace Dining Manager, said.

9. Skip the Utensils

Another problem some seniors face is the inability to hold a fork or knife, and smoothies can be hard to grip.

"Individuals with arthritis or neuropathy who have diminished fine motor skills can benefit from using built-up utensils with rubber or plastic grips," York said. "These grips can help people more effectively and easily hold their utensils. Weighted utensils, which help prevent food from falling off the utensil, can be used for older adults who present with hand tremors."

10. Make It Nice

When eating becomes stressful, anyone is likely to lose their appetite -- and that's especially true of a senior with challenges surrounding mealtime.

"By making dinnertime a production -- by setting the table nicely or playing dinner music, for example -- you can make the food itself feel more exciting," Kroll said. 

Even if you're feeling worried and upset about keeping a senior healthy, it's important not to take your frustrations out on them.

"Remove any element of stress or confrontation around the meal,” Kroll suggested. “Having an argument or getting frustrated about not wanting to eat makes it much harder for both of you."

11. Consider Trying Appetite Stimulants

You could also consider consulting with your doctor to see if there are any herbal remedies or supplements they recommend to help increase a senior's appetite.


* This article is for general informational purposes only, and any views, opinions, or recommendations of expressed in it are solely those of the author, and not Care.com, Inc. It is not intended nor implied to be providing medical advice and is not a substitute for such advice. The reader should always consult a licensed health care provider concerning any medical condition or treatment plan. Neither Care.com nor the author assumes any responsibility or liability with respect to use of any information contained herein.

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