Try: Possible causes physiological or medical causes ; dry mouth; parkinson’s disease; mouth discomfort from gum disease or ill fitting dentures; vision changes – cannot see food or utensils properly; chronic illness causing loss of appetite e g diabetes heart disease etc; acute illness causing loss of appetite e g urinary infection pneumonia etc; constipation causing loss of appetite; depression causing loss of appetite; changed sense of taste from age or medications; muscles of jaw or throat no longer working properly due to motor abilities declining in advanced dementia; hunger sensation from stomach no longer understood or received by brain due to brain changes in dementia; side effect of medications such as antidepressants; day and night sleep patterns reversed; doesn’t remember to eat; agitation environmental causes ; relocation to new environment; poor lighting – unable to see food and utensils; too many distractions such as noise people too much on the plate or table; boredom may cause desire to eat all the time; food looks or smells unappetizing; odors in dining room such as urine or cleaning fluids depress appetite other causes ; no longer understand how to eat; can no longer coordinate use of silverware; caregiver not giving simple or clear enough instructions; task too complicated; feeling of being rushed by caregiver; caregiver’s tension or impatience sensed by person; fear or anxiety coping strategies ; have a good dental check-up of gums teeth and dentures sometimes children’s dentists especially those who specialize in working with children with disabilities are good at working with agitated individuals ask whether your dentist or hygienist will make housecalls; have vision or glasses checked; have a good medical work-up to discover any possible physical causes or medication problems contributing to appetite change; have an evaluation for depression done if appetite loss becomes a problem; stroke shoulders and neck to relax person; try soft relaxing music during meal; provide appetizing odors of fresh food cooking in nursing homes reduce other odors such as cleaning fluids or urine in dining area; improve lighting in eating area but avoid glares; reduce noise and distractions in dining area during meals; in a large family consider serving the older adult earlier than other family members then allowing him her to join the family during their supper so the older adult has a chance to socialize; in a nursing home consider; small group dining; grouping according to eating abilities; allowing particularly agitated individuals to eat alone; reducing excessive noise for example by lowering ceiling or using textured wall hangings; reduce distractions at the table; avoid patterned placemats plates tablecloths; serve only one food at a time if necessary; remove other distracting items from table make eating simple ; use bowls and cups that are larger than the portion of food; use bowls rather than plates; set place with only utensils that are needed; use bowls or plates that are different in color from the placemat to help the person easily locate the place; use brightly colored placemats; place a damp washcloth under the plate to keep it from sliding; don’t use plastic utensils they are too light to manipulate easily and may break in the person’s mouth; try bendable straws or cups with lids and spouts for liquids; use mugs for soups or stews be sure to get mugs with big enough handles for easy holding; use assistive devices such as large handled silverware plates with suction cups on bottom plates with rims or buy white plastic tubing which may be cut and fit on utensils found through medical supply stores; serve ‘finger foods’ such as french fries cheese small sandwiches chicken or pork kebobs fried chicken fresh fruits or vegetables even very impaired people often manage finger foods well; try yawning or asking the person to say ‘ah’ if he she won’t open mouth; put a bite of food to lips as stimulus to open mouth for chewing problems ; try light pressure on lips or under chin to get started; give verbal instructions i e ‘chew now and now swallow ‘; demonstrate chewing; make sure person is in a comfortable position; avoid sticky foods such as bananas peanut butter white bread; avoid foods that fall apart or have tough skins such as nuts; moisten foods with sauces gravy water some medications cause dry mouth; served chopped soft foods; offer small bites one at a time for swallowing problems; remind to swallow with each bite; stroke the throat gently; check mouth periodically for food stored in cheek; omit foods that are hard to chew and swallow such as popcorn nuts raw vegetables; offer small bites one at a time; allow plenty of time between each bite; keep liquids at room temperature; moisten foods for choking problems with liquids; try thicker liquids such as apricot juice or milk shakes; make cooked cereal with milk or water to help hydration; keep liquids at room temperature; notify your doctor of this problem for choking problems with solid foods ; try soft cooked foods such as scrambled eggs canned fruit cottage cheese frozen yogurt jello made with orange juice and fruits chopped chicken mashed potatoes applesauce; notify your doctor of this problem for sweet cravings; have medications checked some antidepressant medications cause a craving for sweets; try nutritious milk shakes or egg nogs for overeating or insatiable hunger ; try 5 to 6 small meals per day; have a tray of low-calorie snacks available such as apples or carrots; consider whether activities such as walks or other exercise might distract the older adult; put food up away from the older adult if necessary particularly if the person is overweight or on a special diet for undereating; try a glass of juice wine or sherry if medications permit alcohol use before the meal to whet appetite; offer ice cream milk shakes or egg nogs; make sure the person is getting enough exercise to stimulate appetite; try to prepare familiar foods in familiar ways especially foods that were favorites; consult doctor about the possibility of physical illness or depression; check with doctor about using supplemental drinks such as carnation instant breakfast or ensure if the older adult is in a nursing home supervise to be sure the older adult receives the supplement; try feeding all or more of one food before moving on to the next some people become confused when the tastes and textures change rapidly; sit directly in front of the person if peripheral vision isn’t good show each spoonful to help orient older adult; mix puddings or ice cream with other courses to sweeten if this encourages person to eat; allow the older adult to eat whenever he her is hungry; make sure meals are offered at regular consistent times everyday; try to make mealtimes simple relaxed and calm be sure to allow enough time for the meal feeding a very impaired person can take 45 minutes to an hour; remind the person of the approaching meal and if necessary help him her smell or taste a drop of the food before eating; be sure the person is in a comfortable upright position for eating in later stages it may be necessary to use a wheelchair geriatric chair or cardiac chair with special supports and or restraints; if necessary coordinate tranquilizing medications with mealtimes to reduce agitation; verbally guide the person through the meal if necessary using simple gentle respectful language when dining at a restaurant; choose quiet well lit restaurants where service is fairly fast; consider carrying printed cards to hand waiters that read ‘my companion has alzheimer’s disease and cannot understand you please direct your questions to me ‘ in long-term care settings; consider use of aprons instead of towels or hospital gowns; consider use of small square tables to aid in socializing and to help establish boundaries; try making milk coffee or juice available first thing in the morning to take the edge off the morning hunger; train staff volunteers or family members who assist with feeding to; bring favorite foods such as fruits or cookies to make eating a more pleasurable experience; encourage staff who has been successful in feeding the older adult to consistently feed the older adult whenever possible other considerations ; observe carefully to begin to assess what might be causing eating or feeding problems is the problem with the use of silverware chewing swallowing distraction noise too much food on plate caregiver impatience; keep in mind the older adult’s past history with food he she may have always had a small appetite been a voracious eater or had a craving for sweets it is perfectly all right to miss an occasional meal; watch food temperatures while warm food is more appetizing some dementia patients have lost the ability to judge when food or drink is too hot avoid styrofoam cups because while they maintain heat they are also easily spill over and some older adult’s may try to eat the styrofoam; mouth care is extremely important with dementia patients if it is possible to get teeth brushed try using toothettes they are inexpensive and found at medical supply stores; there are cookbooks available that contain ‘non-chew’ recipes available at bookstores and medical supply stores; spoiled food in the refrigerator hiding food or not eating regularly may all be signs that someone living alone is in need or more supervision; many older adult’s with dementia do not enough fluid because they forget to drink or may not longer recognize the sensation of thirst be sure to offer regular drinks of water juice or other fluids to avoid dehydration symptoms of dehydration many include thirst refusal to drink flushing and fever rapid pulse dizziness and confusion; many eating problems for older adults with dementia are temporary and will eventually pass as the older adult’s abilities change; choking and swallowing problems can be extremely upsetting to family caregivers it may be reassuring to discuss this with a physician or other health care professional caregiver might consider first aid training that includes the u8e2809cheimlich maneuveru8e2809d the red cross and some health care facilities offer training; family may wish to discuss nursing home policies regarding the use of feeding syringes for people who eat slowly or refuse to eat; some people with dementia reach a point where they are unable to swallow or simply refuse to eat it is important for families to discuss feelings ahead of time about the use of feeding tubes to use or not use a feeding tube is a very personal individual decision but one that needs to be made in advance and discussed with medical and nursing home personnel references 1 alzheimer’s association chapter newsletter 2 mace nancy & rabins peter 1999 the 36-hour day baltimore the john’s hopkins university press 3 robinson anne spencer beth & white laurie 1992 understanding difficult behaviors ypsilanti mi eastern michigan university
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Categories: Cognitive Intellectual, Emotional Psychological, Medical Physical
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*This information is listed as a Fact Sheet and is not explicitly medically licensed