Posts Tagged diet

Mealtime Challenges in Dementia

Asian with OJ


With dementia, the person eventually loses all of the abilities they once possessed and the knowledge that they had acquired over time. Since using utensils and eating politely are acquired skills, they are lost in dementia. Using a fork and knife, for instance, takes practice and we are typically age 6, 7, or older by the time we have mastered all of the fine nuances of eating a meal and utilizing utensils properly. When we are young, we are fed by another person, then we learn how to drink from a bottle unassisted, then a cup or glass, then we learn how to use a spoon, then we master abilities that require more coordination and fine motor skills, such as cutting with a fork and knife or carving a turkey.

It is not surprising that as many as 80% of people with dementia have difficulty with eating and drinking. 50% are no longer able to feed themselves in the later stages of the disease (Ensell & Matheson, 2009). Furthermore, mealtime is an opportunity for individuals with dementia to socialize, feel useful, and embrace culture; if the mealtime experience is unenjoyable or challenging, this may prevent the person from engaging meaningfully with others and could lead to isolation or depression. See the tips below for providing help to individuals at different stages of dementia.




Tips for Early Stage

  • Provide reminders on when to eat.
  • If the person lives alone, clean out their refrigerator regularly. Make sure spoiled foods are not kept or consumed.
  • Drop off pre-made meals or utilize a Meals on Wheels service.
  • Be aware of safety concerns in the kitchen. Supervision may be required, even at an early stage.
  • Declutter the kitchen area. Too much clutter can cause confusion and agitation.
  • Consider assistive devices, such as a rocker knife, that might help the person to remain independent longer. Consult an Occupational Therapist for specific suggestions.
  • Be mindful of the person’s likes and dislikes and life-long habits related to eating.
  • Try to stick to a regular routine.

Tips for Middle Stage

  • Serve finger foods or serve the meal in the form of a sandwich
  • To avoid spilling, serve food in large bowls instead of plates or use plates with rims or protective edges.
  • Consult with an Occupational Therapist to help promote independence. Specific assistive devices may be recommended.
  • Consult with a Speech Therapist/Pathologist if there are chewing or swallowing challenges.
  • Avoid foods such as nuts, popcorn, and raw carrots, which may be hard to chew and swallow.
  • Serve soft foods such as applesauce, cottage cheese and scrambled eggs. Serve thicker liquids such as shakes, nectars, and thick juices. You may also purchase powders that can thicken liquids in order to assist with swallowing.
  • Try to stick to a regular routine.
  • Help the person maintain good oral hygiene.
  • Be alert for signs of choking. Learn the Heimlich maneuver in case of a choking incident.

Tips for Late Stage

  • Weight loss, malnutrition (Sharp & Shega, 2009) and loss of appetite are considered hallmark signs that the person is entering the last stages of the disease. In the Late Stage, the person may eat less and have difficulty swallowing.
  • Consult with a Speech Therapist/Pathologist if there are chewing or swallowing challenges.
  • Consult with an Occupational Therapist to help promote independence. Specific assistive devices may be recommended.
  • Gently place the person’s hand on or near an eating utensil.
  • Show the person how to eat by demonstrating.
  • Try hand-over-hand assistance.
  • Give the person plenty of time to eat. Keep in mind that it can take a person an hour or more to finish.
  • Be conscious of physical illnesses or disabilities that may affect their eating.
  • Help the person maintain good oral hygiene.



Ensell, C., & Matheson, N. (2009). Mealtime behaviours in people with dementia in the absence of dysphagia. Acquiring Knowledge In Speech, Language & Hearing11(2), 92-96.

Hansen, T. (2011). Measuring elderly dysphagic patients’ performance in eating – a review. Disability & Rehabilitation33(21), 1931-1940.

Logemann, J. A., Gensler, G., Robbins, J., Lindblad, A. S., Brandt, D., Hind, J. A., & … Gardner, P. (2008). A Randomized Study of Three Interventions for Aspiration of Thin Liquids in Patients With Dementia or Parkinson’s Disease. Journal Of Speech, Language & Hearing Research51(1), 173-183.

Sharp, H. M., & Shega, J. W. (2009). Feeding Tube Placement in Patients with Advanced Dementia: The Beliefs and Practice Patterns of Speech-Language Pathologists. American Journal Of Speech-Language Pathology18(3), 222-230.

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Food for Thought: Diet Choices Linked to Brain Health

Do your snacking habits affect brain health? Could your diet choices help to reduce (or elevate) your risk for diseases like Alzheimer’s? As the prevalence of Alzheimer’s disease continues to rise (more than 5 millions Americans have a diagnosis), many have been intrigued by these questions. Unfortunately, there is no proven method for preventing Alzheimer’s disease and the research into its prevention is lacking. However, an emerging body of scientific research indicates that certain food choices may be conducive to a healthy brain.

Ever heard the axiom “healthy mind, healthy body”? It’s often true! Hypertension, diabetes, high cholesterol, and other chronic diseases have been associated with an increased risk for developing Alzheimer’s disease and other types of dementia. These diseases are harmful to the blood vessels in the body, and they can ultimately cause a lack of blood flow to the brain.

Want to ensure that your diet will protect your body and your mind? Adhering to a heart healthy food selection, like the Mediterranean diet, may help.


The benefits of diet on heart health are already well-documented, and many researchers believe that these same disease fighting foods can be beneficial in protecting the brain. The studies conducted on this subject have yielded promising results, however, more research must continue in order to learn more about effective prevention strategies for Alzheimer’s.

Don’t forget, aging doesn’t start when we reach 65. It’s happening to us all the time, everyday! Commit to a healthy lifestyle long-term, and you will be more likely to stave off chronic diseases, like Alzheimer’s. Life is a marathon, not a sprint!

grocery store

Want to give it a spin? Below is a sample grocery list that reflects adherence to the Mediterranean diet. The most effective eating plan is one that works with your preferences and lifestyle. Experiment with foods that are most appealing to you and enjoy!

  • Spinach
  • Kale
  • Eggplant
  • Tomatoes
  • Almonds
  • Sweet Potatoes
  • Celery
  • Carrots
  • Salmon
  • Brown rice
  • Whole wheat bread
  • Olive oil
  • Red wine
  • Blueberries
  • Strawberries
  • Bananas
  • Tilapia
  • Basil
  • Oregano
  • Black beans
  • Cannellini beans
  • Whole wheat pasta
  • Tomato sauce
  • Bell peppers
  • Zucchini


Arntzen, K. B. (2011). Impact of cardiovascular risk factors on cognitive function: The Tromsø study. European Journal Of Neurology18(5), 737-743.

Boost your memory by eating right. (2012). Harvard Women’s Health Watch19(12), 1-7.

Féart, C., Samieri, C., Rondeau, V., Amieva, H., Portet, F., Dartigues, J., & … Barberger-Gateau, P. (2009). Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA: Journal Of The American Medical Association302(6), 638-648. doi:10.1001/jama.2009.1146

Mediterranean diet associated with lower risk of cognitive impairment. (2009). Nurse Prescribing7(3), 134.

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