Mealtime Struggles: Eating and Drinking With Dementia Made Easier

To help a loved one with dementia eat and drink well, keep each mealtime calm and simple: one or two foods at a time, finger foods, plenty of time and drinks offered all day. The disease can dull taste and smell and make chewing and utensils harder. Tell the doctor about weight loss or coughing at meals.

This guide explains why eating and drinking with dementia changes, how to set up a calmer mealtime, which foods are easiest, how to keep your loved one hydrated in Florida’s heat and when to get professional help. It is written for families who are worried that their loved one is not eating enough.

Why eating changes with dementia

Dementia affects much more than memory, and mealtime is often where families notice it first.

The Alzheimer’s Association notes that in the middle and late stages, people may feel overwhelmed by too many food choices, forget to eat or think they have already eaten. It lists several causes of poor appetite: not recognizing food, poorly fitting dentures, medicine changes, too little activity and a reduced sense of smell and taste. Read its page on food and eating.

Common changes in eating and drinking with dementia

• Pushing food around the plate or leaving the table early
• Forgetting a meal just happened, or that one was missed
• New preference for sweet foods
• Trouble using a knife and fork
• Holding food in the mouth or chewing for a long time

Understanding that these come from the disease takes some of the frustration out of the moment.

Setting the stage so your loved one can eat and drink well

At mealtime, the setting matters as much as the food.

• Turn off the TV and clear clutter from the table.
• Use plain plates and placemats in colors that contrast with the food.
• Serve one or two items at a time instead of a full plate.
• Check that food is not too hot before serving.
• Allow an hour or more if needed; don’t rush.

Eat together when you can. The Alzheimer’s Association notes that eating together can encourage your loved one to eat.

Keep a steady rhythm

Serving each mealtime at about the same hour each day gives the day a comforting shape. Our guide to creating a calming daily routine shows how to build meals into the day.

Use simple cues

Say “Here’s your spoon” or “Take a bite of the chicken,” one step at a time. You can also eat a bite yourself so your loved one can copy you.

Mealtime foods that are easier to eat

Ask the doctor before major diet changes, especially for diabetes or heart conditions.

Helpful tools

The Alzheimer’s Association suggests bowls instead of plates, large-handled spoons, cups with lids, bendable straws and non-skid placemats. These help your loved one keep feeding themselves longer and eat and drink well with less help, which protects dignity.

Nutrition basics

Offer vegetables, fruits, whole grains, low-fat dairy and lean protein. Use herbs and spices instead of extra salt. If weight is dropping, the doctor may suggest supplements between meals.

Staying hydrated in the Florida heat

Eating and drinking with dementia both matter, and fluids are easy to overlook. Your loved one may not notice or say they are thirsty, and Florida’s heat raises the stakes.

The National Institute on Aging lists signs of dehydration that include dry mouth, dizziness, hallucinations and a rapid heart rate. It notes that dehydration can happen in hot weather or in homes without air conditioning. If your loved one won’t drink water, the NIA suggests juice, flavored water, broth, milk or decaf coffee or tea. See its guide to common medical problems in Alzheimer’s.

• Offer small cups often instead of one big glass.
• Keep a favorite cup filled and within reach.
• Add water-rich foods like watermelon, oranges, cucumber and soups.
• Ask the doctor how much fluid your loved one should aim for.

Read more in our guide to preventing dehydration in Florida’s summer.

Example: lunch in West Palm Beach

This is an illustrative scenario, not a real family. A daughter notices her mother, who has middle-stage dementia, is losing weight. At lunch she pokes at a full plate of chicken, rice and salad and says she isn’t hungry.

The daughter turns off the TV and serves one thing at a time on a solid blue plate: first chicken strips she can pick up with her fingers, then sliced mango. She sits down and eats with her mother, chatting about the garden. She offers a small cup of lemonade, then another later.

She also books a dentist visit and learns a loose partial denture was making chewing painful. Within a month her mother is eating more, and the daughter adds a mid-afternoon smoothie to keep calories and fluids up.

A sample day of meals and drinks

Several small meals and regular drinks are often easier than three big meals, and they help many people eat and drink well across the day. Here is one way a day might look; adjust it to your loved one’s tastes and the doctor’s advice.

• Breakfast: scrambled eggs, soft toast strips, a small glass of juice
• Mid-morning: yogurt or a banana, a cup of water
• Lunch: chicken strips, steamed carrots, milk
• Afternoon: a fruit smoothie or watermelon cubes on the porch
• Dinner: soup and a half sandwich

An evening snack, such as cottage cheese and fruit, can help if your loved one eats little at dinner.

Keep a simple note of what was eaten and drunk for a few days. A pattern, such as eating best at breakfast, tells you when to offer the most nourishing food.

Late-stage changes

In later stages, your loved one may need hand-over-hand help or to be fed. The Alzheimer’s Association mentions hand-over-hand feeding as one way to help. Sit at eye level, offer small bites, wait for each swallow and keep the pace slow. Talk with the doctor about goals of care as needs change.

Swallowing problems and when to get help

Some mealtime changes need a professional’s eye. Call the doctor if you notice:

• Coughing or choking during meals, or a wet, gurgly voice after swallowing
• Unexplained weight loss
• Sudden refusal to eat or drink
• Signs of dehydration, such as dizziness or new confusion

A speech-language pathologist can assess swallowing. Read our guide to dysphagia and dementia. The Alzheimer’s Association also suggests sitting upright with the head slightly forward, checking the mouth after meals and learning the Heimlich maneuver. This article is general information, not medical advice.

Check the mouth

Refusing food or wincing at meals can signal mouth pain or poorly fitting dentures. See our guide to oral care and dementia.

Conclusion

Helping a loved one eat and drink well takes patience and small adjustments. Keep meals calm and simple, offer finger foods and soft foods, eat together and offer drinks all day, especially in Florida’s heat.

Eating and drinking with dementia changes over time, so watch for weight loss, coughing at meals and mouth pain, and bring them to the doctor.

If you would like help at mealtime and good company, get 3 free caregiver profiles within 48 hours or call (689) 333-6079. Visits are $35 an hour for 40+ hours a week, with no long-term contract.