Caring for a loved one with Alzheimer's? Understand what causes eating problems and how you can encourage good nutrition.

By Mayo Clinic Staff

Alzheimer's disease and eating challenges often go hand in hand. As Alzheimer's progresses, poor nutrition can aggravate confusion and lead to physical weakness, as well as increase the risk of infection and other health concerns.

If you're caring for a loved one who has Alzheimer's, understand what causes eating problems and how you can encourage good nutrition.

If your loved one is having trouble eating, check for underlying problems, such as:

  • Oral problems. Make sure dentures fit properly and are being used. Check for mouth sores or other oral or dental issues.
  • Medication effects. Many medications decrease appetite, including some drugs used to treat Alzheimer's. If you think medications are contributing to eating problems, ask your loved one's doctor about substitutions.
  • Chronic conditions. Diabetes, heart disease, digestive problems and depression can dampen interest in eating. Constipation can have the same effect. Treating these or other underlying conditions might improve your loved one's appetite.

In the early stages of Alzheimer's, your loved one might forget to eat or lose the skills needed to prepare proper meals. Call to remind him or her to eat or to offer help with food preparation. If you buy groceries for your loved one, choose food that's easy to prepare or doesn't need to be cooked.

If you make meals in advance, review how to unwrap and reheat them. Or consider using a meal delivery service.

Your loved one might also experience:

  • Diminished senses of smell and taste, which can affect interest in eating
  • Difficulty swallowing in the later stages of the disease

Agitation and other signs and symptoms of Alzheimer's can make it difficult to sit still long enough to eat a meal. Distractions at mealtime might make this even worse. To reduce distractions:

  • Serve food in a quiet setting, away from the television
  • Put your cellphone on vibrate
  • Clear the table of any unnecessary items

Discourage your loved one from drinking alcoholic beverages. Although alcohol might stimulate the appetite, it can lead to confusion and agitation as well as contribute to falls.

Change can be difficult for a loved one with Alzheimer's disease. Maintaining familiar routines can make mealtimes easier. Try to:

  • View mealtimes as opportunities for social interaction. A warm and happy tone of voice can set the mood.
  • Respect personal, cultural and religious food preferences, such as eating tortillas instead of bread, or avoiding pork.
  • If your loved one has always eaten meals at specific times, continue to serve meals at those times.
  • Serve meals in a consistent, familiar place and way whenever possible.

Use white dishes to help your loved one distinguish the food from the plate. Similarly, use placemats of a contrasting color to help distinguish the plate from the table. Stick with solid colors, though — patterned plates, bowls and linens might be confusing.

Sometimes bowls are easier to use than plates. Likewise, spoons might be easier to handle than forks. Try bendable straws or lidded cups for liquids.

If your loved one is overwhelmed by an entire plate of food, place one type of food at a time on the plate. You could also offer several small meals throughout the day, rather than three larger ones.

Cut food into bite-sized portions. Finger foods are even easier — but avoid foods that can be tough to chew and swallow, such as nuts, popcorn and raw carrots.

Don't rush mealtimes. Remind your loved one to chew and swallow carefully, and allow him or her as much time as necessary.

Encourage your loved one to follow your actions, such as holding a fork or drinking from a cup — or gently place your hand over your loved one's hand to hold a utensil and bring food to his or her mouth.

Try to provide healthy foods such as fruits and vegetables, whole grains, low-fat dairy products, and lean protein. If you're having a hard time getting your loved one to eat enough, prepare favorite foods.

Staying hydrated also can be a problem for people with Alzheimer's disease. Offer small cups of water or other liquids throughout the day and foods with high water content, such as fruit, soups, milkshakes and smoothies.

Consult the doctor if sudden weight loss occurs.

Ensuring good nutrition in Alzheimer's can be a challenge, but it's worthwhile. Good nutrition can help your loved one better cope — both physically and emotionally — with the challenges of Alzheimer's.

Jan. 18, 2018