Dementia Gateway: Eating well for people with dementia

Promoting independence at mealtimes

It is up to us to identify what the difficulties are and not make the assumption that they do not wish to eat.

Explore the links below now to read more about this topic:

• 1. Introduction Open

  For people with dementia, eating and drinking can become challenging as the dementia progresses. Dementia can cause difficulties with co-ordination and remembering the processes or sequences involved with eating and drinking. These difficulties can make mealtimes slow and drawn out.

• 2. Problems using cutlery Open

  A person with dementia may start to experience difficulty eating food with cutlery as their dementia progresses, for example they may struggle to use a knife and fork. Food may fall off cutlery and the person may become so frustrated they give up (see the 'Kitchens and dining areas' feature in the 'Environment' section).

  'Finger foods' may be a solution in these situations: this means food that can be eaten easily with hands, such as small sandwiches, orange segments or chunky chips. They are ideal for people with dementia who are struggling to use a knife and fork. Finger foods enable a person to eat independently, helping to maintain their dignity and control at mealtimes.

  As this family carer says: 'At home we found that when dad didn't want to sit down to eat we would place food where he would walk so that he could see it and he would help himself to eat. He was far happier doing this than sitting at the table.'

  If a person needs adapted eating equipment, an occupational therapist can provide assessment and advice. To contact an occupational therapist, ask for a referral from a person's GP.

• 3. Problems seeing and recognising food Open

  We also need to be aware that some people with dementia may difficulties with their sight and visual perception. They may be unable to see or recognise the cutlery, crockery or the food in front of them and simply sit and stare. This may give us the impression that they are not hungry or uninterested in eating. However, this is an incorrect assumption to make.

   It is up to us to identify what the difficulties are and not make the assumption that they do not wish to eat. We need to talk to the person about the food and provide regular prompts as to where their cutlery is and offer guidance to them on how to use it (see the 'Kitchens and dining areas' feature in the 'Environment' section).

• 4. Decision–making difficulties Open

  As dementia progresses a person may have difficulty choosing and deciding on the food they want to eat. Simply calling out a list of options can be confusing and difficult for the person to understand as they may no longer recognise what the food is from hearing the words alone and may struggle to remember all the options given to them.

  If the person can see the food this will help them recognise it and be able to choose well. Showing packets or boxes of the food can help the person connect the words with their memory. For example, showing the person a box of breakfast cereal can help that person make sense of what they have been offered. Always describe and talk about the food or meal that is being served.

• 5. Help with choices Open

  At mealtimes show the food or plated meals to the person and allow them to choose what they would like to eat at the time they are about to eat. They may be able to choose from the options using words or by indicating with a gesture what they would like to eat.

• 6. Timing menu selections Open

  Avoid asking a person with dementia to choose a meal in advance, for example, asking them to choose their lunch at breakfast time. People with dementia experience difficulty with their short-term memory and will often struggle to remember what they requested. Allow the person to choose the food they want to eat at the time they will be eating it. Showing a person with dementia food or using pictures or photographs of food can help them make a choice.

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