The eating environment for people with dementia

For many of us, the way food is presented and served, the surroundings and the company in which it is eaten all add to the satisfaction and enjoyment of eating a meal. This is equally important for a person with dementia: a good mealtime experience can have a positive impact on their health and sense of wellbeing.

You may also be interested to read the feature Kitchen and dining areas in the Dementia-friendly environments section.

Minimising distractions

Imagine you are in a restaurant with a group of friends and there is loud music playing or a live band playing close to your table. The restaurant is busy and the conversations around your table are loud. You are trying to make a choice from a long list of options on the menu as well as keep up with the conversation among the friends you are with.

The waiter is hovering and you are feeling pressure to choose your meal. It may be a challenge for you to concentrate on the conversation around you while choosing from the menu, but you will manage to make this choice and continue to converse with your friends despite everything else going on around you.

For a person with dementia a noisy environment can be confusing: it can make it difficult to concentrate and focus. So if you had dementia and you were in that noisy restaurant you may have just got up from the table and walked out as the music, conversation and waiter were all competing for your attention.

We need to be aware that people with dementia may struggle to concentrate at mealtimes if there are other distractions. The eating environment needs to be calm and relaxed. Switch off the television or turn down loud music to avoid distractions.

For more on these ideas, read the feature on Noise levels in the Dementia-friendly environments section.

Feeling comfortable

A person with dementia may not be comfortable eating with other people or in an unfamiliar environment. They may have difficulty eating food and this can only make feelings of embarrassment worse if they are sitting with others. As a result, they may leave food uneaten.

Allow a person to sit and eat in a place where they feel comfortable, either at a table or perhaps sitting with a tray on their lap on a comfortable chair.

Sight problems

It is important to be aware that some people with dementia may experience visual impairments that make it difficult to see the food in front of them. Sight difficulties may mean their perception of food – that is, the way they see the food – changes. For example, the shape or colour of the food may be confusing to them. Food should be presented colourfully and attractively. Always describe the food you are offering.

Avoid using patterned crockery – it can be confusing and distract focus from the food. Keep crockery plain and simple. Ensure there is significant contrast between the colour of the crockery and the food. For example, rice pudding in a white bowl may be difficult to see as there is poor contrast between the bowl and the rice. However, putting the rice pudding in a plain coloured bowl will help to ensure the food stands out and contrasts well with the bowl. Adding a topping such as strawberry jam further improves visual contrast.

Ensure the area in which a person with dementia eats is bright and well lit so they can see the food easily (see the Lighting feature in Dementia-friendly environments section).

Food memories

Food and images of food can also be used for promoting memories connected to food or as part of reminiscence-based activities. This can help stimulate discussion and interest in food and mealtimes by helping the person to reconnect with familiar food from their past. (See the feature in this section on ‘Activities based around food’).

• Further reading Open

  Alzheimer’s Society, ‘The eating environment’, online information.

  Coleman, G. (2009) Alzheimer’s Society guide to catering for people with dementia, London: Alzheimer’s Society.

  Crawley, H. (2002) ‘Food, drink and dementia: How to help people with dementia eat and drink well’, Stirling: Dementia Services Development Centre, University of Stirling.

  Crawley, H. and Hocking, E. (2011) Eating well: Supporting older people and older people with dementia, London: The Caroline Walker Trust.

  Marshall, M. (ed) (2003) Food glorious food: Perspectives on food and dementia, London: Hawker.

  Pool, J. (2010) The Alzheimer’s Society guide to the dementia care environment, London: Alzheimer’s Society.

• Useful links Open

  Alzheimer’s Society
  The Alzheimer’s Society website has a section entitled Eating and drinking, which covers a wide range of issues to do with helping people with dementia to eat well: difficulties with eating and drinking, preparing meals, the eating environment and finger foods. The Society also produces a factsheet on Eating and drinking (511).

  Eating and drinking well: supporting people living with dementia
  A team from Bournemouth University has developed a 26-minute training film aimed at nurses and care home staff, based on findings from a major study in this area. A workbook to accompany the film is also available from the research team.

  Eating well for older people and older people with dementia: Practical guide
  This 2011 guide from the Caroline Walker Trust explains why eating good food matters for older people with dementia, suggests types and amounts of food that might be appropriate to meet nutritional needs, and includes sample menus.

  Eating well for people with dementia: a guide for carers
  This 24-page booklet has been produced by the Northern Health and Social Care Trust in Northern Ireland. It covers topics such as ‘Encouraging eating’, ‘Common problems with eating and drinking’, ‘Dealing with diabetes’, as well as explaining the role of occupational therapists and speech therapists in this area, and the importance of mouth and dental care.

  Nutrition and dementia
  This 2014 report from Alzheimer’s Disease International investigates the links between diet and dementia and looks in detail at a range of ways in which nutrition can be improved for people who live with dementia.

  Prevention and early intervention of malnutrition in later life: best practice principles and implementation guide
  The Malnutrition Task Force have produced a range of guides, each bearing this main title and then focusing on a particular area (such as hospitals, care homes or community). The guides each include detailed attention to the particular needs of people with dementia.

• Related pages from this section Open

  • Eating well
    • Why nutrition is important for people with dementia
    • Chewing and swallowing problems
    • Promoting independence at mealtimes
    • The eating environment
    • Can diet prevent or slow down dementia?
    • Eating well at home
    • Activities based around food