It’s no secret that proper nutrition can play a significant, positive role in both our mental and physical well-being. We are what we eat, so to speak, and a well-balanced diet, paired with sufficient hydration, can have tremendous benefits at any stage of a person’s life.

But for many people living with dementia, establishing or maintaining healthy eating routines can be very challenging, which, in turn, can lead care partners to feel frustrated and concerned when healthy food and water intake becomes an issue.

Common dietary concerns for people living with dementia

While research has shown a potential link between nutrition and dementia prevention, Dr. Heather Keller, a researcher at the University of Waterloo who specializes in nutrition in seniors, says there’s not a lot of data on how specific nutrients can affect cognition in people who already have dementia. Nevertheless, since most people with dementia tend to be older, it’s important for them — like it is for all aging adults — to adhere to a diet that incorporates plenty of protein, calcium and vitamin D to combat bone and muscle loss.

Dr. Heather Keller

Of course, that can be easier said than done, especially if a person with dementia starts to lose interest in food, refuses to eat things they used to enjoy, or develops trouble chewing or swallowing — all of which are quite common. In those instances, maintaining not only important nutrients but also enough calories to keep weight on can become a problem. Plus, dementia can make even the most beloved foods taste different, and people with dementia often develop “food jags,” which lead them to only want to eat certain things.

“One of the biggest concerns with people living with dementia is that they start to either change what they eat, or they just stop eating, and that leads to significant challenges with maintaining body weight,” Keller says. “Malnutrition in any person is not good. But a person with dementia will probably also have physical challenges happening because of their disease that impact food intake, leading to malnutrition.”

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Keller says that hydration is also a common concern and, while some caregivers may be inclined to limit water intake in fear of worsening problems with incontinence, a lack of fluids can lead to issues with cognition and how medications are absorbed by the body. Since many people see a decrease in their thirst as they age, encouraging a person with dementia to drink enough water can also be a challenge.

What can caregivers do?

In Keller’s view, the main food goal for people with dementia and their caregivers should be to keep up that caloric intake and some sense of nutritional balance, while also accepting that mealtime will not necessarily look like it did before the dementia diagnosis. One of the most important ways to encourage eating is for caregivers to sit down and eat with the person they’re caring for. The act of eating together not only allows for quality time spent together, but watching someone else eat can also prompt the person with dementia to follow suit.

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“Eating with others can have a huge impact, and research shows that mimicry — seeing someone else eat and drink — really is helpful,” Keller says. “When someone is eating with someone with dementia it really does help them to eat as well, especially if they're facing each other rather than sitting side by side. The person with dementia can see the actions of someone else and mimic that.”

It’s also essential to recognize that only eating at mealtimes might not be enough for some people with dementia, and that caregivers may have to adapt to their loved one’s changing needs. If a food jag means that the person with dementia only wants to eat peanut butter, for example, they can be presented with different applications of that food (such as peanut butter on apples or celery instead of just crackers or toast).

"Minimize the work of making food so you can spend the time eating with the person with dementia and enjoy the social connection."

– Dr. Heather Keller

Keller also recommends having easy-to-eat food at the ready for when the desire to eat may strike: a regular supply of healthy muffins on the kitchen countertop or sliced cheese in the fridge allows for more chances for spur-of-the-moment snacking. If the person with dementia gets anxious at the thought of sitting down at the table, liquid food like soup or smoothies can be served from a travel mug, with the extra bonus of some added hydration.

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Ultimately, Keller doesn’t want caregivers to beat themselves up if mealtimes don’t look like they did before a dementia diagnosis. Meals don’t need to be complicated — things that are easy for the person with dementia to eat on their own and are bright in colour and high in flavour (for diminished taste buds) are good choices that take the stress out of meal preparation and allow everyone to continue to enjoy the time they have together at home. If a meal ends up consisting of cut-up vegetables with hummus and a few slices of cheese, caregivers can still consider that a win.

“A lot of it is about the pleasure of food, and about our food traditions. We need to recognize that healthy eating isn’t the only goal,” Keller says. “Keep trying to do different and small offers of food and fluid. You don’t have to spend a lot of time preparing food. Minimize the work of making food so you can spend the time eating with the person with dementia and enjoy the social connection.”