Dementia is defined as a loss of brain function. Dementia is not a single disease but rather refers to a group of several different illnesses that involve memory, behavior, learning, and communicating problems. Dementia illnesses are progressive, meaning the symptoms of the disease tend to get worse with time.
Alzheimer’s Disease is one form of dementia. Alzheimer’s disease is a progressive, degenerative brain disease which adversely affects memory, thinking, and behavior. Memory impairment is a critical symptom for the diagnosis of Alzheimer’s disease. Any change in any one of the following areas is the second component necessary for the diagnosis of Alzheimer’s disease: language, decision-making ability, judgment, attention, decrease mental function or ability, and drastic personality change.
People with dementia and/or Alzheimer’s disease are at risk for unintentional weight loss. Studies have shown that weight loss in the patients with dementia or Alzheimer’s disease are at greater risk than patients with cancer and heart failure. Greater weight loss is associated with earlier death in Alzheimer’s patients.
Many factors seem to contribute to weight loss of patients with dementia and/or Alzheimer’s disease. These factors include:
- Decreased sense of smell
- Brain damage to areas of brain responsible for ap- petite
- Lack of attention
- Lack of initiative
- Higher metabolic requirements
- Dental problems or pain
- Swallowing problems
- Gastrointestinal pain
- Tremors or constant shaking
- Inability to use utensils
- Lack of physical mobility
- Lack of hand coordination
- Arthritis-making utensils difficult to hold
Suggested Nutritional Interventions for the Dementia or Alzheimer’s Patient:
- Serve food at appropriate meal times even if patient does not act or seem hungry.
- Eat with the patient. Meal times are a social activity and a person is more likely to eat when others around them are eating.
- Serve small portions so not to overwhelm them or serve one food at a time.
- Serve food that is easy to eat, chew, and digest. For example, sandwiches are easier to eat than soup.
- Use seasonings and color to make food appealing and more attractive.
- Make sure food is not served too hot.
- Pre-cut food into bite size pieces.
- Serve food that is easy to eat with a spoon.
- If a patient is having trouble with utensils, then serve “finger foods”.
- Food likes and dislikes will have changed with dementia due to changes with sense of smell and taste. Make sure to try different types of food to encourage intake.
- Restricted diets due to other health problems may need to be liberalized at this time to encourage adequate food intake. Always consult the patient’s doctor or dietitian before making a diet change.
- Encourage intake of vitamin/mineral, fortified/enriched foods such as dry and hot cereals, breads, juices, instant breakfast drink, or nutritional supplements.
- Consider giving a daily multiple vitamin/mineral supplement. Always consult patient’s doctor before adding this to their medication routine.
- Serve frequent snacks in between meals. Cold foods like ice cream, pudding, yogurt, or instant breakfast drink seem to work well at snack time.
- Change the subject if the patients refuses to eat and try again later.
- Add calories to favorite foods. Example: the patient likes Jell-O so substitute juice for water during preparation.
- Try feeding meals on a schedule similar to what had been normal for the patient as well as incorporating normal meal time behavior i.e. patient always had the radio on at dinner time.
- Remove clutter from eating area.
- Encourage hydration and keep beverages available and in sight at all times.
- Keep non-perishable snacks in sight at all times.
- Monitor food intake by doing inventory of cabinets, trash, and refrigerator.
- Monitor weight weekly and notice how clothes fit.
- Maintain good oral hygiene and look for mouth sores.
- Provide repetitive cues during meal times to remind patients to take a bite.
- Ask about pain prior to meal times and if pain is present than give pain relief medication 30 mins. prior to meal.
Information from: Medline Plus, www.nlm.nih.gov/medlineplus/ency/; Caring For Someone Dementia, Food For Thought, www.alzheimers.org.uk; Health YOUniversity-Health and Wellness Library, www.nifs.org/hyou/nutrition/alzheimers.htm. Nutrition Education for MAY 2007. Produced by Meals On Wheels, Inc., of Tarrant County. For questions regarding nutrition education contact Denise Blevins, R.D./L.D., Director of Nutrition Services, at 817-336-0912 or email: email@example.com.