It’s normal to have trouble eating in the later stages of Alzheimer’s. Also, it’s not unusual for people living with the disease to stop eating altogether.
Understandably, this causes caregivers a lot of concern. The first thing to do is to stay calm. While understandable, going into panic mode will make it tougher to find clues that might indicate a problem that can be resolved.
Are there other illnesses that may be causing problems? A cold, urinary tract infection, stomach problem, even constipation can make someone eat and drink less. This is where being a medical detective is essential.
Could your loved one be suffering from anxiety or depression? Many people don’t eat when they’re sad (not me). Analyzing what is going on in their lives might offer some insight.
Could a new medication be causing nausea? Even if nausea isn’t a side effect, if you think a new drug may is the culprit, it’s worth quizzing the doctor and pharmacist about options.
What about their dentures? Do they fit as well as they should? It’s worth going to the dentist, even if you don’t get 100% cooperation from your loved one. Focus on the top concern first. If your loved one ends the treatment early, at least you’ve addressed the essential matter.
How physical are they? Many people living with Alzheimer’s don’t walk well or cannot walk easily. Sitting all day every day isn’t going to help their appetite either. Try a dance-off, or have them set the table. My Mom liked to sweep up leaves. Sweeping is more physical than it looks.
In the later stages, many people living with AD no longer recognize food. They may also have a decreased sense of smell and taste.
All of these issues are normal and common, but there are things to try.
Solutions to Try
Keep mealtime simple. Use smaller, colorful plates, and serve one type of food at a time. Finger foods are easy to maintain independence and hopefully keep things neat. (This isn’t an important consideration, but as a neat freak myself, it’s hard to enjoy my meal if the table is a mess.) It’s helpful to put a few bites of food on their plate. Many people with Alzheimer’s lose focus, and a lot of food may be overwhelming. If you offer limited amounts of small bites, you can then follow up with encouragement when they’re finished.
Keep the encouragement on the food. For example, instead of commenting on the great a job they did eating, I’d say, “Wow! You ate all your food; you must have enjoyed it. Here’s a little bit more for you.”
Making the statement in this way does not infantilize them, and you’re not asking if they want more. No, always seems to be the answer regardless, so don’t ask yes or no questions.
You could also try, “I’m so happy that you liked your chicken, try these potatoes, and tell me if you like them.” This approach allows you to be encouraging while also adding in a second, more investing food.
Keeping the encouragement lighthearted also allows you to be social and keeps mealtime relaxed. Make sure you’re both seated comfortably, and everything you need is easily reached. Keep the table as clear as possible, focusing on just the food. Keeping a clear table is a delicate balance between having everything handy and not cluttering up the surface. Don’t give your loved one other things to focus on instead of their food.
Be Flexible, Have Options
Keep a list of your loved ones’ favorite foods but be aware that they may have a sudden change of taste. It may be necessary to serve dinner at breakfast or eggs for dinner. If getting them to eat is your goal; letting go of the idea that you have to eat certain foods at certain times of day may be an easy solution.
Eggs are a good option for several reasons. You can cook them in various ways, they’re easy to eat, and they’re healthy. Hard-boiled eggs are great finger food that your loved one can eat with their fingers. Boil up a dozen, or more so you have them handy when needed. They’re also a pretty good portable food for when you need to head out.
My Dad, who did not have Alzheimer’s, was an overly fussy eater. He would have been happy with a fried hamburger patty, mashed potatoes, and a vegetable (carrots or corn mostly) every night for dinner. If eating the same familiar meal every night gets them to eat, I’d make hamburger patties in bulk to make life easier. You can even make a huge batch of mashed potatoes. If you’re like my Mom and unable to eat the same thing every night, you can make your dinner and heat theirs. You could put their meal on a plate and ask them to put it in the microwave. Please pay attention when they turn it on, though. If they tend to overheat the meal, use some distraction so you can adjust the cooking time. You can have them put what they want on the plate, and you can do the heating.
Encouraging them to be a part of meal prep may help them be more interested in eating. If handling food isn’t in their skill set anymore, try having them put things on the table, like napkins or placemats. If they fail at this, it’s not more work for you.
Multiple, Small Meals
Keeping in mind that broken brains have to work hard to process typical, everyday situations will help keep your frustrations down. Your loved one may get distracted because of their broken brain. There’s not a lot we can do about that. Instead of three meals a day, try more, smaller meals. The goal is to get them to eat, not eat breakfast food at the counter in the kitchen in the morning. While that may be nicer for us, the frustrations we’d encounter trying to make that happen are not worth the effort.
Vary the Eating Locations
I’ll be honest and say my first reaction to this idea is not 100% positive. I can see food messes in places you don’t want food messes. In thinking about various locations, I don’t mean eating in front of the TV. It is worth considering other locales for multiple reasons.
The simple act of waking up and starting their day may be exhausting. If the morning routine takes a lot longer than you have the patience for, give breakfast in bed a try. Your loved one may need more sleep even after sleeping all night. (Hopefully, they’ve slept all night.)
One woman fed her husband breakfast in bed, gave him his meds, and then he took a nap. Doing this gave her time in the morning to attend to other needs, and it avoided problems from an overly tired spouse.
Other places to consider eating; the kitchen counter, formal dining room, patio, or even picnicking in the house or yard. Of course, the variety may confuse, so as with everything, you have to evaluate what works and what doesn’t.
Eating Aids: There are many options available that may make eating easier. They’re worth a try. Weighted utensils are designed for people with arthritis or shaking hands. The weight and shape may help your loved one eat easier. There are plate guards that prevent food from being pushed off the back of the plate. A plate guard would have helped my Mom. There are also plate risers that bring the dish closer to their faces. Risers are suitable for those whose visual processing doesn’t work well anymore. Once you start looking at the options, you’re likely to find a solution because there are so many options!
Ideas for the really challenging eater:
For some caregivers, the only option to get nutrition into their loved one is to let them eat while walking around. Some loved ones prefer sweets to the neglect of all other foods. Sweetness is the last taste sensation to be lost; this is why many people with Alzheimer’s want only sweets.
With that in mind, I have come up with ideas that are sweet yet more nutritious. Being a sugar fiend makes that essential for my own life!
First, the easy ideas; a sweet way to get water in your loved one is to serve them watermelon. It’s excellent finger food, has fiber, and a lot of water. I eat my weight in watermelon (ok, almost) during the summer. Try adding in a cheese stick for a healthy snack or small meal. I’d look for cheese sticks designed for kids. The plain white ones probably won’t get much attention.
Protein shakes are acceptable as long as they can suck from a straw. A simple recipe is a large handful of raspberries, some silken tofu, and a big squirt of chocolate syrup and enough milk to make it the consistency you want. Between the milk and the tofu, you’ve got a fair amount of protein, and the berries and chocolate are a decadent combination that should please even a hardcore sweet tooth. Add a bit of sweetener or sugar if needed. The syrup should be sweet enough, but adding a bit more is always ok.
Another option for an on-the-move food that is sweet yet still (somewhat) nutritious is a protein muffin. If you bought some protein powder but weren’t crazy about the taste as a drink, this is a great way to use that up. If not. I like Quest protein powders the most.
For the most part, protein muffins are a standard muffin with protein powder in them.
Chocolate is the preferred flavor if you’re like me, so here’s one of my favorites.
Double Chocolate Chip
- 2 cup flour (I prefer unbleached or white whole wheat, but use what you have)
- 2/3 cup Allulose (or any granulated sweetener)
- 1/2 cup Cocoa powder
- 1/4 cup protein powder (plain or chocolate)
- 1 1/2 tsp baking powder
- 1/4 tsp salt
- 1/3 cup vegetable oil
- 1/2 cup unsweetened almond milk
- 3 large Eggs
- 1/2 tsp Vanilla extract
- 3/4 cup dark chocolate chips
Preheat oven to 350.
Mix wet ingredients first, add in dry ingredients.
For a standard-sized muffin tin (12 count), bake for 20-25 minutes.
If you’re using a min muffin pan, cook for 12-15 minutes.
Want to incorporate some fruit? Try this recipe from ifoodreal.com
Whole Wheat Banana Strawberry Protein Muffins Recipe – no added sugar, moist and not rubbery at all. Made only with whole wheat flour, whey protein powder, and fresh strawberries.
- 2 ripe bananas, mashed
- 1 egg, large
- 1/2 cup Greek Yogurt, plain & 0% fat
- 1/4 cup almond milk, unsweetened & vanilla (plain)
- 2 tsp pure vanilla extract
- 1 + 1/4 cup whole wheat flour
- 1/2 cup whey protein powder, naturally sweetened, plain or vanilla
- 2 tbsp flax seeds, whole, roasted or raw
- 2 tsp baking powder
- 1/8 tsp salt
- 1 cup fresh strawberries, sliced or diced depending on strawberries size
- Cooking spray
- Preheat oven to 350 F, spray regular size 12 muffin baking pan with cooking spray and dust with flour. Set aside. Make sure to cover the sides and bottom of each muffin “hole” completely. Do not use muffin liners.
- In a medium bowl, mash 2 bananas with a fork until smooth. Add egg, Greek yogurt, almond milk, and pure vanilla extract. Mix with a fork until smooth and all wet ingredients are combined.
- In another medium bowl, add all dry ingredients: whole wheat flour, protein powder, flax seeds, baking powder, and salt. Mix with a spoon or spatula to combine all ingredients—no need to sift the flour.
- Add dry ingredients to the bowl with wet ingredients and mix just enough to combine. Do not over mix! You don’t want the gluten starting to form and make the muffins rubbery. Add strawberries and give a couple of stirs just enough to incorporate the berries into the dough.
- Using 1/4 cup measuring spoon distribute the batter evenly among the 12 muffin forms. Bake for 20 minutes or until the toothpick inserted in the middle comes out clean. I recommend checking the muffins for readiness at minute 18 of baking time as ovens vary. Cool completely before serving.
Lastly, one thing I learned about baking is you can substitute silken tofu for half the butter. If the recipe calls for two sticks of butter, use 1 and an equal amount of tofu. No one will notice a difference in taste. I use this for cookies all the time. By combining the tofu with a higher fiber flour, you have cookies that “stick with you” more than the simple sugar and carb version. Another trick I learned is using quinoa flour gives anything you bake a nutty flavor. I used 1/4 cup of it in my regular oatmeal cookie recipe, and it gives the cookies a nice nutty flavor. It’s a strong flavor, so use it sparingly until you determine how much of it you prefer.