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Alzheimer's: Making mealtimes easier
From MayoClinic.com
Special to CNN.com

Although nutrition may have little effect on how Alzheimer's disease progresses, it's important for your loved one to eat a variety of foods, particularly fruits and vegetables.

Poor nutrition can result in physical weakness, increasing the likelihood of falls and fractures. It can also reduce the efficiency of the immune system, making it less able to fight off disease and heal wounds. Malnutrition and dehydration may increase confusion and stress, and reduce your loved one's ability to cope.

Determine the cause

Some eating problems are caused by factors that can be changed. So the first step is to figure out what exactly is causing the problem. It may be:

  • Ill-fitting dentures. As a denture wearer ages, the fit of his or her false teeth tends to loosen. This can cause pinching or rubbing that can make eating painful. Make sure dentures fit properly, and regularly check your loved one's mouth for sores.
  • Disease. Diabetes, heart disease or stomach problems can decrease appetite, as can depression or constipation. Treating these conditions can improve appetite.
  • Medications. Many types of medications can impair appetite, including certain antibiotics, heart medications, arthritis drugs and antidepressants. Your doctor may be able to substitute other medicines that have less of an impact on appetite.

Fading skills and senses

The senses of taste and smell tend to diminish with age. So even healthy seniors often eat less because food doesn't smell or taste as good as it once did. Alzheimer's disease seems to inhibit eating even further.

In the early stages of Alzheimer's, your loved one may simply forget to eat or lose the skills needed to prepare proper meals. Some families call to remind loved ones to eat. Others prepare food in advance and then, over the phone, talk their loved ones through the steps of unwrapping, reheating and serving.

As the disease progresses, your loved one may forget table manners and eat from others' plates or out of serving bowls. He or she may lose impulse control and eat anything in sight, including items not intended as food. During the later stages of the disease, swallowing difficulties may develop.

Agitation and distraction

Agitation, one of the most common symptoms of Alzheimer's, can make it difficult for the person to sit still long enough to eat a meal. Distractions at mealtime make things even worse. To reduce distractions, you might turn off the telephone ringer, television and radio. Some caregivers clear the table of items that may distract the person with Alzheimer's from focusing on his or her meal. Even patterns on dinnerware may be too distracting, so choose solid colors.

Plates and utensils

In fact, studies have shown that people with Alzheimer's eat as much as 25 percent more when their food is served on brightly colored plates. Bright red and bright blue plates work much better than those in pastel colors. Researchers believe it's easier to distinguish between the plate and the food when there's more visual contrast.

It may be easier for your loved one to substitute a bowl for a plate. Make sure plates or bowls don't slip around by setting them on a place mat that has traction on both sides. You can make your own place mat from a roll of the rubbery mesh typically used to line shelves. Even a wet washcloth will work. Large-handled spoons are easier to use than forks. Try bendable straws or lidded cups for liquids.

Easy, safe foods

If an entire plateful of food is too overwhelming, try placing just one type of food at a time on the plate. You could also offer several small meals throughout the day, rather than three large ones. Cut food into bite-sized portions. Finger foods are even easier. If necessary, thicken fluids to prevent choking.

Give your loved one plenty of time to eat. Remind him or her to chew and swallow carefully. Avoid nuts, popcorn and raw carrots, which can become lodged in the throat. Learn how to perform the Heimlich maneuver, just in case.

Extra nutrition

If you're having a hard time getting your loved one to eat enough, you might try to take advantage of the fact that many people with Alzheimer's disease are most alert and hungry in the morning.

You may want to offer more food at breakfast time or even serve your loved one several breakfasts, each featuring just one food item. The first breakfast could be a glass of juice, the next one could be eggs, and the next one could be toast or cereal.

If your loved one is losing weight, you may want to try adding high-calorie snacks, such as protein milk shakes. Consult your doctor if your loved one suddenly loses a substantial amount of weight, such as 10 pounds in a month.

Quality of life

Alzheimer's itself reduces a person's quality of life, and this disease's common side effect of malnutrition can make this situation even worse. Supplying your loved one with good nutrition can provide him or her with the fuel needed to better cope — both physically and emotionally — with this difficult disease.

  • Alzheimer's caregiving: Maintain your support network
  • Alzheimer's: Planning for the holidays
  • Alzheimer's caregivers: Dealing with repeated questions
  • Alzheimer's: When to stop driving
  • Communicating effectively with a person who has Alzheimer's
  • Alzheimer's care: Practical tips
  • Alzheimer's: Balancing needs of caregiver and loved one
  • Alzheimer's: Long-term care options
  • Alzheimer's: Understand and control wandering
  • Alzheimer's: Dealing with family conflict
  • Alzheimer's: Smoothing the transition on moving day
  • Alzheimer's: How to help the caregivers
  • Alzheimer's: Helping children understand the disease
  • Alzheimer's: Dealing with daily challenges
  • Alzheimer's: Mementos help preserve memories
  • Alzheimer's: Spirituality can be comforting
  • Early-onset Alzheimer's: Financial challenges
  • Anticipating end-of-life needs of people with Alzheimer's disease
  • October 31, 2005

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